What to Do When Your Water Breaks Prematurely

Your baby is cushioned from injury, protected from infection, provided with nutrition and a lot of other things, thanks to your amniotic fluid, a.k.a your water. When that water ‘breaks’ there are a lot of complications that can happen to you and your baby.

Read to find out more:

What causes my water to break early?

Most times, the uterine membrane will rupture following a traumatic experience like a car accident. But in some rare cases there is no given reason. There are however some risk factors and potential causes for this. They include:

• Cervical insufficiency – Insufficient cervical fluid
• Having a previous pregnancy in which your water broke
• Previous cervical or uterine surgery
• Infections or inflammation
• Polyhydramnios (too much amniotic fluid levels)
• Carrying multiples (twin, triplets, quadruplets)
• A cerclage (treatment of the cervix when it opens too early in pregnancy) or amniocentesis (testing of the amnotic fluid for abnormalities or fetal infection)

What treatments are given when my water breaks early?

Your doctor will treat you based on how many weeks pregnant you are, if you have an infection, if labor follows quickly and how much amniotic fluid baby has left. That being said, some common steps that will be taken include:

• IV antibiotics will be administered; depending on if any infections are found.
• Depending on how many weeks pregnant you are, magnesium will be given to protect baby’s brain as well as potentially stop or reduce contractions, especially if you’re less than 32 weeks.
• Baby’s heart rate will be monitored continuously
• You will be monitored for infection via temperature checks, blood work and symptoms
• The usual goal is to carry the pregnancy until 34 weeks, when possible, but if mother or baby are no longer tolerating the pregnancy (e.g. infection, fetal heart-rate concerns, decreased movement, high blood pressure, etc) then birth becomes necessary regardless of gestation

Water breaking at less than 24 weeks

Before 24 weeks, baby needs amniotic fluid to help lungs develop properly. Extremely low fluid levels at this stage can impact lung development even when the pregnancy is prolonged. However, if there isn’t any infection, magnesium will be given, strict bed rest will be recommended, and a few steroid injections to help baby’s lung development.

Water breaking at 24-31 Weeks 

At this stage, baby is viable enough to survive, but will need to spend more time in the uterus and amniotic fluid to survive and not have long-term health issues. Provided that there is no active infection, magnesium will be given to protect baby’s brain and reduce risk of labor beginning right after water breaks.

Water breaking at 32-33 Weeks

At this stage of pregnancy, your doctor will want you to prolong pregnancy as long as there’s no active infection, you’re not showing signs of labor, and baby is tolerating the low fluid levels. If there seem to be any problems with baby, a c-section or an induction may be discussed.

Water breaking 34-36 Weeks

If you’re over 34 weeks, many doctors believe baby is well-developed enough to be born. This is safer than risking waiting and then developing an infection. However, some doctors might recommend carrying to full term by using  antibiotics.