Waters breaking early (PPROM)

If your waters break early, seek medical advice straight away as you could be at risk of premature labour.

PPROM infographic

Your unborn baby lies in an amniotic sac of fluid or ‘waters’. ‘Waters breaking’ means that the sac has ruptured or broken. Your waters normally break around the time labour is due but in around 2% of pregnancies they break early for various reasons (see below).

If your waters break before your baby has reached full term (37 weeks), the medical name for it is preterm prelabour rupture of the membranes, or PPROM. If this happens early, before the contractions start, it can (but does not always) trigger early labour.

This page deals with waters breaking early before 37 weeks. Read here about what to expect when your waters break AFTER 37 weeks.

Have my waters broken early (PPROM)?

If your waters have broken early, you will experience it as a trickle or a gush of water from your vagina. It is likely to continue leaking once it has started If it isn't too heavy you can use a sanitary towel to catch it. This will also allow you to see what colour it is, which will be helpful information for health professionals. It may be pinkish if it contains some blood, or it may be clear. If it greenish or brown go to the maternity unit as soon as possible. If it is heavy, you may need to use a towel.

Phone your maternity unit immediately for advice.

What are the risks if my waters break early (PPROM)?

If your waters break early the risks and treatment are dependent on the stage of pregnancy you are at.

  • You are at risk of going into labour prematurely – the health risks for the baby of early birth are greater the younger they are.
  • If you do not go into labour, you and the baby are at risk of infection.

The doctors have to balance these two considerations. If the waters have broken because of infection, you and the baby have a high risk of getting the infection and you may need to deliver sooner to prevent this.

If the waters have broken but there is no infection currently present, you and the baby are still at risk but the immediate risk is lesser and your treatment will depend on your stage of pregnancy.

If you are under 24 weeks of pregnancy and the baby is born, sadly, it is unlikely the baby will survive.

If you are over 30 weeks and the baby is born, the likelihood of your baby surviving is much higher - over 95%

What will happen if my waters break early (PPROM)?

You are likely to have an internal examination. This will allow the doctor to look at your cervix and check:

  • if the leaking fluid is amniotic fluid
  • if it is changing in preparation for labour
  • to check for infection by taking a swab.

You might have an ultrasound scan to estimate the amount of fluid left around your baby.

If only a very small amount of amniotic fluid leaks, it is not always easy to be sure whether your waters have broken.

  • You may be advised to wear a pad and stay in hospital for a few hours to monitor the situation.
  • If you go home but continue to leak fluid at home, you should return to the hospital again.

If your waters are shown to have broken, you will be advised to come into hospital for at least 48 hours. You and your unborn baby will be closely monitored for signs of infection. This will include having your temperature and pulse taken regularly, and your baby’s heart rate will also be monitored.

Going home from hospital with PPROM

If there is no infection present you may be able to go home. You will be at risk from infection however, and you will need to self-monitor by

  • checking that your temperature is normal (37 °C or less) every 4–8 hours
  • checking the colour of the fluid does not change by wearing a pad.

You should avoid having sexual intercourse.

Contact your doctor or midwife and return to the hospital immediately if you have:

  • a raised temperature (more than 37 °C)
  • flu-like symptoms (feeling hot and shivery)
  • vaginal bleeding
  • if the leaking fluid becomes greenish or smelly
  • contractions
  • abdominal pain
  • if you are worried that the baby is not moving as normal.

Inducing labour or premature labour with PPROM

If you are past 34 weeks the doctor will weigh up the benefits of inducing labour before the due date to avoid the risk of infection with the disadvantages of being born premature, and may make a recommendation for early delivery.

You may need to stay in a hospital that has a neonatal unit and be monitored carefully for any sign of infection. You may also be treated with antibiotics, corticosteroids and magnesium sulphate (if you are less than 30 weeks) to help prepare your baby in case the are born prematurely.

Over 80% of women who have PPROM deliver their baby within seven days of their waters breaking.

What if there are no waters left in my womb?

