Water Breaking Signs: What It Feels Like & Next Steps

Water breaking signs: a calm, clear guide for the third trimester

That sudden wetness. A slow, steady trickle. Or a dramatic gush. If you are in your third trimester, you might be wondering: is this one of the classic water breaking signs, or something else entirely? This guide explains how to recognize signs your water broke, how to tell an amniotic fluid leak vs discharge, what to do when your water breaks, and what to expect at the hospital—grounded in guidance from ACOG, StatPearls, Mayo Clinic, and Cleveland Clinic.

Key takeaway: If you think your water has broken at any time in the third trimester—especially before 37 weeks—call your maternity provider right away.

1) Water breaking 101: PROM and PPROM explained

Water breaking is the rupture of the amniotic sac, the fluid-filled membranes that cushion and protect your baby. In medical terms, it is called prelabor rupture of membranes (PROM) when it happens before labor begins. When it occurs before 37 weeks, it is preterm prelabor rupture of membranes (PPROM).

Why amniotic fluid matters:

Cushions the baby and umbilical cord
Helps maintain temperature
Supports lung development and movement

How common is it? ACOG notes that term PROM happens in about 8% of pregnancies, while PPROM affects roughly 2–3% and is a leading cause of preterm birth (ACOG Practice Bulletin No. 217; StatPearls/NCBI).

PROM: Rupture at or after 37 weeks
PPROM: Rupture before 37 weeks

These categories matter because timing, recommended tests, and interventions differ by gestational age (ACOG; StatPearls).

2) How to recognize if your water broke

Water breaking signs vary. You might notice:

A sudden gush of clear or pale fluid that you cannot control
A slow, steady trickle that continues over time
Persistent wetness in underwear that does not smell like urine

Other helpful clues:

Ongoing leakage: Unlike discharge or urine, amniotic fluid often keeps leaking, especially when you stand up or change positions.
Color: Typically clear, pale, or slightly yellow-tinged. Green or brown fluid may mean meconium (baby’s first stool) and needs prompt evaluation.
Smell: Usually mild or slightly sweet; urine often smells like ammonia.

Mayo Clinic and Cleveland Clinic both emphasize that not all water breaking looks like a dramatic movie-style gush—sometimes it is just a trickle that can be mistaken for urine or discharge. If you are unsure, call your provider for guidance and next steps.

If you suspect your water broke—no matter how small the leak—call your provider. Early evaluation helps reduce infection risk and guides safe timing of delivery (Mayo Clinic; Cleveland Clinic).

3) Amniotic fluid vs urine or discharge: simple checks

It can be tricky to tell an amniotic fluid leak vs discharge or urine. Try these safe, at-home observations while you await guidance from your provider:

Use a clean sanitary pad (not a tampon). Note the amount, color, and smell of any leakage.
Lie down for 20–30 minutes, then stand up. If fluid has pooled in the vagina while reclining, you may notice a small gush or renewed trickle when you stand.
Sniff test: Amniotic fluid is typically mild or slightly sweet. Urine often smells like ammonia.
Watch for continuous leakage: Discharge can be thicker and intermittent; amniotic fluid tends to be watery and ongoing.

Do not do internal checks, avoid sex, and do not insert tampons or menstrual cups. These steps help lower infection risk until you are seen (Mayo Clinic; Cleveland Clinic).

If you are uncertain after these checks, it is still best to be assessed. Hospital tests can confirm rupture quickly and safely.

4) When to call your provider—or go in now

Call your provider immediately if you suspect your water broke. Seek urgent care or go directly to labor and delivery if any of the following occur:

Before 37 weeks (possible PPROM)
Green or brown fluid (possible meconium)
Fever, chills, or foul-smelling fluid
Heavy vaginal bleeding
Decreased fetal movement
Signs of cord prolapse: sudden gush with severe pressure and you can see/feel cord at the vaginal opening; call emergency services and get into knee‑chest or hands‑and‑knees position with hips elevated while you wait for help

These red flags warrant prompt evaluation to protect both you and your baby (ACOG; Cleveland Clinic; StatPearls).

