When your waters break
Your waters will usually break during the very first stages of labour. This signals to the mother-to-be that it’s time to go to the hospital.
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It’s worth knowing how to recognise when your waters break as sometimes it is not that noticeable. It can also take place prematurely making a quick journey to the maternity ward necessary.
The amniotic sac, a sterile environment
The foetus is protected by two membranes forming the amniotic sac in the mother’s stomach, as though in an egg. These membranes are surrounded by amniotic fluid, which is essentially composed of the baby’s urine as soon as the kidneys start to function (around the third month of pregnancy). It is possible to see the amniotic fluid in the two final ultrasounds.
Professor Michel Dreyfus, gynaecologist and obstetrician at The Central University Hospital (CHU) in Caen, explains that, “The amniotic sac is a completely sterile environment, locked in by the neck of the uterus.” The vagina, in contrast, contains germs.
During labour, contractions intensify and the neck of uterus starts to open up, allowing the membranes to rupture and then burst. The water that flows out is the amniotic fluid contained by the amniotic sac. This fluid renews itself all the way up to the birth.
“It is the first sign that the mother should go to the maternity ward. This is essential whether full-term or not and whether or not contractions have started,” the doctor advises, “as the baby is no longer in a protected, sterile environment and there is a more significant risk of infection.”
Broken waters: urine or amniotic fluid?
How can you tell the difference between your waters breaking and your own leaking urine, which is a frequent occurrence towards the end of pregnancy, as a result of increased pressure on the perineum.
In contrast to urine, amniotic fluid is colourless and odourless. It resembles warm water at around 37°C. If it presents as a stream of water, then the rupture will be obvious and you can be sure your waters have broken.
“If it is a small trickle that flows and then stops,” Dr Dreyfus advises using a liner or pad. If this pad is constantly moistened without any effort or coughing, then there is no doubt that your waters have broken.
However, be careful not to confuse amniotic fluid with vaginal discharge either, which is a whitish colour and thicker. As for the mucus plug, which seals the neck of the uterus, it is made up of brown mucus, sometimes spotted with blood, and does not signal a rupture in the amniotic sac. When the plug is expelled, this does not necessarily mean labour is imminent.
After broken waters, at the hospital
On arrival at the maternity ward, a mid-wife will take a sample from the vagina in order to verify the absence of any bacteria, which could be dangerous for the baby. If a rupture in the amniotic sac is diagnosed and your pregnancy is not at term, you will be hospitalised. If it is not confirmed, you might just return home for a while.
In 80% of cases, when the mother is full-term at around the 37th week – labour will start unprompted around 24 hours after the amniotic sac has ruptured. This is because the rupture causes a substance called prostaglandin to be released, which stimulates the contractions.
According to the gynaecologist: “A period of 24 to 48 hours is required in the maternity ward before inducing labour artificially. On the other hand, this will be done straight away if there are signs of possible infection”. Such signs could for example be: fever, colour in the amniotic fluid, too many white globules in blood tests, presence of streptococcus B, tachycardia or if the baby’s heart rhythm is a cause for concern.
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Copyright © 2011 Doctissimo
Posted 30.08.2011
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