Gush! Warm fluid everywhere, the emotional pregnant woman gazing down before exclaiming, “my waters broke!” and just like that, in the magical world of television, the woman is in active labour, and therefore must rush in a panic to get to the hospital! Reality? It could happen with a gush, it could be nothing more than a tiny trickle which leaves you wondering whether it was or wasn’t (as happened with me during my first pregnancy, and I’ll elaborate later) your membranes may release on their own at some point well into your labour, or, they may never break at all, and baby will born inside its amniotic sac – this is an en caul birth. So, we’ve got lots of variables here, which makes it important to understand what is happening within your body.
What actually happens when your ‘waters break?’
“Rupture of membranes (ROM) or amniorrhexis is a term used during pregnancy to describe a rupture of the amniotic sac. However, since discovering the term, I much prefer the gentler description, ‘releasing membranes’. Normally, it occurs spontaneously at full term either during or at the beginning of labor. Rupture of the membranes is known colloquially as “breaking the water” or as one’s “water breaking.” A premature rupture of membranes (PROM) is a rupture of the amnion that occurs prior to the onset of labor.”
How can it feel?
As mentioned, it can occur as a gush, or just a tiny trickle. During my first pregnancy, at 41 weeks and 1 day, I stepped out of the shower and noticed the trickle, but given I had water rolling off of my body, really had to tap into my intuition – was it, was it not? My gut said yes, but I wasn’t sure what to do. I told my partner, and a quick search on the Internet came up with the consensus that if you aren’t sure, lie down for half an hour. The idea being that if it was amniotic fluid, as you lie, the liquid will pool. When you next stand, you’d be likely to get more of a gush – bingo! That’s exactly what happened for me. During my next birth, my membranes must have released at some point in the birthing pool, so I never noticed it. A friend once told me that she felt and actually heard a ‘pop’ at the onset of her membranes releasing! Her labour unfolded very quickly.
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What does it look and smell like?
Amniotic fluid is generally clear, and can have a tinge of pink to it, as was the case for me. If you are leaking fluid, your care provider will want to know how it looks and smells. Amniotic fluid does not have much of a smell. I have heard the smell described as to similar to straw, but I would describe the smell as very similar to that of my newborn, as I would discover – pleasant, and slightly sweet. Looking at it? Smelling it? Yep! It’s all important to gain a clear picture. Yellowy, green or brown fluid can be a sign of meconium having been passed by baby. This could be an indication of baby being distressed, it may just be part of the process. As I said, the whole picture needs to be taken into consideration. Your health, baby’s health, the length of your pregnancy, how you’re feeling physically and emotionally.
What if I’m not sure if it was amniotic fluid?
The fluid can be tested to give you the answer. I wasn’t leaking very much after the small gush, and didn’t need more than a panty liner. When I arrived at the hospital, the midwife asked me to remove the liner and sent it off to be tested in the lab to establish whether it contained amniotic fluid or not – the result was positive and I was then admitted to hospital.
Testing to see whether your waters have indeed been released can result in a vaginal examination with the use of a speculum (the instrument used to stretch the vaginal walls open during a Pap smear). I would strongly recommend that you do your own research on this method of testing – it seems both unnecessary and very invasive. Every vaginal examination increases the risk of infection, and aside from that, can be a painful or upsetting experience. I recently wrote about this with regard to having a ‘stretch and sweep’ of the membranes: you can read that post here
Will labour start soon after my waters breaking?
We’re all different, as are our pregnancies, labours and births. My membranes releasing during my first pregnancy saw my labour start straight after. The same may happen for you, or it could take some time. Do your research ahead of time, and discover what feels right to you in what you would do if you hadn’t had any signs of labour starting within 24 hours. In the medical realm, you will most likely feel pressured into an induction. Know that there are precautions you can take to minimise your risk of infection, and induction doesn’t have to be the only way out for your baby, nor does being given antibiotics. I can’t more highly recommend this post by Birth Attendant, and all round wise woman, Gloria Lemay, to empower yourself.
What if my care provider wants to rupture my membranes?
AROM stands for Artificial Rupture of Membranes. SROM stands for Spontaneous Rupture of Membranes – when things happen naturally, on their own, with no form of intervention. Doctors or midwives can suggest doing an AROM as a means to induce labour, or, some just do this as a routine procedure in the last weeks of your pregnancy. Too many women have reported this happening, and we need to be aware of its prevalence. Know what you are consenting to or the intentions of your care provider before agreeing to any vaginal examinations. Getting back to having a stretch and sweep, your membranes can rupture during the procedure, so you need to be aware.
If you agree to an AROM (an amniotomy), this is what happens:
The membranes are punctured with a crochet-like long-handled hook during a vaginal examination, and the amniotic fluid floods out. Rupturing the membranes is thought to release chemicals and hormones that stimulate contractions.
Is AROM safe and effective?
This is what a Cochrane review (15 studies identified, involving 5583 women) summarised:
Evidence does not support routinely breaking the waters for women in normally progressing spontaneous labour or where labours have become prolonged.
On the basis of the findings of this review, we cannot recommend that amniotomy should be introduced routinely as part of standard labour management and care. We recommend that the evidence presented in this review should be made available to women offered an amniotomy and may be useful as a foundation for discussion and any resulting decisions made between women and their caregivers.
Trusting in the process
At this point in time, more and more I find myself questioning why intervention happens so much in birth. True medical necessity for intervention is low, yet the rates for its occurrence are so incredibly high. We’re told not to have sex after our waters have broken or to insert a tampon to soak up amniotic fluid, yet fingers can go in there to assess ‘readiness,’ ‘progression.’
As my family and I live amongst nature, and have been witness to multiple calves being born, I can’t recall looking across the hill to see the calfing mother lying on her back whilst having the hoof of another cow inside the mother’s vagina – just to check, or just to speed things up because her baby has not followed the calendar!
In most pregnancies, we can trust that nature has got it right, and we will move to the beat of our own drums – not as one. We don’t all start menstruating at the same age, nor do we develop breasts at the same age – in fact, the time-frame difference for us all can be years. So when we consider our pregnancies ending at different times within a matter of weeks, it kind of puts it all in perspective. Our timing for readiness to give birth is as unique to us as our physical attributes – quite simply, we’re ready when we’re ready.
From the Womb to the World
Thank you for reading my blog post! I welcome your comments.
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