Your baby’s amniotic sac has to have the right amount of amniotic fluid for the pregnancy to continue normally. If there is a break in the waters your baby will continue to produce amniotic fluid.

Before 23 weeks, the baby needs ‘waters’ to be present for their lungs to develop normally. Loss of water before this can lead to severe problems with lung development that can be critical after birth. After 23 weeks your baby does not need the amniotic fluid so much, so low levels of fluid may not be a problem in itself, but if the low levels are due to your waters breaking then there is a risk of infection.

Read more about intrauterine infection and chorioamnionitis

Causes of waters breaking early (PPROM)

Intrauterine infection is present in around a third of women with PPROM. In many cases however it happens without any infection being present. The reason for these cases is unclear, however it has been linked to heavy smoking (more than 10 cigarettes a day) in pregnancy

Read more

  • Discharge in pregnancy

    Discharge in pregnancy

    Having more vaginal discharge during pregnancy is common, but speak to your midwife or doctor if you are unsure about any increase or change in your vaginal discharge.

Sources

  1. RCOG (2012) Information for you When your waters break early, Royal College of Obstetricians and Gynaecologists
  2. J David, Steer P et al (2010) High risk pregnancy, management options, Elsevier Saunders
  3. RCOG (2006) Preterm Prelabour Rupture of Membranes, Greentop guideline 44, Royal College of Obstetricians and Gynaecologists
  4. England MC, Benjamin A, Abenhaim HA (2013) Increased Risk of Preterm Premature Rupture of Membranes at Early Gestational Ages among Maternal Cigarette Smokers. Am J Perinatol. 2013 Jan 17 
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Last reviewed on October 5th, 2016. Next review date October 5th, 2019.

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Comments

Please note that these comments are monitored but not answered by Tommy’s. Please call your GP or maternity unit if you have concerns about your health or your baby’s health.
  • By Midwife @Tommys on 15 Feb 2019 - 12:05

    Hi Monika,
    Sorry for the delay in responding to your query and your situation may have changed now. However if you would like to discuss this then please do email us [email protected]
    Best wishes
    Tommy's midwife

  • By Emma (not verified) on 3 Feb 2019 - 21:56

    7 weeks ago, i was 24 weeks and 2 days when my water broke around 11.30pm as i was sleeping. Drove myself into the hospital straight away and they managed to keep me pregnant up up until exactly 25 weeks. My baby boy has been in neonatal from 25 weeks gestation and is now 32 weeks. Have had one infection and doing very well. There is hope in everything.

  • By Anna (not verified) on 1 Feb 2019 - 20:59

    I had bleedings since week 12 and went in to check up on another gush of blood round 17w3d. Turned out that I was also losing fluids, in 2days had none left. Despite IV antibiotics an infection started progressing and doctors ordered terminating pregnancy to stop it from turning septic. Most heartbreaking decision and experience in my life. My little boy was born at 18weeks. Too tiny to stay with us.

  • By Midwife @Tommys on 11 Feb 2019 - 16:08

    That is so sad Anna. We hope that you are being well supported and wish you all the very best in the weeks ahead. x

  • By Jan (not verified) on 29 Jan 2019 - 21:24

    Hi, I am 31+ weeks pregnant with twins, I got leakage and went to hospital. Mean time, I have learned about this condition via internet, and those consultants explained well. so now still in hospital, and waiting for another couple of weeks as my babies are not matured well. also, having hyperglycemia and thrombocytopenia, I am being monitored . I am happy to have my babies in couple of weeks.

  • By Midwife @Tommys on 30 Jan 2019 - 14:04

    Hi Jan
    I am pleased to hear that you are being well cared for in hospital by your midwives and doctors. If you have not done so yet, please also ask to speak to a Neonatal doctor so that you know what to expect if the twins are born prematurely. You can also be shown around the NICU to help orientate you to the ward if your babies are likely to need care there once they are born. All the best, Tommy's Midwife

  • By Tamrah (not verified) on 17 Jan 2019 - 22:36

    My water broke last night, I’m currently 33 weeks pregnant and they’d like to keep me pregnant for at least another 2 weeks, I’m scared because my other 2 daughters were born over a week past their due date this will be my first “preemie “, freaking out .

