When Your Water Breaks… Ummm… Last I heard, water doesn’t break. Something that holds water can break and water can gush or leak out, but water doesn’t break. There are a lot of terms used around birth that confuse women and if a doulas first role is to educate, then let’s get started. This water we talk about breaking is actually in a sac. It is called the amniotic sac, to be specific. The sac is made of a pair of membranes that are transparent and although thin, they are pretty tough. As you can see in the photo, the amniotic sac is part of the placenta. One side of the placenta (the maternal side) is attached to the uterine wall and the other side (the fetal side) is part of the sac. The umbilical cord attaches the baby to the placenta in the sac. Make sense? The sac holds the embryo/fetus/baby until shortly before it is birthed as well as the “water”. The water is called amniotic fluid. This fluid is pretty magical (if you ask me). It changes to meet your baby’s needs. In the very beginning of the pregnancy, it is made up of mostly water and electrolytes. But by the second trimester, the fluid contains protein, carbohydrates and some other cool stuff to help with your baby’s growth. Then there’s the amount. Remarkably, that changes too. Early in pregnancy, there is about 25ml of fluid. That number increase to about 400ml by around the half-way mark of gestation. At 28weeks you can expect that number to double to about 800ml and level out there. In cases of women who go past 41weeks gestation, most doctors/midwives will be checking their fluid levels, as around 42weeks, fluid levels are know to decline to about 400ml. Ok, back to the sac. Why and when does it break? This, my friends, is one of the many mysteries of pregnancy and birth. With the exception of infection, we do not know why or when this will happen. What we do know is that when it breaks, you will feel wet and messy and the fluid will continue to leak out periodically until your baby is born. When or if you feel the amniotic sac break or you just feel the fluid come out, remember the acronym C.O.A.T COLOR, ODOR, AMOUNT, TIME Amniotic fluid is clear to cloudy. If your baby has pooped in utero, the fluid will be green or brown and your doctor/midwife will want to know. It should be mild in odor. A strong smell could indicate infection and your doctor/midwife will want to know that too. They will also want to know approximately how much (a gush, a trickle, etc.) came out and the time that it happened. The amniotic sac breaking is no indication of how soon your baby will be born. For about 10-15% of women, it is the first sign of labor. For many women, it will happen after labor has begun and for others, the doctor or midwife will artificially rupture it at some point during the labor with your permission. I hope you realize how remarkable you are, I certainly do! Authored by: Randy Patterson