62. How to Tell if Your Water Broke or If It’s Pee and What to Expect Next

Have you ever wondered how to tell if your water has broken or if you accidentally peed your pants? It’s more common than you probably think, so please don’t feel embarrassed!

This episode will help clear up any confusion and provide you with the information you need to feel confident and prepared.

In this episode, we cover:

• The differences between amniotic fluid and urine, including color and odor…
• Key signs that your water has broken and how to identify them…
• When to consider going to OB triage to be assessed and navigating seeking help…
• Various tests your provider can use to confirm if your water has broken…
• Immediate steps to take, when to go to the hospital, what to expect next…
• …and so much more!

Thank you for tuning in to this episode of Your Birth Bestie podcast! Every pregnancy is unique, and understanding what to expect can help you stay calm and prepared. If you enjoyed this episode, please subscribe, leave a review, and share it with other expectant mothers. Stay tuned for our next episode, where we'll continue to support you on your pregnancy journey.

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👋 WHO AM I?

Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free hospital birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Welcome back to episode 62 of Your Birth Bestie podcast! Today we are going to be talking about one of the most common questions pregnant moms have and that most feel embarrassed about, which is how to tell if your water broke or if you just peed your pants. I have seen this scenario over and over again, and it’s sometimes hard to tell, so if this is you, you’re not alone at all! And then once we talk about some tips about how to tell if it’s pee or amniotic fluid, we will dive a little bit into when you might want to consider going to the hospital, and what your experience might be like when you go into OB triage to be assessed.

As you probably already know, amniotic fluid is the liquid that surrounds and protects your baby in the amniotic sac. It’s usually clear or pale straw-colored and odorless or sometimes even slightly sweet-smelling, which is a weird way to describe it, but there is a distinct smell that is different then urine, but it is kind of hard to describe. 

On the other hand, urine is typically yellow and has a distinct odor. The main reason for moms to be confused sometimes is that as your baby grows and puts pressure on your bladder, it can sometimes cause you to leak urine–especially when you laugh, cough, or sneeze. So, now that you know the difference, I can share some signs that your water has broken, signs that it might be just pee, and how to tell the difference.

As far as feeling confident that it is your water that has broken, first does it look and smell like amniotic fluid like I mentioned before? The clear or pale straw color, odorless or maybe slightly sweet smelling. If you don’t know because this one isn’t always obvious, one of the key differences is how much fluid there is and then what the flow is like. When your water breaks, it can either be a dramatic gush or a steady trickle, which can make it maybe more confusing, but it is actually helpful to know that when your water breaks, it’s usually not like in the movies where your water breaks and everyone starts rushing around and baby is born shortly after. The statistic on how many moms have their water break before labor starts like in the movies, is 10-15 percent or so. So it’s not really all that common!

Some moms describe it as feeling like they’ve peed their pants, with a warm gush of fluid, but the sensation doesn’t stop. Unlike urine, which you can control to some extent, amniotic fluid will continue to leak for your entire labor until your baby is born. So, if you notice a constant flow, even if it’s a slow trickle, it’s more likely your water has broken. 

Another trick I like to use when generally assessing, is to have mom to put on a clean pad, lie down, and give a couple of really good coughs to see if anything else comes out and further assess in that way. Or even changing position with a clean pad on, like lying down for 15 minutes or so and standing up. If there is a gush of fluid when you stand up, it’s more likely to be amniotic fluid.

At this point too, if it is your water that broke, another important point is that you might see a small amount of blood or mucus in the fluid. This is normal and can be part of what’s known as the 'bloody show'—which is a sign that labor is possibly approaching. Every pregnancy is different, so the experience can vary from one mom to another, but generally that blood show indicates cervical change which would be great if your water broke and labor is starting and your cervix is starting to dilate and thin out to give birth your baby. 

Okay, so now let’s talk about the signs that what is happening is probably urine and not amniotic fluid. Urine typically has a yellow color and a distinct smell, which can help you identify it. One simple assessment that you can do by yourself, is to empty your bladder completely and see if the leaking stops.

If you change your position, like standing up after sitting or lying down, and the leaking stops, it's more likely to have been urine. 

It's important to remember that urinary incontinence is quite common in pregnancy, especially as you get closer to your due date. Your baby is getting bigger and putting a lot of pressure on your bladder, and those pelvic muscles might be a little bit weaker than normal. This would be a good reminder to seek out help from a pelvic floor physical therapist if you’re interested and coming up with a plan so this isn’t regularly happening and reduce any concerns in the postpartum period as well or at least continue addressing them if they are continually a problem. Urinary leakage is very common for women who have had babies before, but it’s not normal and doesn’t have to be something you accept is going to happen for the rest of your life. There are treatment options and pelvic floor therapy is great for this!

