The term “water breaking” refers to the Rupture of Membranes (ROM), which occurs when the amniotic sac tears, allowing amniotic fluid to leak from the vagina. This event typically signals the start of labor or happens during labor. For a healthy pregnancy, the physical strain from common actions like coughing, sneezing, or laughing is unlikely to cause the membranes to rupture spontaneously, despite the noticeable internal pressure these movements create.
Coughing and Internal Pressure
Coughing and sneezing generate a sudden increase in intra-abdominal pressure, a normal force the pregnant body is designed to absorb. The abdominal muscles contract sharply, pushing down onto the uterus and pelvic structures.
A healthy body mitigates this downward force using several mechanisms. The pelvic floor muscles provide a strong, hammock-like support system that counters acute pressure changes. The robust uterine muscles contain the pregnancy, directing the force away from the lower pole of the sac near the cervix.
What is often mistaken for water breaking during a cough is the involuntary leakage of urine, known as stress urinary incontinence. The pressure from the cough temporarily overcomes the strength of the bladder sphincter, causing a small trickle of fluid. This leakage is solely a function of bladder pressure, not membrane integrity.
The Strength of the Amniotic Sac
The fluid-filled sac protecting the baby is a tough, multi-layered structure composed of two main membranes: the inner amnion and the outer chorion. The amnion provides mechanical strength, consisting of dense collagen fibrils that give the sac its significant tensile strength.
This membrane is designed to withstand continuous pressure changes throughout pregnancy, including fetal movement and the growing weight of the uterus. The amniotic fluid acts as a hydrostatic cushion, distributing internal or external pressure evenly across the sac’s surface. This fluid dynamic prevents localized stress points from forming tears, which would be necessary for a sudden rupture.
Medical Factors That Cause Water to Break Early
While coughing is not a direct cause, the amniotic sac can rupture prematurely due to underlying medical conditions. This state is known as Premature Rupture of Membranes (PROM), or Preterm PROM (PPROM) if it occurs before 37 weeks.
The most common risk factor is infection, particularly ascending infections or intra-amniotic infection (chorioamnionitis). These infections introduce enzymes that weaken the collagen structure of the membranes, compromising their integrity.
Structural issues involving the uterus also play a role in early rupture. Excessive uterine stretch, such as from polyhydramnios or multiple gestation, increases tension on the sac walls. Cervical complications, like a shortened cervix or cervical insufficiency, expose the membranes to increased pressure and mechanical stress. Associated factors include a history of previous PROM, tobacco use, and vaginal bleeding during pregnancy.
What to Do If Your Water Breaks
If you suspect your water has broken, contact your healthcare provider or maternity unit immediately. They will determine whether the fluid is amniotic fluid, urine, or discharge. To aid this assessment, place a clean pad, not a tampon, to collect the fluid for inspection.
Note the fluid’s color and odor. Amniotic fluid is typically clear or pale yellow and has a mild, slightly sweet scent, unlike urine. If the fluid is green, brown, or has a foul odor, it may indicate a complication, and you must inform your provider immediately. If rupture occurs before 37 weeks, head to the hospital right away, as this is considered PPROM and requires prompt medical attention.