  • By Midwife @Tommys on 18 Jan 2019 - 13:48

    Hi Tamrah,
    Sorry to hear that you are having a difficult time in this pregnancy at the moment. It is completely understandable that you are feeling worried and anxious. It will depend on the gestation as to how much support your baby will need. It is likely that they will need to go to the neonatal unit for a short period of time to make sure they are breathing and feeding all ok. It is also likely that you will be give steroid injections to help with your baby's lungs development. A member of the neonatal team should also come to speak with you at some point to give you more information about what to expect for when your baby is born.
    If you would like to talk further then please do be in touch with us, [email protected]
    Tommy's midwife

  • By R Moss (not verified) on 24 Jan 2019 - 21:49

    Hi Tamrah,

    Please try to not worry. My son was born at 34 weeks. My waters ruptured at 31 weeks and I was induced 3 weeks later. I was absolutely terrified but I gave birth to a beautiful, healthy little boy. He is now 2 and is loving life. You will be fine x

  • By Dinah (not verified) on 17 Jan 2019 - 02:28

    Hi , my water broke at 18wks and 5days ,was advised to go to A&E by the midwife . while been examined water came out again thats when i was admitted to the hospital for further monitoring. An Uhrasound was done and showed no water around the baby and i had no pain even cramps. I was holding for more than 3days as a mother who will try everything for her baby to be ok ,was advised for the pregnancy to be terminated as the infection level was raising. It really broke my heart because , i had a miscarrage about a year a go . Dr's couldn't know what was the cause . It has been 5weeks now after the loss. Sorry for the long story.

  • By Midwife @Tommys on 17 Jan 2019 - 14:52

    Dear Dinah - Thank you so much for having the bravery to share your story with us. Our heartfelt condolences to you on your losses. If we can support or help in anyway. please feel free to contact us on our helpline 08000147800 or via email at [email protected],org.

  • By Dee (not verified) on 23 Jan 2019 - 12:46

    My water broke on 21.01.19 at 18 Weeks 5 days. Was told I would most probably miscarry within 48 hours. Sad to say that I am in the process of losing my little as we speak.

  • By Midwife @Tommys on 23 Jan 2019 - 16:45

    Hi Dee, So sorry to hear that you are going through such a difficult time. Please get in touch with us via email or telephone if we can be of any further assistance or support. Tommy's Midwife

  • By Grace (not verified) on 4 Feb 2019 - 06:14

    I am so deeply sorry for your loss!

  • By Prasanna (not verified) on 11 Feb 2019 - 13:49

    Hi dear my first miscarriage was at 17 weeks in 2016 water just burst at 4am I was sleeping. We dunno why. 2nd on 2017 8weeks bleeding and it came out by itself. 3rd one 2018 8weeks same thing. But I bled even after for 3 weeks became very weak. 4th one at 2018 again I was 4 weeks than bleeding something came out. But I was still pregnant. Suspect it was twins and I lost one. Gave birth preterm via c sect in Feb 2019. Baby was 35 weeks. I guess all this is for some reason God has plans for us. I know it's really hard. Keep praying. Be positive and kind always. Keep yourself strong. God bless you.

  • By Mrs faiz (not verified) on 12 Jan 2019 - 10:19

    My water broke at 39weeks and for three days today labor hasn't started so what might be the problem and what should I do?

  • By Midwife @Tommys on 14 Jan 2019 - 16:02

    Hi Mrs Faiz, In the UK it is policy to induce labour after 72 hours of the waters breaking. I suggest you see your doctor to discuss the option of this.

  • By Mya (not verified) on 5 Jan 2019 - 06:31

    Hey, My water broke at 25 weeks and 4 days I am now 28 weeks. The baby hasnt turned yet but I am still hopeful.

