Water breaking: how to tell and what to do next

Maybe you felt a pop and then a gush. Or your underwear has been damp for an hour and you can’t tell whether your water has broken.

If you think your water broke, call your doctor, midwife or labor and delivery unit, even if you’re not having contractions. In most pregnancies labor starts first. At term, the water breaks before labor in about 8% of pregnancies (ACOG). In the UK this is called your waters breaking; it’s the same thing.

Signs of water breaking

Your baby grows inside a fluid-filled bag called the amniotic sac. When it tears, amniotic fluid leaks out of your vagina. Some people feel a pop followed by a gush they can’t control. Others notice only a slow trickle or wet underwear. The water breaking itself doesn’t hurt.

Signs that point to amniotic fluid, according to Cleveland Clinic:

• fluid that’s thin and watery, not thick and sticky
• fluid that’s clear or pale yellow and has no odor
• leaking you can’t stop or hold in
• more fluid when you stand up, move or have a contraction
• contractions that get stronger after the leak, if labor has already started

How much comes out varies. Near your due date there’s less fluid than a few weeks earlier: about 2.5 cups at 40 weeks (Cleveland Clinic). Your baby’s head can also act like a cork in the cervix. So a small but steady leak can still be your water.

Water breaking vs. pee vs. discharge

Late in pregnancy it can be hard to tell whether the drips in your underwear are amniotic fluid, pee or vaginal discharge (Cleveland Clinic). These differences help:

	Amniotic fluid	Urine
Look	Clear or pale yellow, thin	Usually darker yellow
Smell	Usually none	Distinct urine smell
Can you hold it back?	No	Yes
Does it keep coming?	Yes, often when you move or with a contraction	No, your bladder empties and refills slowly

Discharge tends to be thick and sticky. The mucus plug can show up as discharge that’s clear, pink or slightly bloody (ACOG). Our mucus plug guide explains how that differs from your water.

If you’re still not sure, Cleveland Clinic suggests this check:

1. Put on a clean pad (no tampon).
2. Lie down for 15 to 30 minutes.
3. Stand up and see whether fluid runs out.

If it does, it’s more likely amniotic fluid. Note the color, the amount and any smell. Only your care team can confirm it, for example with a speculum exam or a test strip that reacts to amniotic fluid.

What color should amniotic fluid be?

Look at the fluid on your pad. Your care team will ask about the color early on, because it helps them decide how soon to see you.

Color	What it may mean	What to do
Clear or pale yellow	Normal	Call your provider and follow their plan
A little pink at first	A small amount of blood, which can happen when the water breaks	Call and mention it
Green or brown	Meconium (your baby’s first poop) in the fluid, which can be a sign of stress	Call and go in now
Bloody, or you’re bleeding	Needs to be checked right away	Go in now; for heavy bleeding, call your emergency number (NHS)
Bad smell, or the color or smell changes later	Can be an early sign of infection	Call right away

The NICE guideline lists meconium-stained or bloodstained fluid, vaginal bleeding and bad-smelling fluid among the reasons to be seen in person immediately. HealthLinkBC’s advice for green fluid is to go to the hospital. If you can’t judge the color, keep the pad so your midwife or nurse can look at it (NHS).

My water broke: what to do next

1. Note the time.
2. Put on a pad, not a tampon, so the color stays visible.
3. Call your doctor, midwife or labor and delivery unit, even if you have no contractions.
4. Follow their instructions. ACOG’s patient advice lists “your water has broken and you are not having contractions” as a reason to go to the hospital.

Expect questions like these on the phone (Cleveland Clinic, NICE):

• When did it happen?
• How much fluid came out, what color is it, and does it smell?
• Are you having contractions?
• Is your baby moving as usual?
• Are you bleeding or in constant pain?
• Did you test positive for group B strep?
• How many weeks pregnant are you, and how is your baby lying?

In the UK, NICE’s phone triage asks when your water broke and checks for risk factors. If any are present, NICE advises going in straight away for an urgent check. Besides the signs above, its list includes:

• your baby is breech or lying sideways
• you carry group B strep and have a plan for antibiotics in labor
• you feel unwell
• your care team has found that your baby isn’t growing as expected or your placenta is low-lying

NICE advises the same urgent check if anything is uncertain. Without risk factors, NICE says you should be seen within 12 hours, sooner if you’re worried or want induction.

At the hospital, your team checks that it really is amniotic fluid and how your baby is doing. If it’s certain your membranes have ruptured, NICE advises against a speculum exam; if it’s uncertain, a speculum exam can confirm it. Finger (digital) exams are avoided while you’re not having contractions.

Water broke but no contractions: how long can you wait?

Labor often follows soon. ACOG notes that most women go into labor within hours after their water breaks. NICE says 60% go into labor within 24 hours.

Time matters because without the fluid around your baby, there’s a small increased risk of infection (NHS). NICE puts the risk of serious newborn infection after prelabor rupture at term at 1%. With intact membranes it’s 0.5%. The risk rises the longer the time from rupture to birth.

That’s why induction comes up. NICE offers a choice: induction as soon as possible, or waiting up to about 24 hours. If labor hasn’t started by then, induction is offered. If you’ve tested positive for group B strep in this pregnancy, NICE offers immediate induction. In the US, ACOG lists prelabor rupture of membranes among the medical reasons for inducing labor. The timing is a shared decision with your team.

If you’re waiting for labor to start, NICE and the NHS advise you to:

• take your temperature every 4 hours while you’re awake and report a raised temperature. The NHS says that’s usually above 37.5°C (99.5°F), but check the number with your team.
• report any change in the color or smell of the fluid right away
• call right away if your baby moves less than usual
• know that baths and showers aren’t linked to more infections, but sex may be

When contractions start, time them. Our free online contraction timer works in your browser. The app alerts you when your contractions reach the 5-1-1 rule. Our guide on when to go to the hospital covers the next step, and the stages of labor explains what comes after. If you have time, finish your hospital bag.

PROM and PPROM: when your water breaks before labor

Doctors call water breaking before labor begins prelabor rupture of membranes, or PROM. You may also hear “premature rupture of membranes”; it means the same thing (ACOG). When it happens before 37 weeks, it’s called preterm PROM, or PPROM.

ACOG estimates that term PROM occurs in about 8% of pregnancies. Preterm PROM affects about 2% to 3% of pregnancies in the US. Preterm PROM is a different situation because your baby may be born early. If your water breaks before 37 weeks, call your labor and delivery unit right away.

Cord prolapse: if you see or feel the cord

Rarely, the umbilical cord slips down through the cervix after the water breaks. RCOG puts cord prolapse at 0.1% to 0.6% of births. If you see or feel the cord in your vagina, call 911 in the US or 999 in the UK. RCOG guidance describes an emergency ambulance transfer to hospital. While you wait, it advises getting on your knees with your chest down.