5) What happens at the hospital: tests and monitoring

Your team will confirm whether your membranes have ruptured and check on you and your baby. Common steps include:

Speculum exam to look for pooling of fluid in the vagina
pH testing (nitrazine): amniotic fluid is more alkaline than normal vaginal fluid, though blood/semen can cause false positives
Microscopy (ferning): amniotic fluid can create a fern-like pattern on drying
Immunoassay test (for example, AmniSure): detects placental proteins with high sensitivity
Ultrasound to assess amniotic fluid volume and baby’s position
Fetal heart rate monitoring

Your team will also review your Group B Streptococcus (GBS) status and discuss the plan for induction or expectant management depending on gestational age and your clinical picture (ACOG; StatPearls).

6) At term (37+ weeks): induction and timing

At term, many people are offered induction within about 24 hours of confirmed rupture to lower the risk of infection (chorioamnionitis). The landmark TERMPROM data and guideline summaries show that planned induction (often with oxytocin) reduces maternal infection without increasing cesarean rates compared with waiting for labor to start on its own (ACOG; StatPearls summarizing TERMPROM).

What to expect:

If contractions do not start, your team may recommend oxytocin to induce labor
GBS antibiotics are given if you are GBS positive or status unknown
Vaginal exams are minimized and performed with sterile technique to reduce infection risk
Pain relief options include nitrous oxide, IV medications, epidural, or non‑pharmacologic methods—your choice, with support from your team

Induction methods: When membranes are ruptured, some clinicians avoid intracervical balloons due to possible infection risk; many favor oxytocin, and prostaglandins may be considered on a case‑by‑case basis (StatPearls; ACOG).

7) Preterm (before 37 weeks): care and medications

If rupture occurs before 37 weeks, your team will balance risks of prematurity against risks of infection or cord complications. Management (PPROM symptoms and care) varies by gestational age (ACOG; StatPearls):

34–36 weeks 6 days (late preterm)

- Delivery is recommended if GBS positive - If GBS negative or unknown, some may offer expectant management with close monitoring until 37 weeks; this approach carries a higher infection risk but may lower cesarean risk - A single course of corticosteroids is recommended if birth is likely within 7 days to help mature the baby’s lungs - Routine latency antibiotics and tocolytics are not recommended at this gestational age

24–33 weeks 6 days (early preterm)

- Expectant management in hospital if no contraindications - Corticosteroids to improve lung maturity - Latency antibiotics for 7 days to reduce infection and prolong pregnancy (typically IV ampicillin and erythromycin followed by oral amoxicillin and erythromycin; avoid amoxicillin–clavulanate due to higher NEC risk) - GBS prophylaxis unless known negative - Magnesium sulfate for fetal neuroprotection usually considered up to 31 weeks 6 days - Tocolytics may be used short‑term (up to 48 hours) before 34 weeks to complete steroid course if needed

Periviable (<24 weeks)

- Individualized counseling on maternal and neonatal risks - Management depends on your values and local neonatal resources; maternal risks include serious infection and hemorrhage

Throughout PPROM care, you can expect continuous monitoring for infection, changes in fetal heart rate, contractions, and amniotic fluid volume.

8) Risks to be aware of — and how to reduce them

Main risks after membranes rupture:

Infection (chorioamnionitis, postpartum endometritis)
Cord compression or, rarely, cord prolapse
Placental abruption

Risk increases with time since rupture, which is why timing of delivery is tailored to your situation (ACOG; StatPearls).

Simple steps to lower risk until you are evaluated or admitted:

Avoid vaginal intercourse
Use pads only (no tampons or menstrual cups)
Skip baths, pools, and hot tubs; showers are generally okay unless your provider advises otherwise
Do not douche or perform any internal checks at home
Minimize frequent vaginal exams; your care team will limit them when possible

If you are at home awaiting instructions, note the time of rupture, keep track of baby’s movements, watch for fever, and head in sooner if anything changes.

9) Common myths and facts about water breaking

Myth: It is always a dramatic movie‑style gush.

- Fact: Many people experience a slow trickle or intermittent leaking. A small leak still matters—call your provider (Mayo Clinic; Cleveland Clinic).

Myth: Labor starts immediately every time.

