What Happens If Your Water Breaks Without Contractions?

Premature Rupture of Membranes at Term (PROM)

Pregnant woman discussing issues with her doctor.
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We often associate water breaking with labor. Occasionally, water can break before labor begins. This is known as premature rupture of membranes (PROM). If your water breaks before you are 37 weeks pregnant, this is called preterm premature rupture of membranes (PPROM).

What to Do If Your Water Breaks

If your water breaks before your contractions begin, you will be given a few options based on your other symptoms and your medical history.

The options that you have will be offered by your doctor or midwife. Together you can decide what's best for you. Some recommendations may not be safe and it's possible that you may not respond to others, given your medical history.

You will also want to discuss when you should go to the hospital or the doctor's office, or if you are planning a home birth, when your doctor would come to you to check on you and baby.

Watchful Waiting

Sometimes it will take a few hours for contractions to kick into gear. As long as you and your practitioner are fine with it, waiting for a while may be appropriate assuming that you and baby are doing well. This generally means:

  • No baths
  • No sex
  • Nothing goes into your vagina

Antibiotics are not recommended for all women who experience PROM. In the absence of an infection, there are no benefits to using them and there are potential risks associated with their use.

There is also the question of whether care should be given at home or in the hospital setting.

Currently, we do not have enough data to say that one results in a better outcome. For many, it's a personal preference.

Generally, it is safe to stay at home as long as you are not showing any signs of infection: you aren't running a fever, there is no foul odor, and there is no discolored fluid. One study reported that waiting up to 24 hours, known as expectant management, didn't increase the risk of complications as long as mom and baby didn't have an infection.

Natural Labor Stimulation Techniques

You may opt to get into labor using natural means. You can try nipple stimulation, using your hands, or a breast pump to stimulate your nipples. This helps produce oxytocin, which can help jump start contractions. If you don't have a breast pump you can usually get one from a hospital lactation consultant.

You can also try walking around to get labor going. A walk around the house or even outside might help you. Acupressure may also be useful. This involves using pressure on certain spots on your body, like the roof of your mouth, to help stimulate oxytocin and in turn labor.

Medical Techniques to Get Labor Going

If your doctor recommends, medical interventions can also be helpful when you don't want to wait. Pitocin is a synthetic form of oxytocin, a natural labor causing hormone. It is given through an IV attached to a special pump that provides just the right dose.

It is given only in hospitals with good fetal monitoring because of increased risks to you and your baby, such as fetal distress, too strong or long contractions, and uterine rupture

What About PPROM?

Preterm premature rupture of membranes is different. The course of action will really depend on how far along you are in your pregnancy and if your health care providers can determine the cause of your water breaking.

For example, if your water broke due to an infection, IV antibiotics may be started immediately while deciding if the baby needs to be delivered immediately.

Another course of action may be to use corticosteroids to help mature your baby’s lungs if your pregnancy is earlier than 32 weeks gestation. While you may still have your baby early, the steroids help to reduce the number of complications your baby has once born.

A Word From Verywell

If you experience your water breaking before the start of labor, call your midwife or doctor to discuss your symptoms. This will help you choose the safest course of action for you in this pregnancy.

Know that the further away you are from your due date, the more likely you are to need hospital-based care to help you have a healthy baby.

Sources:

Abou El Senoun G, Dowswell T, Mousa HA. Planned home versus hospital care for preterm prelabour rupture of the membranes (PPROM) prior to 37 weeks' gestation. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD008053. DOI: 10.1002/14651858.CD008053.pub3

Chandra I, Sun L. Third trimester preterm and term premature rupture of membranes: Is there any difference in maternal characteristics and pregnancy outcomes? J Chin Med Assoc. 2017 Apr 18. pii: S1726-4901(17)30060-6. doi: 10.1016/j.jcma.2016.12.006. [Epub ahead of print]

Dussaux C, Senat MV, Bouchghoul H, Benachi A, Mandelbrot L, Kayem G. Preterm premature rupture of membranes: is home care acceptable? J Matern Fetal Neonatal Med. 2017 Jun 14:1-18. doi: 10.1080/14767058.2017.1341482. [Epub ahead of print]

Lorthe E, Goffinet F, Marret S, Vayssiere C, Flamant C, Quere M, Benhammou V, Ancel PY, Kayem G. Tocolysis after preterm premature rupture of membranes and neonatal outcome: a propensity-score analysis. Am J Obstet Gynecol. 2017 Apr 13. pii: S0002-9378(17)30516-1. doi: 10.1016/j.ajog.2017.04.015. [Epub ahead of print]

Wojcieszek AM, Stock OM, Flenady V. Antibiotics for prelabour rupture of membranes at or near term. Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.: CD001807. DOI: 10.1002/14651858.CD001807.pub2

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