How Long After Your Water Breaks Do You Have to Deliver?

As you get closer to your due date, you might be feeling anxious about your water breaking when you’re out and about. But what exactly does it mean when it “breaks”?

Your baby is surrounded by amniotic fluid — your “water.” It’s contained in a sac inside your uterus. When this sac breaks, it typically happens soon before or during labor. If it breaks before your contractions begin, it’s called premature rupture of membranes (PROM).

Here’s the thing: PROM only happens in 8 to 10 percent of pregnancies. So, in most pregnancies, your water will break after your contractions begin.

That said, here’s what you need to know about how PROM might affect the timing of your labor and delivery.

Survival after your water breaks

Amniotic fluid is made up of hormones, nutrients, and antibodies. It’s a protective cushion for your baby that starts collecting around 12 days after conception. Your baby actually drinks the water-like fluid — and eventually pees into it as well.

The fluid is responsible for keeping your baby warm and for helping develop their lungs, digestive system, and even musculoskeletal system.

But after week 23, your baby doesn’t rely as much on the amniotic fluid for survival. Instead, they receive nutrients and oxygen from your placenta. In later pregnancy, the amniotic sac serves more as protection only. If the sac is broken, your baby is more prone to infection and other risks, like cord prolapse.

How long a baby can live once your water breaks depends on a number of factors, so there’s really no straight answer with all things considered.

  • In cases where your baby would be premature, they may survive just fine for weeks with proper monitoring and treatment, usually in a hospital setting.
  • In cases where your baby is at least 37 weeks, current research suggests that it may be safe to wait 48 hours (and sometimes longer) for labor to start on its own. (But your caregiver may have a different protocol, like 24 hours.)

A typical scenario when your water breaks before labor

In later pregnancy, you likely have a lot of discharge and other leaks going on. You may even have trouble telling if your water has broken or if you’ve simply peed yourself. (It happens more than you’d think!)

The basics

Why might your water break before you’re in labor?

Possible risk factors include:

  • natural weakening of the sac from contractions
  • uterine infection
  • chlamydia, gonorrhea, and other sexually transmitted infections (STIs)
  • history of preterm birth
  • smoking cigarettes
  • socioeconomic status (not enough prenatal care)

Signs your water has broken:

  • feeling of wetness in your underwear/vagina
  • constant leaking of fluid, small or large amounts
  • intermittent leaking or gushes of fluid, small or large amounts
  • seeing fluid that is either clear or light yellow in color
  • observing fluid that is odorless (urine typically has some odor)

If you’re unsure, call your doctor or labor and delivery unit. Your medical team may suggest you get your discharge tested (using special papers that show pH levels) to see if it’s amniotic fluid or something else. You may also have a physical exam, ultrasound, or other tests to assess the situation.

What happens next

Once confirmed, your care provider will take into account the following before creating your game plan:

  • your baby’s presentation (head down, breech, etc.)
  • your current health status (signs of infection)
  • your baby’s current health status (signs of distress)
  • any risk factors (group B strep, for example)

What happens if labor doesn’t start

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With this data in mind, you may have heard that doctors will give you just 24 hours before trying induction techniques.

Again, remember: After your water breaks, your baby is supported by the placenta for oxygen and other needs. The main concern of your water breaking early is infection for both you or your baby.

While more and more research is showing that longer windows of time may be safe, it’s true that there is a standard of 24 hours in many medical settings.

If you have no risk factors, your doctor may follow what’s called “expectant management.” This basically means you’ll wait and see if/when your labor begins on its own.

This management and exact timeframe may vary from provider to provider. You’ll likely have your temperature taken regularly (as well as other signs, like white blood cell count) to monitor for infection.

If you’re positive for group B strep (GBS), your doctor will probably recommend you begin antibiotics upon your water breaking to protect your baby from infection. Augmenting labor is also more likely in this scenario since the potential for complications is higher.

In one 2015 study of 100 women with PROM, 28 percent of their deliveries ended with a C-section. The reasons for this intervention include things like failed induction and fetal distress.

Signs of infection to watch for

The risk of infection can be for either mom or baby. Fortunately, doctors and nurses know what to look for and will watch you carefully and act accordingly.

If you choose to labor at home (with guidance from your caregiver), you may want to familiarize yourself with signs of infection so you can get prompt medical care when needed. Chorioamnionitis, for example, is an infection of the uterus. It doesn’t cause symptoms in every case.

Possible signs of infection include:

  • fever
  • fast heart rate (in either the mom or baby)
  • sweating
  • tenderness around the uterus
  • pain that’s constant (not passing contractions)
  • foul-smelling discharge

While in the hospital, your doctor can monitor your temperature, heart rate, and other vital signs. Your baby will also be monitored (using an external or internal fetal monitor) during this time to look for signs of distress, like:

  • fast heart rate
  • slow heart rate
  • decelerations
  • decreased movements

If your water breaks before term

It’s possible for your water to break before you reach 37 weeks in your pregnancy. This is called preterm premature rupture of membranes (PPROM) and it’s responsible for up to one-third of all premature births.

The takeaway

Unfortunately, there’s really nothing you can do to prevent your water breaking prematurely. However, some research shows a link with smoking, so kicking that habit is a good idea.

Be sure to keep an eye on the discharge/fluid you have throughout your pregnancy. Your doctor’s office has likely fielded thousands of false alarms before, so don’t worry about bugging them if you’re concerned or have questions.

And if your water has broken, work together with your doctor to decide what birth plan is right for you. In cases where you’re low risk, as long as you are regularly monitored, you can wait within reason for labor to start on its own. Otherwise, there are other options in place to get your baby into your arms safe and sound.

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