- Fact: Contractions may begin soon, but sometimes take hours or longer. Induction within about 24 hours at term reduces infection risk (ACOG; TERMPROM data via StatPearls).

Myth: Baths and sex are fine after membranes rupture.

- Fact: Both can increase infection risk. Use pads only and follow your provider’s guidance on showers (ACOG; Mayo Clinic).

Myth: If leakage stops, your membranes must have resealed.

- Fact: A high leak can wax and wane; true resealing is uncommon. Seek confirmation with hospital testing (StatPearls).

10) Partner’s checklist: how to help

Practical ways a partner or support person can make a big difference:

Note the time of the first leak or gush
Observe color and smell of the fluid (clear vs green/brown; sweet vs ammonia)
Help the pregnant person use a pad and change clothes if needed
Time contractions if present and track third trimester labor signs
Arrange transport and child or pet care
Pack or grab the hospital bag, IDs, insurance card, birth preferences, and phone chargers
Call ahead to the birth unit and share key details (gestational age, GBS status, fluid color, fever, fetal movement)
Advocate for comfort needs and ask clarifying questions during triage

11) Prepare ahead in the third trimester: set up a plan

A little preparation makes suspected water breaking far less stressful:

Keep provider and hospital numbers saved and visible
Know your GBS status and due date
Pack your hospital bag by 34–36 weeks (essentials, snacks, chargers, toiletries, baby clothes, car seat installed)
Waterproof your mattress and place a towel or absorbent pad in the car
Review when to go in: suspected rupture, regular painful contractions, vaginal bleeding, decreased fetal movement, or any concerning symptoms
Map your route and backup plan for after‑hours
Prepare childcare and pet care plans

These steps also help you recognize broader third trimester labor signs—regular contractions, back or pelvic pressure, and possible loss of the mucus plug—so you feel confident about what to do when your water breaks.

12) FAQs: quick answers

How long until labor starts after my water breaks?

- At term, many people go into labor within 12–24 hours. Induction is often recommended within about 24 hours to lower infection risk (ACOG; TERMPROM data via StatPearls).

Can membranes reseal?

- Rarely. Small high leaks can ebb and flow, but confirmation testing is important and management should follow your provider’s guidance (StatPearls).

Is a shower safe after rupture?

- Most providers allow a brief shower; avoid baths, pools, or hot tubs due to infection risk (Mayo Clinic; ACOG).

Can I travel or wait at home?

- Follow your provider’s instructions. Many are asked to go in for evaluation right away. If PPROM is suspected, go to the hospital promptly.

What if I am having twins or have a prior cesarean?

- Plans may differ based on presentation, gestational age, and your individual history. Call your provider immediately for tailored guidance.

What about fluid that looks pink or streaked?

- A small amount of blood‑tinged fluid can occur, but heavy bleeding needs urgent evaluation.

What if I felt a gush only once and then nothing?

- Leakage can be intermittent. Use a pad and call your provider; hospital tests can confirm whether membranes ruptured.

13) Sources and guidelines: evidence you can trust

ACOG Practice Bulletin No. 217: Prelabor Rupture of Membranes (2020)
StatPearls (NCBI Bookshelf): Preterm and Term Prelabor Rupture of Membranes (updated)
Mayo Clinic: Water breaking—understand this sign of labor
Cleveland Clinic: Premature Rupture of Membranes—causes and treatment
TERMPROM trial summary (as reviewed in StatPearls): Induction vs expectant management at term
Jena et al., 2022: Global PPROM incidence data (Scientific Reports)
Chandra et al., 2017: Outcomes after third‑trimester PROM/PPROM (Taiwanese Journal of Obstetrics & Gynecology)

This article is informational and not a substitute for personalized medical care. If you suspect your water has broken, contact your healthcare provider or go to labor and delivery.

The bottom line

Recognizing water breaking signs—whether a gush or a slow trickle—matters because timing and safe next steps depend on gestational age and your symptoms. When in doubt, call your provider right away. With prompt evaluation and evidence‑based care, most pregnancies proceed safely.

Call to action: Save your provider’s number now, keep a pad in your bag or car, and share this guide with your support person so everyone knows exactly what to do when your water breaks.