When you experience PROM, it’s really important that you don’t wait to contact the midwife-on-call.
Amniotic fluid, which surrounds the baby in the womb, plays an important role during pregnancy and even throughout labor if the sac is still intact. The amniotic sac forms about 12 days after pregnancy begins. Until about 20 weeks, the amniotic fluid consists mostly of water that your body makes. After 20 weeks, the baby’s urine accounts for the majority of the fluid, which contains nutrients, hormones, and antibodies.
The amount of fluid increases during pregnancy and is highest around 34-36 weeks when it’s at about 800 milliliters. By 40 weeks, the amount decreases to approximately 600 milliliters. What’s the purpose of amniotic fluid in the uterus? During pregnancy, it has the following functions.
Enables movement and, therefore, proper bone and muscle growth
Allows lungs to form properly because the baby breathes in the fluid
Prevents pressure on the umbilical cord, which carries the baby’s food and oxygen supply
Keeps a constant temperature around the baby
Protects the baby from outside injury by cushioning movements
Develops the baby’s digestive system because they swallow the fluid
Protects the baby from infection because the fluid contains antibodies
When Does Water Typically Break?
The amniotic sac usually ruptures during labor because of pressure from the contractions and the baby. In an ideal world, the water stays intact until you are almost fully dilated or about to start pushing. When your amniotic sac remains unbroken during labor, it provides several benefits — in addition to the ones listed above. These include:
Protecting the baby if augmentation methods are used to increase the frequency and intensity of contractions
Helping the baby to rotate and engage in the pelvis
Diluting meconium and helping to prevent aspiration
“If your water breaks and you’re not having contractions, we’ll have you come to the birth center within two hours. ”
What Should I Do If My Water Breaks Before Contractions Start?
When the amniotic sac breaks after 37 weeks but before labor begins, this is called premature rupture of membranes, or PROM for short. (Water breaking before 37 weeks is referred to as preterm premature rupture of membranes, or PPROM.) How common is PROM? Evidence shows that approximately 8-10 percent, or about 1 in 10 people, will have their water break before the onset of labor. Early rupture and low fluid level are more likely to result in labor induction, administration of antibiotics, fetal heart rate decelerations, posterior fetal presentation, and a prolonged pushing stage.
If you are planning to deliver your baby at Magnolia, the first thing you should do if you experience PROM is called the birth center. During your conversation with the midwife-on-call, you should be ready to discuss the following items about your water breaking.
Note the Time
Clinical providers have protocols governing how long after PROM that antibiotics should be administered and when a hospital transfer should occur.
Note the Amount
It could be a large amount of fluid, as in cups, or a consistent trickle.
Note the Color
Amniotic fluid is usually clear. It may have some mucus, discharge, or even be tinged with blood. If it is brownish or greenish, let your provider know as soon as possible.
Note the Odor
Amniotic fluid is normally odorless. Again, if you notice a foul smell, this could be a sign of infection, and your midwife needs to know immediately.
Can I Still Deliver at the Birth Center If My Water Breaks Before Labor Begins?
Like many situations during pregnancy and birth, the answer is: It depends. The laws that govern birth centers in Florida say you have to be in active labor 12-24 hours after rupture of membranes because there is a risk of infection. At the 12-hour mark, we can consult with our medical director and extend the waiting period to 24 hours.
If your water breaks and you’re not having contractions, we’ll have you come to the birth center within two hours. To get labor going, we can suggest various strategies, including acupuncture, an enema, nipple stimulation, or castor oil. If contractions pick up and you’re in active labor within the recommended time frame, you can continue the birth process at Magnolia and have your baby at the birth center.
When you experience PROM, it’s really important that you don’t wait to contact the midwife-on-call. Some clients are afraid that their water breaking will derail their birth plan, or they’re hesitant to “bother” the midwife-on-call. However, broken water requires active management if you want to have a chance of achieving your out-of-hospital birth plan. If labor does not start or contractions are not consistent enough to be considered active labor, our protocols require you to go to the hospital for a medical induction.
Labor and Birth Services at Miami’s Premier Natural Birthing Center
At Magnolia, we want to help you achieve your out-of-hospital birth while keeping you and your baby safe. To learn more about prenatal care and birth services at Magnolia, fill out our form to set up a free consultation!
