I think I can name at least 5 movie scenes in which the pregnant woman’s water breaks in a dramatic gush, all hell breaks loose, and there’s a frantic taxi cab ride (always in New York City). The next scene is the woman, red-faced and angry, surrounded by at least 3 of the other characters (who usually have NO reason to be at this birth). She pushes about 3 times then, with a huge scream, suddenly it’s like angels singing and immediate happiness ensues as the clean, crying, “newborn” baby is given to the new mother.
It’s no surprise then, that when I sit down with soon-to-be parents at one of our prenatal meetings there’s a few questions about a particular part of labour. We settle in, usually in their living room with some water or tea, and we start discussing how labour might begin and what signs to expect so they’ll know when they are really in labour. We talk about the different signs of early labour and the big question they always have is, “How do I know when my water breaks and what do I do?”
What NOT to do.
The paranoia is always the same. The women is worried that she’ll be out, running errands or doing groceries, or worse- what if she’s still working and her water breaks in her office chair? The partner is always worried about if the water breaks in the car or what will happen if he’s at work and he can’t get to her in time, and she delivers before even getting to the hospital.
Take a deep breath guys, I’ll always say, this is yet another time when the movies have set us up for major disappointment. Real life is (usually) never that exciting. For most women, having their waters break is not even the way labour usually begins.
Sometimes the water breaks much later, when you’re at the hospital with strong contractions.
Sometimes it’s actually the doctor who breaks the water, which is a technique used to augment the labour or get contractions started or to increase their strength.
Sometimes, your water breaks as you’re pushing- the intensity of the pushing causes the sack to finally break open.
Rarely, your baby is born in the bag of waters, otherwise known as being born in the caul.
It’s important to note that just because your water has broken, does not mean the baby will be born immediately (or even shortly) after. You may not even have contractions yet, or they may not be strong. Depending on your medical history, you might want to even consider staying home until you’re in more active labour.
In general, if you’ve been cleared medically to not have to go in right away (being GBS + for example, would mean that you would need to go to the hospital so your doctor could administer antibiotics), then staying at home is probably fine as long as you remember to check for the following:
A helpful acronym to remember is C.O.A.T.
Colour- If your waters are murky, green, brown, black, or pea soup like, head to the hospital. Clear or slightly cloudy is fine.
Odour- If there is a strong smell, there may be an infection.
Amount- Sometimes a HUGE gush of water with a baby who may not have been engaged yet is not a good thing. Try a variety of positions to make sure that it is actually water leaking. It will continue to leak, but sometimes a small leak can go undetected (since there tends to be a LOT of bodily fluids at the end of pregnancy, you might just think it’s yet another way your body is just taunting you!)
Time- Depending on your care provider, staying at home might be fine, but only for a certain number of hours. This can vary from 0-24 hours. There is an increased chance of infection as time goes on with broken waters. But, there is also something to said for staying at home where nobody will do vaginal exams, which can introduce bacteria that cause infection.
Moral of the story? Don’t live the last few weeks of pregnancy afraid that your water will break on your friend’s Louboutins, a la Carrie Bradshaw. Trust me. Just like the rest of your life it will be less predictable and less dramatic, but much more realistic and beautiful than a movie birth could ever be.