  • By Mya (not verified) on 19 Jan 2019 - 02:13

    I am now 30 weeks ,the baby has turned head down. I am very hopefull. The 6 week hospital stay has not been easy but the nurses are very nice. I am grateful

  • By Aaliyah (not verified) on 27 Jan 2019 - 08:27

    I’ve been going to the restroom every 5 minutes and I am starting to think it’s not pee, what do you think it is??

  • By Midwife @Tommys on 29 Jan 2019 - 14:17

    Hi Aaliyah. Please go into your local maternity triage/day assessment unit to be reviewed. You may have a urinary tract infection developing, which will need urgent antibiotic treatment. They will test your urine when you arrive, as well as check you and the baby too. Please be seen as soon as you can. All the best, Tommy's Midwife

  • By Melissa (not verified) on 2 Jan 2019 - 02:38

    My water broke at 19+4 days, however I was hospitalized at 18+5 weeks due to my cervix which had gone from long and closed to short and open within seven days. This is hard because exactly a year ago I was in the same hospital at 19+1weeks because my water broke. I ended up delivering at 21 weeks due to fever and my daughter was too premature. My infection turned into septic shock which became life threatening (spent 3 days in the ICU). At that time they couldn’t tell me what had caused my water to break. During this pregnancy I was closely monitored for infection and I didn’t have one, however after my open cervix was discover an amniocentesis showed I had an elevated white blood cell count and likely infection. They suspect the infection was there before my pregnancy began and the changes to my immune system in pregnancy lead to the infection flaring up. Please have this checked with a uterine biopsy before future pregnancies as it’s heartbreaking to go through this twice. I wish someone had told me to ask for this test before now. Best of luck ladies. (Sorry for the long post)

  • By Juanita (not verified) on 30 Dec 2018 - 11:41

    hello,

    In May of 2018 my water broke at 21 weeks, i was fortunate enough that my little girl held onto 26 weeks, she was born on the 2nd of july, she had a lot of fighting to do, but she made it, i never googled anything before on how often it goes wrong and im seeing a lot that it does, but posting this i hope i can show people that it can go well. My daughter is nearly 6 months old now and she is as healthy as can be. We never expected she could make it but here she is, so for the mums still going through this, i hope your kids will make it too, for the mums who lost theirs, i hope you can find some comfort eventually, the hardest thing in life is to lose a child.

  • By Heather (not verified) on 10 Jan 2019 - 16:34

    Thank you so much for sharing your story, it really gives me so much hope. I have next to no amniotic fluid left. I turned 25 weeks on Monday. I am praying that I can at least stay pregnant till week 30 if not weel 34 like they are wanting. God bless you guys <3

  • By Sophie (not verified) on 15 Jan 2019 - 11:33

    Hi Heather I'm in the same boat water went at 20weeks and still hanging in there a week later I'm praying that enough fluid is getting in to keep things stable until the doctors can start steroid shots to speed up lung development I wish you all the luck in the world

  • By Midwife @Tommys on 16 Jan 2019 - 15:42

    Hi Sophie. Supporting others is incredibly admirable.
    We are here if you need any support at this difficult time. You can get us on the helpline 0800 0147800 or on email - [email protected]
    We are here Mon to Fri 9 am to 5pm.
    All the best, Tommy's Midwife

  • By Swap (not verified) on 11 Feb 2019 - 11:28

    Thanks for sharing. I have the same problem. Now at 21weeks couple days. Have you been admitted into hospital? Or taking care at home? Have they started with any antibiotics or steroids?

  • By Danielle (not verified) on 18 Feb 2019 - 18:52

    This gave me alot of hope my bag broke at 22 weeks and 4 days i am now 23 weeks and 2 or 3 days my fluid levels going down now i was starting to wprry reading ur story has given me some encouragement

  • By Mama coco (not verified) on 20 Dec 2018 - 15:35

    My waters broke at 36 weeks and tbh i didn't know untill my sister told me, "the couch is damped and you couldn't feel it". I replied no thinking my son had sat on it after me when he came back from the pools, it wasn't till a week later i started feeling weak and heavy especially around the mid part of my tummy. When i had my scan this week st 36 weeks 3 days the lady noticed there wasn't any water around baby the first sack had already broken. .if this is the case especially after having 3 previous c-sections and baby number 4 bring 8yrs apart from my last baby is there any chance of having a natural birth or no?.

