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During pregnancy, your membranes break (rupture) when a hole or tear
develops in the fluid-filled bag (amniotic sac)
that surrounds and protects the fetus. Most women describe this by saying their "water broke."
Your membranes can break by themselves (spontaneous rupture of the
membranes), or they may be ruptured by the doctor or nurse-midwife to start or
speed up labor (artificial rupture of the membranes). The spontaneous rupture
of the membranes most often happens after active labor has started.
Your contractions may get stronger after your membranes
A large gush of fluid usually follows the rupture of the membranes.
The uterus continues to produce amniotic fluid until the baby's birth, so you
may continue to feel some leaking, especially right after a hard contraction
(tightening of the muscles of the
Sometimes it is hard to tell if your membranes have ruptured. As
you approach your due date, your uterus puts increasing pressure on your
bladder. A strong Braxton Hicks contraction or sneeze can cause some leakage of
urine. This is sometimes mistaken for a rupture of the membranes.
If you are lying down when your membranes break, you are more
likely to experience the rupture as a gush of liquid. If it happens when you
are standing up, it's more likely to be just a trickle because the baby's head
gets pushed down against the cervix and acts like a cork when you stand.
If you believe your membranes have ruptured:
You can also go to the place you have selected for the delivery of
your baby. The health professionals there will test the drainage to determine
if it is amniotic fluid.
Amniotic fluid is normally a cloudy-white to an amber-straw color.
Let your health professional know if the leaking fluid is:
To start (induce) or speed up labor, the doctor may
rupture your membranes. This should only be done after your
cervix has started to open (dilate) and the baby's
head is firmly descended (engaged) in your pelvis. If the membranes are
ruptured too early, there is a risk of the umbilical cord slipping down around
or below the baby's head (cord prolapse). If the cord gets squeezed between the
baby's head and the pelvis bones, the blood supply to the baby may be decreased
To rupture your amniotic sac (amniotomy), your doctor
inserts a sterile plastic device into your
vagina. The device may look like a long crochet hook,
or it may be a smaller hook attached to the finger of a sterile glove. The hook
is used to pull gently on the amniotic sac until the sac breaks. This procedure
is usually not painful. A large gush of fluid usually follows the rupture of
the amniotic sac. The uterus continues to produce amniotic fluid until the
baby's birth. So you may continue to feel some leaking, especially right after
a hard contraction.
November 13, 2013
Kathleen Romito, MD - Family Medicine
& Kirtly Jones, MD - Obstetrics and Gynecology
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