Why your water may break early

She had taken four years before conceiving her third child. Ritah Namukwaya, a businesswoman, got her water breaking prematurely and was in labour for four days.
“When I conceived, I was always in and out of hospital most of the time. At eight months, my waters broke. I was very scared because I still had another month to go. I was rushed to a nearby hospital and started experiencing labour pains that were not frequent,” she recalls.
After a while, the pain subsided but the doctor disclosed that cervix was open. She was then given an oxytocin injection to induce labour but it did not help. This was the second day. She was then taken to a referral hospital where the doctor told her to wait but the water continued leaking.
Namukwaya says: “I did not know what to do. I got another set of labour pains and when the doctor checked, the baby still had a long way to go. I delivered my first two babies normally and did not experience any complications. I declined to the doctor’s advice that I should go for a cesarean birth.”
When she was about to give in to c-section birth, she gave birth to a baby girl although it was weak.

What happens?
The amniotic fluid forms 12 days after conception and is generated from the mother’s plasma. The baby starts feeding on it in the fifth month of pregnancy and its volume can be increased by drinking more water.
According to Dr Junior Ndozire, a gynaecologist at Mildmay Uganda, the water should sustain the foetus until the time of delivery adding that it contributes to the maturity of the foetus’ lungs and the digestive system.

A sign of delivery
Dr Ndozire says: “At the time of delivery, there is a leaking of a watery fluid from the vagina commonly referred to as breaking the water. When the waters of a pregnant woman break, it is a sign that she is at term and ready to deliver the baby. It is as a result of the natural weakening of the membrane or the force of contractions.”
He says there are several reasons why women get premature rupture of the membrane that contains amniotic fluid. “Infection of the uterus is the leading cause of the preterm rupture. Other factors include change of the baby’s position, especially if the legs go down first, trauma- in case the pregnant woman falls on her tummy, sexually transmitted infections such as gonorrhea and chlamydia and smoking. All these cause a mother’s water to break before the actual delivery time,” he says.
He also adds that women who have a history of low birth weight babies, having preeclampsia, previous preterm birth are also susceptible to having a premature rupture of the membrane.

Complications
Premature rupture of the membrane should be a concern. This is the reason why it is recommended that a woman seeks medical attention as soon as they notice water breaking.
Dr Ndozire says, “If the woman is not delivered of the baby immediately, there is a risk of accidental compressing of the umbilical cord by either the mother or the foetus itself.
At the compression of the cord, the nutrient supply for the baby is cut off, which increases the risk of a still birth.”
He also adds: “The placental can also detach from the uterus which can result into a premature birth. Babies born prematurely usually do not have fully developed lungs and in cases where the amniotic fluid broke before term, the situation usually gets worse.”
A complicated labour calls for caesarean birth. She is also likely to develop an infection that puts both the mother and baby at risk before and after birth.