And after you consider what I mentioned for either scenario, you might still be unsure if your water has broken or if you just peed yourself, and that’s okay. Calling your provider or going into OB triage to get checked out would be the next step. Your provider would be able to do a test measuring the pH of the fluid, where a strip of paper is used to measure the pH level. Amniotic fluid has a higher pH compared to urine. There is also a ferning test, where a sample of the fluid is looked at under a microscope for a characteristic fern-like pattern. If the fern pattern is seen, that would be a positive result and indicate your water has broken. 

There is also a test called the AmniSure test that is used to detect the presence of amniotic fluid in vaginal discharge. And what I didn’t really mention before, is also that the amount of vaginal discharge can greatly increase during pregnancy, especially near the end, so normal clear vaginal discharge can sometimes be confused as someone’s water breaking, it’s very individualized.

But what happens with this test is your provider, or you can request to do the test yourself if you’re more comfortable, will insert a sterile swab into the vagina for about one minute to absorb the fluid. The swab is placed into a tube and a strip, similar to a pregnancy test strip, is used to test the sample. If the test shows two lines, it is positive and suggests amniotic fluid is present and your water has likely broken. Where a single line is negative.

This test is very simple to do and accurate and also the results are received very quickly in the clinic setting. All benefits to help you and your provider make informed decisions about your care and get more information about what is going on.

So let’s say you get a positive result and your water is officially broken. What should you expect next? I don’t want for anyone’s initial reaction to be to panic and rush into the hospital right away, or even if you’re there and getting checked out in OB triage,, you are not required to stay there either if you’re not ready to be. It’s case-by-case if that would be recommended, but confirming your water is broken and given everything else is going well, you can go back home with that extra information and have a plan on when to return, but labor at home if you want.

The first thing to do is to stay calm. It’s natural to feel a rush of emotions, maybe some anxiety and fear, hopefully also some excitement and relief that you are finally going to be meeting your baby after all this time. But taking a deep breath, staying focused, and trusting your preparation and the process that you are ready for this experience will help you handle the situation more effectively.

This would be a time to avoid inserting anything into your vagina, also being aware that every cervical check has the potential to introduce bacteria into the area and also irritate the cervix, so being mindful of that is important. Also avoid using a tampon or having intercourse as this can also increase the risk of infection.

It would also be helpful to make a few mental notes when your water broke, remembering the acronym TACO. And this stands for the time your water broke, the amount of fluid there was, the color, and if there was an odor or not. Color is especially an important one because amniotic fluid is usually clear or pale yellow, so if you notice the fluid is green or brown or even flecks of brown, anything like that could mean that your baby pooped inside of you and that would be considered meconium stained fluid. This is more common with mom’s that have longer pregnancies past their guess dates and could be more serious indicating fetal distress or suggest that baby might need closer monitoring.

Also, it’s important to know that after your water breaks, labor may start right away, or it might not at all. For many women, contractions begin within 12 to 24 hours after the water is broken, but the plan for safety of how long to wait for contractions to begin is individualized. But having a plan for this as well is important, because I recently had someone reach out to me that their provider said they would have to be given pitocin to speed labor up if their water was broken for greater than 6 hours. I don’t know of any research to support this is a low-risk mom and baby, so very well was probably the rushing along of birth that is so commonly seen in the hospital. So know that you do have time to wait it out usually after your water breaks before intervening. 

By the 24 hour mark, if contractions haven’t started, often times providers will want to discuss options to induce labor because the longer your water is broken, the higher the risk of infection for both you and your baby. Like I said, all providers have different guidelines they practice by and some are willing to wait longer than others. So know your options, communicate with your provider, and at the end of the day if you want to wait and ask for more time, that is your choice to make as long as you are aware of potential risks for your situation. 

Like I said before, there may be other considerations such as if there is green or brown amniotic fluid, if you’re bleeding, if you feel unwell and have any signs of infection like a fever, chills, foul-smelling discharge, or if you’re GBS positive and planning to treat with antibiotics, these are all reasons the timeline may change a bit as well. Always being in communication with your provider while also upholding your values and advocating for yourself to have the experience you want, is important. 

Thank you so much for tuning in to Your Birth Bestie podcast today. Please remember that the onset of labor can vary widely, but staying calm, knowing what to look for and when to seek medical attention can help you navigate this stage of pregnancy. I recommend moms to trust their instincts and stay in contact with your healthcare provider. They are there to guide you through the process and help you and baby stay safe. If you have more questions please connect with me on instagram @bethconnors_cnm or on my website at bethconnors.com and I would love to learn what support you are looking for in pregnancy and how I can make this the best possible birth experience. Thank you again for being here and I will be back next week with another episode. Bye everyone!