On this episode we are talking waters breaking. The amniotic sac, also called “membranes” or the “bag of waters,” contains amniotic fluid that serves as a cushion and a layer of protection for your baby. Obviously the waters come out with the baby, so let’s talk about the different ways this happens. Talking what about the differences between spontaneous ruptured membranes, artificial rupture of membranes, and en caul births.

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No time to listen? Here’s the transcript:

Welcome back to the birth class podcast. We took last week off for Thanksgiving.. My goal right now is to get ahead on the podcast episodes and have them just like boom, boom, boom. Ready to go. One episode a week with maybe a bonus second episode that’s a little shorter. Eloise has some things to say right now too. So, we’ve got Lizzie and Lulu here on your birth class podcast. Anyways. I would love to hear from you. If you’re listening and you liked this episode take a screenshot, shout it out on your Instagram, tag me. Or if you have an episode topic that you’d like me to cover or you want to come on to The Birth Class Podcast as a guest, send me a DM on Instagram. I would love to connect with you and give you guys what you want on this podcast.

Okay, today we’re going to talk about waters breaking and the different ways that your waters break. So the first thing let’s just cover a little bit of the anatomy, so the amniotic sac is the sac that holds everything in it surrounds the baby. It also has the fluids and the placenta inside. Sometimes we we call it the sac, sometimes we call it the membranes, sometimes we call it the bag of waters, all the same thing. So obviously inside that sac is the fluids, which we’re going to talk about the waters breaking today. So when your baby comes out, everything else has to come out too- your placenta, your waters or your amniotic fluid, your amniotic sac. It all comes out. So the waters come out with the baby. But let’s talk about the different ways that this can happen. 

So you can have your waters break spontaneously. That means they break completely on their own without any intervention. And so we call that the spontaneous rupture of membranes, and a lot of times we just use the acronym S R O M or S rom just depends how you like to say it but the spontaneous rupture of membranes means our waters break on their own. Now this can happen in like a couple of different ways, right? We can have a spontaneous rupture of membranes before labor starts, or during labor, or while we’re pushing. 

So let’s talk about the spontaneous rupture of membranes before Labor starts. That is also called, another acronym for you, PROM, premature rupture of membranes, and that happens about eight to 10% of the time, one study says. Another study I was looking at said 10 to 20% of the time. That happened to me with two of my three births, waters broke before labor started. And we call that PROM, premature rupture of membranes not to be confused with waters breaking with a premature baby, so that gets confusing. So we have another term called preterm premature rupture of membranes and that’s when your waters break before labor starts before 37 weeks. So that is concerning. And obviously depending, more concerning the further away from 37 weeks you are.  And even still premature rupture of membranes, even if you’re 40, 41, 42 weeks and your waters break before labor starts- that’s not ideal, especially when we’re talking about the hospital birth because you very often get that time clock put on you, which is not evidence based, by the way. We talk way more about that in my course. Unmedicated Academy. 

Right now, I just want to cover the basics of waters breaking. So it can happen before labor starts, and when your waters break before labor starts, they can break as a gush or a trickle. And usually when they break as a gush, it’s like a few gushes. So it’ll be like “oh my gosh, my water just broke, like that definitely wasn’t pee.” You can definitely tell when it’s a gush that it’s not pee. And then, let’s say for me both times it happened with movement, as I got up from the toilet, one time and as I was bending over, getting something out of the oven with another pregnancy, and so, you know, you do some sort of movement and that pops your bag and you have a gush of waters and you’re like oh my goodness, that definitely wasn’t pee. That was definitely waters breaking and then as you m, stand up right or move a little bit more to go get a towel, more fluids are coming out. So that’s how the gush goes. 

And you could continue to lose in a few gushes over time. The way if you imagine like a baby inside the uterus, head down, and the heads engaged, there’s waters in the front of baby Those are called your fore waters, so like, on top of baby’s head or under, since baby is upside down, and then there’s water behind baby shoulders, and those are called hind water. So of course, when you have that rupture of membranes, it’s going to be the fore waters that come out first, and then possibly the hind water’s coming out a little bit later or immediately after it just depends on baby’s positioned in there.

