What to Expect When Your Water Breaks Prematurely

Pregnancy often comes with a long list of questions and “what ifs,” and one of the concerns some expectant moms face is their water breaking too early. Normally, the amniotic sac—the protective bubble around your baby—breaks when labor starts, but when it happens before 37 weeks of pregnancy, it’s called preterm premature rupture of membranes (PPROM).

If your water breaks early, it can feel scary, but understanding what’s happening and what to expect can help you feel more prepared. Let’s break it down in simple terms.

What Does It Mean When Your Water Breaks?

Your water breaking is the rupture of the amniotic sac, which holds the fluid that surrounds and protects your baby. The fluid helps cushion your baby, keeps their environment sterile, and supports their lung development. When the sac breaks, this protective barrier is lost, increasing the risk of infection and potentially triggering labor.

When this happens before 37 weeks, it’s considered premature, and it requires immediate medical attention.

What Does It Feel Like?

When your water breaks, you might feel a sudden gush of fluid or a slow, continuous leak. It’s often clear or pale yellow and may have no smell. If you’re unsure whether it’s your water or something else (like urine or vaginal discharge), call your healthcare provider—they can check to confirm.

Why Does PPROM Happen?

PPROM can happen for a variety of reasons, though sometimes there’s no clear cause. Common factors include:

• Infections: Bacterial infections in the uterus, cervix, or vagina can weaken the membranes.
• Previous PPROM or preterm birth: A history of PPROM increases the likelihood of it happening again.
• Multiple pregnancies: Carrying twins, triplets, or more can increase pressure on the amniotic sac.
• Smoking: Smoking during pregnancy is linked to a higher risk of PPROM.
• Trauma: An injury or invasive procedures like amniocentesis can sometimes trigger PPROM.

What Happens After Your Water Breaks Prematurely?

When PPROM occurs, your healthcare team will assess both you and your baby to determine the next steps.

Confirming PPROM
Your provider may use a physical exam, ultrasound, or lab tests to confirm that your water has broken.

Checking for Infection
Since PPROM increases the risk of infection, they’ll monitor you closely for signs like fever, unusual discharge, or a fast heart rate.

Monitoring Baby’s Health
Baby’s heart rate and movements will be checked, and an ultrasound may be done to measure how much fluid remains around your baby.

Making a Plan
If you’re close to term (34-36 weeks), your provider may recommend inducing labor to reduce the risk of infection. If you’re less than 34 weeks, the goal is to keep baby in the womb as long as it’s safe while monitoring closely for complications. You may receive:

• Steroid injections to help baby’s lungs develop faster.
• Antibiotics to prevent infection.
• Medication to delay labor (if needed and safe).

What Are the Risks of PPROM?

PPROM can come with risks for both mom and baby, but your healthcare team will work to minimize them. Potential risks include:

• Infection: Without the amniotic sac, the uterus is more vulnerable to infection.
• Preterm birth: The earlier your water breaks, the higher the chance baby may be born prematurely.
• Cord prolapse: Rarely, the umbilical cord can slip into the birth canal, which requires immediate attention.

What Can You Do?

If you suspect your water has broken prematurely, here’s what to do:

• Call your healthcare provider immediately: Even if you’re not sure, it’s always better to get checked out.
• Note the color and smell: This can help your provider assess the situation.
• Avoid anything that could introduce bacteria: Don’t use tampons, take baths, or have sex until you’ve been evaluated.

Staying Positive

Hearing that your water has broken early can be overwhelming, but many babies born after PPROM go on to thrive with the right care. Advances in medicine, like steroid treatments and neonatal care, have greatly improved outcomes for preterm babies.

Your healthcare team will work closely with you to create the best plan for you and your baby. Whether that means carefully monitoring you until it’s safe to deliver or preparing for an earlier birth, you’re not alone in this journey.

Moving Forward with Confidence

PPROM can be unexpected, but knowing what to expect can help ease your worries. Listen to your body, stay in close contact with your provider, and trust that you and your baby are in good hands.

Every pregnancy comes with its own unique challenges, and you’re doing an amazing job navigating yours. Take it one step at a time—you’ve got this!