“My Waters Have Broken, But I’m Not in Labour!”
Understanding Your Options When Labour Doesn’t Start Straight Away
We’ve all seen it in the movies: a sudden gush of water and the mad dash to the hospital. In real life, though, it’s common for your waters to break before labour begins. This is known as pre-labour rupture of membranes (PROM), and it happens in around 8–10% of full-term pregnancies.
If this happens to you, it can bring up a lot of questions—especially if contractions haven’t started yet. One of the most common recommendations is induction of labour within 24 hours. But it’s important to know: this is a recommendation, not a rule.
Let’s break down what the evidence says, what your options are, and how to make a choice that feels right for you.
💧 What Is PROM?
PROM stands for pre-labour rupture of membranes—when the amniotic sac breaks before labour begins, usually after 37 weeks. You might experience a trickle or a gush of fluid. Sometimes it's unmistakable, and other times it’s more subtle.
Once waters have released, the barrier between your baby and the outside world is thinner, which slightly increases the risk of infection over time. This is why many clinicians recommend induction of labour around 24 hours after PROM.
But it’s essential to remember: you always have the right to decline or delay induction, and to request ongoing monitoring and support while awaiting labour naturally.
📚 What Does the Evidence Say?
One of the most well-known studies on PROM is the TERMPROM trial (Hannah et al., 1996), which explored outcomes between people who were induced versus those who waited for labour to start on its own.
Key findings include:
Around 80% of people went into labour spontaneously within 24 hours.
Induction slightly reduced the risk of maternal infection (2% vs 4%).
No increase in caesarean rates between induction and expectant management.
No significant difference in newborn outcomes (such as NICU admissions).
So while induction can slightly lower the chance of infection, it doesn’t guarantee a better outcome—and many people may prefer to wait for labour to begin on its own.
💛 What Are Your Options?
When your waters release before labour begins, you can choose from:
✨ 1. Expectant Management (Waiting)
You may choose to give your body time to go into labour naturally—especially in the first 24–72 hours. This might include:
Staying home and observing
Keeping vaginal exams to a minimum
Monitoring your temperature and baby’s movements
Staying hydrated and well-rested Some people choose home monitoring or opt for regular check-ins to assess baby’s wellbeing while they wait.
⚡ 2. Induction of Labour
You can also choose to begin induction straight away. This might include:
A pessary, gel, or balloon catheter to soften the cervix
Artificial rupture of membranes (if not already complete)
Synthetic oxytocin (Syntocinon) to start contractions
Each method has its pros and cons, and you can explore them in depth with your midwife or birth support team.
🧾 Questions You Can Ask
What are the actual benefits and risks of waiting in my specific situation?
Can I have regular monitoring and support while waiting?
What signs should I look out for that mean labour or infection may be starting?
How can we keep things safe and low-intervention while we wait?
📊 Risk Is Not the Same as Emergency
One of the most important things to remember is that being given a recommendation doesn’t mean you are required to follow it. Risk is about probability—not certainty. And decisions about your care are always yours to make.
You cannot be “made” to be induced, and you don’t need permission to wait. You can request monitoring, discuss your personal circumstances, and take your time to decide.
🧘♀️ If You’re Choosing to Wait…
While waiting, it’s helpful to monitor:
Your temperature
Baby’s movements
Colour and smell of vaginal fluid (it should stay clear or pinkish, not green or foul-smelling)
If anything changes or you’re unsure, you can always seek advice—but you’re also allowed to wait with confidence, trust in your body, and continue to explore your options.
🪄 You Are the Decision-Maker
The phrase “the hospital won’t allow it” doesn’t apply to your body. You always have the right to decline, delay, or request alternatives to any suggested treatment—including induction. Your care team is there to support you, inform you, and walk with you—not to override your decisions.
Want support navigating PROM, induction, or birth planning with confidence?
We offer compassionate, evidence-based guidance to help you make decisions that feel right in your heart and grounded in good information. You deserve a birth experience that’s not only safe—but yours. 💛
References
NICE Guideline NG207: Inducing labour (2021)
Hannah ME et al. “Induction of labor compared with expectant management for prelabor rupture of the membranes at term.” NEJM, 1996;334(16):1005–10.
Royal College of Obstetricians and Gynaecologists: When Your Waters Break Early – Patient Information