And then you can also have spontaneous rupture of membranes before labor starts as a trickle. And so with a trickle. This one’s kind of tricky because it’s harder to identify if it was pee or is it just the extra discharge that I’m having in week 38, 39, 40, 41? Or is it my waters breaking? So that is a little harder to distinguish. Some people say you could like do a sniff test. And amniotic fluid is said to be odorless, so it won’t smell like urine, which  has a kind of specific smell, odorless or kind of sweet smelling. Or, this is what I think it smells like. It kind of smells like semen which kind of makes sense if you’re thinking about like reproductive fluids. Anyways, so with a trickle is harder to tell but I do want you to know that you can have like little micro tears in your sac that repair themselves. So I wouldn’t be too worried about a trickle I would trust more that my body is going to like, patch up that hole and I wouldn’t really consider that the start of labor. Versus like a gush. It’s like okay, now that’s the start of labor. 

If you have a gush before labor starts you need to make note of the time, make note of how much fluids came out, make note of what the fluids look like. They should be clear anything other than clear would be a sign of concern. And that’s it. Those are the things I didn’t put this in my notes but those are the things that you would want to kind of make note of. And inside of Unmedicated Academy we talk more about like making a plan for going into the hospital if your waters break before labor starts.

So that’s one way of having your waters break,  spontaneous rupture of membranes. Before contractions start. You can also, this is the most common, have your waters will break spontaneously during labor so either when contractions take up a couple notches and later active labor or could happen while baby is coming through the birth canal or while you are pushing or even if you’re not pushing while your body is pushing for you or you’re having a fetal ejection reflex that can break the sack of waters and and on their own spontaneously. And really if you think of labor that’s that’s how it’s supposed to work, like perfect, like everything’s on track, check, check check. Perfect physiological birth, because that gush of fluids is is aiding in moving baby through the birth canal. Think of going down a slide that’s wet versus dry. Okay. So the water served that purpose and also your sack keeps baby safe from infection so having it closed and waters not broken during most of labor is ideal.

If you’ve ever had your waters break, before labor starts look into a high dose vitamin C protocol that helps strengthen your sack. And you can also look into other like nutrition, and foods to include in your diet to make your amniotic sac strong. And I’m telling you this is really important if you want an unmedicated birth because like I said, if your waters break, it kind of puts a time clock on your birth and if you’re having a hospital birth, they’re going to be like pressuring you to induce and you guys my number two tip for having an unmedicated birth is do not get induced. So having a strong sac of waters is going to help you prevent the infection and prevent that cascade of interventions. Okay. So, those are the spontaneous ruptures where waters break on their own without us doing anything.

And then there is an artificial rupture of membranes. So we call that AROM,, also called an amniotomy, and that is when your provider intentionally breaks your bag, your bag of waters and so what they do is they get a little like hook. It’s a little plastic long hook, like It looks like a crochet hook. They use that and they put it in your vagina and they nick your bag of waters to to break it. So you remember that you get to choose if you want that, they’re not super effective in like speeding things up. 

Let’s talk about like the pros and cons. So on the pro side having your water’s broken, having an amniotomy, it may make labor shorter, it may reduce your chances of needing Pitocin right by speeding things up. It may make contractions more effective, causing your cervix to dilate so your labor can progress. So imagine again that baby had down and waters intact so they have those those fore waters and it’s providing a cushion. Now this is also beneficial to baby because it’s protecting baby from strong contractions. Now, if we pop those fore waters, that water that cushioning has gone now baby’s head is more directly pressing on your cervix. And this can make your cervix dilate quicker because of that pressure that’s on your cervix now. So it can speed up in that case. Now let’s talk about the cons. It can increase your risk of infection again we already kind of talked about that once that sack is open baby is open to any bacteria that could be introduced into your vagina. It removes the protection of the intact amniotic sac against the umbilical cord compressing. And so like basically the baby loses that cushion so it baby feels more of the contractions and it can contract against the cord more also which can lead to fetal distress which can lead to a cesarean so you have to be very careful with choosing the amniotomy. 

And then also it could likely cause more painful contractions than you have been having because it does take up the intensity a notch as there’s more pressure on your cervix. So when you’re choosing to have an amniotomy or not, hopefully your provider is very skilled and like knowing when it would be helpful and when it wouldn’t really be as helpful. Baby’s head needs to be engaged you should be like already in active labor like you should be more towards the end of labor than the beginning of labor. You wouldn’t want to break your waters if you were like three, four centimeters dilated or you didn’t have a bulging sack or baby wasn’t engaged very well. So keep that in mind.