  • By Midwife @Tommys on 20 Dec 2018 - 16:16

    If you have had 3 previous c sections, it is unlikely that you will be advised to deliver vaginally.

  • By Theresa (not verified) on 13 Nov 2018 - 07:21

    All of the written comments gives me HOPE. I'm currently 26 weeks pregnant, I broke my water on my 24th week. I'm still in hospital since then, monitoring blood pressure, temperature, heart rate, any signs of discharge and also infection. I don't know how long I'll be in hospital for but I'm hoping everything goes well and my baby will survive as I have high risk chances of premature labour. Ultra sound and results for my baby are very good no negative comments yet. So fingers crossed, my baby and I will be fine.

  • By Midwife @Tommys on 13 Nov 2018 - 16:21

    Wishing you and your baby the very best.

  • By Missy (not verified) on 13 Dec 2018 - 03:50

    How long were you able to stay pregnant after water broke?

  • By Midwife @Tommys on 14 Dec 2018 - 15:35

    Hi Missy,
    I am so sorry to hear that you are going through a difficult time in this pregnancy. At 22 weeks, it is important to try and keep your baby inside you for as long as safely possible, however this can be unknown how long this will be. It is a question of continuing to weigh up risk, as long as the baby is growing and developing and there are no signs of infection then the pregnancy will continue. If there are concerns or signs of infection then it is likely the baby will need to be born.
    Best wishes
    Tommy's midwife

  • By Gina (not verified) on 18 Dec 2018 - 02:26

    Im exactly in your boat!! Howd it go for you!!?

  • By Megan (not verified) on 30 Dec 2018 - 21:06

    My water broke at 28 weeks I was very low in fluid so they rushed me my ambulance to a hospital about an hour away and I was on bed rest for 6 weeks. At 34 weeks they released me and said that my sons head has clogged the hole and sent me home 3 weeks after I got out I had him. It’s definitely scary but have trust in the dr.’s and keep hoping for the best. I hope all is well.

  • By Khocy (not verified) on 5 Feb 2019 - 05:16

    I wilsh al th best

  • By Carribgirl29 (not verified) on 5 Nov 2018 - 07:49

    Hi
    My water broke at 24 weeks and I'm currently in hospital, I've been out in antibiotics and steroid shot for the baby boy's lungs. Pressure and temperature is going well. Doctor ordered a WBC and might discharge me today if everything seems to be going well. The only thing I'm worried about now is this slime like vaginal discharge (smells mostly of antibiotics and has a creamish yellow colour). Oh... baby's heart beat is going good(143-147). I'm not sure how long I'd be able to keep my baby in but does anyone know the risk of baby being ok with all the antibiotics I'm receiving? Also if the discharge is normal?

  • By Midwife @Tommys on 8 Nov 2018 - 14:51

    Hi Carribgirl29. Thank you for your comment.

    Prescribing antibiotics when your waters break prematurely is very normal practice and this is to try and prevent the development of an infection for you or your baby. The discharge that you may be experiencing could be due to thrush, which can be very common in pregnancy especially if you are on antibiotics. We would recommend that as you are in hospital, speak to the midwives or Doctors that are looking after you and explain the discharge that you are experiencing then they will be able to give you any treatment if needed. Hope this helps, take care, Tommy's Midwives x

  • By Nontozintle Sus... (not verified) on 23 Oct 2018 - 09:29

    Good day, my water broke at 20 weeks 5 days of pregnancy. They don't know what caused it or how did it come out but they say the water which is left its to little for a baby to survive. They suggest termination.the scan says everything about the baby is fine expect the water being little, and I'm fine also. No pain,no licking ,I can feel my baby moving.im confused I don't know what to do

