When your waters break

Although women have visions of their waters breaking in Tescos, the reality for many women is that they don't break until much later.

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Most people think one of the landmarks of going into labour is the rush of breaking waters, at an inopportune moment – in the supermarket or at the bus stop – but this is not usually the case for most women going into labour.

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What happens when your waters break?
This is called the ‘rupture of membranes’ and it happens when the sac of aminiotic fluid your baby has been growing in begins to leak.
This can happen as a gradual trickle or in some cases, as a major rupture causing a large amount of fluid to flush out, and then a constant trickle to follow. You may find that the flow changes if you sit or stand, as the baby will move slightly and might stem the flow temporarily.
In some cases, a woman will start to get contractions before the waters break, or during induction, the waters may need to be broken by the midwife to bring on full labour.
In other cases, the waters break weeks before the birth and once they have, the doctors will choose to move quite swiftly to deliver the baby, as it’s home inside you is no longer a sterile environment.

If it happens at night, you may worry that you have wet yourself rather than that your waters have broken. However, amniotic fluid does not smell strongly like urine and will instead smell a little sweet.
If the fluid is clear and light yellow, then it is pretty regular. If it looks brown or green, tell your doctor or midwife straight away as this suggests there is meconium staining. (This is the baby’s bowel movement and usually happens after birth. If it happens before it can be a sign of fetal distress.) Do not worry, in itself it is not automatically sign that there is a problem, but your midwife will want to know about it.

What should you do if they break or if you suspect they have broken?
Call your doctor or midwife team when this happens. 
They will probably expect your labour to come on more strong after rupture and, if you are not at the hospital, they may now want you to come in (if you are having a hospital birth).
Once the waters have broken, the seal around your baby has been ruptured and, whilst there is no instant cause for alarm, doctors will want to see your baby born within 24 hours to ensure against infection.
Talk to your midwives during ante-natal checks to see what the policy is in your area as some doctors like to move faster, while others may be happy to ‘wait and see’, but offer drugs to stave off infection. If they do, these drugs with not harm your baby, whereas an infection will.
Clean yourself up but avoid having a bath at this point. When going to the loo, make sure you wipe from front to back to make sure no bacteria can affect your vagina. Do not have sex. Stem the flow of any more fluid with a sanitary towel rather than inserting a tampon or anything else inside you.

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Complications
Although it is a strange sensation, your waters breaking is not a cause for concern, especially if you are near your due date.
If that is still a few weeks off, you should call the midwife immediately and practice hygienic self-care. 
If there is an excess of amniotic fluid, it can give your doctor cause for concern. If the baby is not ‘head down’, a rush of water might bring down the cord or a limb first, cutting off the blood supply, for example. Then an emergency operation would be needed. 
However, if the baby is in the optimum ‘head down’ position, then this should only be something of note rather than an immediate sign of a problem.
A regular ultrasound scan can show doctors how much fluid there is.
If the cord drops down as the waters break, or the rupture causes some of the placenta to come away early, then these are emergency situations and you need 999 help immediately.
It should be noted that this is rare and NOT a regular cause for concern.

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