And when it does work well is when things have kind of already are going, baby’s head is engaged. You maybe have a bulging sack of waters, or maybe you’re already at 10 centimeters, and then we just pop that bag and it helps baby, so in that case when you’re already complete, your cervix is gone and we pop the bag, one it’s giving you that lubrication that can be helpful. Right? the the wet slide and two it’s like it’s moving that sack out of the way so baby can, you know just baby comes through your body’s not bringing a whole bubble through the birth canal. Not to say your body can’t do that.

And that’s the third way, is having an encaul birth, where a baby is born with the sac of waters intact. surrounding them. These births looks so cool. They’re also called veiled births. And there’s a lot of folklore surrounding babies who are born in call. They’re said to possess supernatural powers, psychic abilities, and they’re really like in some cultures held in very high esteem and just around the world are considered to be like extremely lucky babies. Now I feel like we see a lot of encaul births like in the Instagram world but I also feel like we share them more in the Instagram birth world because they’re like, they’re just so magical and they’re so amazing and they’re so lucky, right? And if you look like in medical literature, medical literature says that babies are born encaul about one in every 80,000 births. But one of my favorite Instagram accounts. Oh gosh, I’ll linked to her Instagram handle. I can’t remember what it is right now but she’s a midwife in Orange County. And her name is Lindsay Meehleis. I think that is her Instagram handle, but again, I’ll link it in the show notes. She says that she sees them a couple of times a year, and she obviously doesn’t do 80,000 births a year. So that just goes to show you that when you leave birth alone, all of these different things can happen. Versus like in the hospital, they’re more likely to break your waters, or give you Pitocin which will cause contractions to break your waters, that sort of thing.

Those are the three different ways that your waters can break on their own- spontaneously, and that can happen during labor or during pushing or before labor starts and then artificially rupturing the membranes, when a provider intervenes and breaks the sac. And then your waters not breaking until your baby’s born. And then of course, like when your baby’s out. We open the sac, we take it off of them. So that does happen. So what I want you to remember is that artificial rupture of membranes is an intervention and so they don’t you know, any intervention messes with physiological birth and can have negative side effects. Of course, the biggest risk being like infection and opening that sac of waters and then it not speeding things along and obviously, we see more benefits when we don’t mess with labor. That would be letting your waters break on their own which in a majority of births they break on their own during labor. And then as far as like the encaul birth again, I like to believe that that would happen for a reason like there would be a reason that your waters wouldn’t break in labor. Whether it be like protective to the baby, or something like that. Because one thing to also know that’s important is when babies come through the vaginal canal, they pick up good bacteria and so with an encaul birth baby’s not picking up that good bacteria from your vagina. So if we were to choose the best case scenario it would be your water’s breaking on their own in labor, like hopefully, as baby is coming through the birth canal once your cervix is complete. But like why does the sac stay intact? Like I totally trust that like our bodies know better than us and there would be a reason that babies would be born in the sac. But then keep in mind that you might want to do some vaginal seeding so baby can pick up the bacteria from your birth canal and have that good bacteria. And this is something you should also consider or just know about for Cesarean birth because cesarean babies dont come through the birth canal. They don’t pick up that good bacteria that really sets them up for success. But skin to skin is another way that babies can pick up good bacteria from your skin. Because our skin has you know its own microbiome going on. So there are ways to get those benefits back

 If your  baby was born encaul,, I would actually love to hear from you if you had an encaul birth. Send me a message. I’d love to see how many moms I hear from whose babies were born with the sac intact and if you were at home or birth center or in the hospital. It doesn’t really happen in the hospital that much.

That’s all I have for you for this episode. I hope you enjoyed it. I hope you learned a lot and it’s you guys Knowledge is power. The more we know about birth, the better birth experiences we have because we just we know what to expect and we know how to make better decisions for ourselves and for our birth experiences and our babies when we know what’s going on. So if you liked this episode, I would love if you would take a second and give The Birth Class Podcast a review and a rating because that really helps with the algorithm and showing more moms to come listen to “not your average childbirth”, birth class podcast. All right. Bye moms.