  • By Midwife @Tommys on 23 Oct 2018 - 14:30

    I can't advise what you should do. This will be your decision. I would suggest that you discuss with the doctors the chance of survival of your baby and what would happen if you continued with the pregnancy. i hope that they will understand your dilemma and help you to come to your decision. Take good care of yourself

  • By Kayleigh (not verified) on 25 Oct 2018 - 11:32

    My waters went at 16 weeks with my youngest and I was told to terminate due to little fluid, but I didn’t and although it was difficult we got to 36 weeks, he was poorly when born but he’s now 2 and doing amazing! I’m currently pregnant again and my water went at 19weeks I’m now 22 weeks so I’m getting there! Have hope and whatever decision you make I wish you all the luck in the world.. just remember premmie babies are stronger than we know x

  • By Saba (not verified) on 19 Feb 2019 - 17:59

    What precuations you adopt after pprom.. Because i rupture my membranes at 12 weeks and have enough fluid for baby to survive

  • By Jocelyn (not verified) on 22 Nov 2018 - 18:18

    Hi there. I am currently pregnant with twin boys. The sac for my twin A broke at 21 weeks pretty close to where you are now. The drs recommended termination to me as well however I felt that if I wasn’t going into labour and both babies were doing well I wanted to wait and see what happened. I’m currently almost 27 weeks both my babies are still doing great and I feel good no infection or any signs of labour. Of course they don’t know exactly what complications my twin A will have due to his lack of fluid but they know it can effect lung and muscle development. I have already made it to the point where if I have to deliver now both my boys have a great shot and I am so happy I didn’t listen to the doctors when they were pushing termination. Just wanted to let you know that you have more options and there is hope that your baby will be just fine :). Hope that helps

  • By Stephany (not verified) on 12 Oct 2018 - 10:37

    I was 26 weeks pregnant with my second son when I was in a car accident which broke my water. I didn’t know at the time that was my water breaking but I had my monthly checkup the following week so I didn’t go to the doctor or hospital. At my doctors appointment they realize my water had in fact broke and the fluid was low. My doctor advised me to head straight to the hospital where I would spend the next 8 very long weeks. My doctor thought I’d deliver within 2 weeks but to everyone’s surprise my son stayed in for 8 weeks. My water work when I was 26 weeks pregnant and they did a csection when I was 33 weeks and 4 days pregnant. My son was born at 4lbs 11oz. He only spent 18 days in the nicu. He’s almost bigger then his 4 year old brother at only 2 1/2 years old. You’d never know he was born over a month early and went through what he did being he kind of had no ammenoic fluid or 2 months. So ladies don’t give up hope if your water has broken early. Our bodies amaze us everyday!! ❤️❤️

  • By Midwife @Tommys on 15 Oct 2018 - 16:04

    Thank you Stephany for your lovely positive story. I think that our readers will find this very encouraging and if it helps just one other woman it is worth reading. We wish you and your sons all the very best. Tommy's midwives x

  • By Yee Yang (not verified) on 6 Nov 2018 - 05:24

    Thank you for the case sharing

  • By Kei (not verified) on 8 Oct 2018 - 06:05

    Im on 16weeks on pregnancy, when my waters broke and i felt some little pain or contractions in my stomach and back. What should i do?

  • By Midwife @Tommys on 8 Oct 2018 - 12:34

    Hi Kei, I don't know which country you are living in but, it is really important that you see a doctor or midwife as soon as possible. If your waters have broken it is important to check for infection and to treat you if you do have any signs. Best wishes to you from Tommy's midwives.

  • By Darshini Saulick (not verified) on 17 Sep 2018 - 17:37

    Hi my water broke at 18 week all of a sudden. Few hours earlier was having little contraction on amd off thought it was due to baby moving. When water broke rush to the hospital and by that time wascalready bleeding heavily. All happen so quick didnt realise wat was happenong. Today already 1 month since lost yhe baby. Waiting for nexy cycle to try again.

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