Labor and delivery, postpartum care

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continued:

Water breaking: Understand this sign of labor

After my water breaks, when will labor begin?

Most women who experience premature rupture of membranes go into labor soon after their water breaks. Sometimes, however, there's a delay — which may result in the need for an induction. The longer it takes for labor to start after your water breaks, the greater the risk of developing an infection.

What happens if my water breaks too early?

If your water breaks before the 37th week of pregnancy, it's known as preterm premature rupture of membranes. Risk factors for water breaking too early include:

  • A history of preterm premature rupture of membranes in a prior pregnancy
  • A genital tract infection
  • Vaginal bleeding during more than one trimester
  • Smoking during pregnancy

If your water breaks too early, your health care provider will evaluate you and your baby. It's sometimes possible to extend pregnancy for a short time after the membranes rupture, but generally there's no turning back. Most women who have preterm premature rupture of membranes deliver within one week of their water breaking. Potential complications include infection, placental abruption — when the placenta peels away from the inner wall of the uterus before delivery — and umbilical cord prolapse, in which the umbilical cord drops into the vagina ahead of the baby. The baby is also at risk of complications due to premature birth.

What if my water doesn't break on its own?

Remember, the amniotic sac usually doesn't rupture before labor begins. If labor begins on its own, your water will break at some point before the baby is born.

If your health care provider believes the amniotic sac should be opened during active labor — when your cervix is at least partially dilated and the baby's head is deep in your pelvis — he or she may use a technique known as an amniotomy to rupture the membranes. During the amniotomy, a thin plastic hook is used to make a small opening in the amniotic sac. The procedure doesn't hurt, but you may feel a warm gush of fluid when the sac opens.

If you don't go into labor on your own, your health care provider may do an amniotomy as part of a planned induction to encourage labor to begin.

It's natural to feel anxious about labor and delivery. Try to relax. While you may not be able to predict when your water will break, you can take comfort in your knowledge about the next steps.

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References
  1. How to tell when labor begins. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp004.cfm. Accessed Aug. 31, 2010.
  2. Labor induction. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp154.cfm. Accessed Aug. 31, 2010.
  3. Duff P. Preterm premature rupture of membranes. http://www.uptodate.com/home/index.html. Accessed Aug. 31, 2010.
  4. Scorza WE. Management of premature rupture of the fetal membranes at or near term. http://www.uptodate.com/home/index.html. Accessed Aug. 31, 2010.
  5. Labor and birth. The National Women's Health Information Center. http://womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm. Accessed Aug. 31, 2010.
  6. Inducing labor. March of Dimes. http://www.marchofdimes.com/pnhec/240_20202.asp. Accessed Sept. 7, 2010.
  7. Herbst A, et al. Time between membrane rupture and delivery and septicemia in term neonates. Obstetrics & Gynecology. 2007;110:612.
  8. What to expect after your due date. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp069.cfm. Accessed Sept. 14, 2010.
  9. Wing D. Induction of labor. http://www.uptodate/com/home/index.html. Accessed April 1, 2009.
  10. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 16, 2010.
  11. Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 23, 2010.
  12. Murry MM (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 28, 2010.
MY01442 Dec. 4, 2010

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