Can Coughing Cause Your Water to Break? Facts on PROM Risks

Can Coughing Cause Your Water to Break?

It's a common concern for many expectant mothers - can coughing actually lead to your water breaking before your due date? While coughing itself doesn't directly cause your water to break, there are some connections between coughing and premature rupture of membranes (PROM).

What Happens When Your Water Breaks

Your "water" is the amniotic fluid that surrounds your baby in the uterus. This fluid acts as a cushion to protect your baby during pregnancy. When your water breaks, it means the amniotic sac has ruptured and the fluid is leaking out through the vagina. This is also called PROM.

For most women, the water breaks at the start of labor, either with a big gush or a slow trickle. It can happen anytime from early labor up until delivery. Sometimes the sac will break before you go into labor (prelabor rupture of membranes). When this happens before 37 weeks of pregnancy, it is called preterm PROM.

What Causes the Water to Break

The amniotic sac is a tough membrane designed to hold your baby safely inside the uterus. So what causes it to rupture? Here are some of the common causes:

• Natural weakening of the membranes close to your due date
• Changes in hormones and pressure on the uterus when labor begins
• Stretching or changes to the shape of the uterus
• Direct trauma to the abdomen
• Infection inside the uterus (chorioamnionitis)
• Defects or weak spots in the sac
• Too much amniotic fluid (polyhydramnios)

When the sac ruptures before labor begins, it is often related to infection or weakness in the amniotic membranes. Sometimes the cause is unknown.

Can Coughing Break Your Water?

Coughing itself does not directly cause PROM. However, coughing can lead to added pressure and straining that may contribute to the rupture of membranes in some cases. Here's how coughing fits into the picture:

Coughing and Pressure Changes

When you cough, it leads to a sudden increase in abdominal pressure and contraction of the muscles. This can put stress on the uterus. In some cases, this added pressure from intense or prolonged coughing spells may be enough to cause the amniotic sac to rupture.

Coughing and Infections

Coughing is most often caused by respiratory infections like colds and flu. Pregnant women are at greater risk of developing infections due to changes in their immune systems.

Some of these maternal infections can spread to the amniotic fluid and membranes, causing chorioamnionitis. This inflammation weakens the amniotic sac and makes PROM more likely. Studies show respiratory and genitourinary infections increase the risks for preterm PROM.

Coughing and Irritation

Forceful coughing can also cause direct irritation to the cervix. Some research suggests this can potentially release prostaglandins and lead to changes in the cervix that may contribute to PROM.

So while coughing alone won't directly cause your water to break, frequent coughing spells may indirectly increase risks in some pregnancies based on these effects.

When to Be Concerned About Coughing and PROM

For most healthy pregnancies, occasional coughing is not a major concern regarding PROM. However, you should contact your doctor right away if you have any of the following:

• A sudden gush or trickle of fluid from the vagina
• An increase in mucus or discharge
• Abdominal cramping or pain
• Pressure in the pelvis or low abdomen
• Bleeding or spotting
• Fever, chills, or other signs of infection
• More than 4-6 hours of persistent coughing

Notify your doctor immediately if you notice your water breaks, so the timing and amount of fluid can be assessed. Preterm PROM may require interventions to avoid preterm birth and complications.

You should also let your doctor know about any persistent coughing spells, especially if due to a contagious respiratory infection. Your doctor can evaluate and treat any underlying illness and monitor you more closely for PROM.

Other Risk Factors for PROM

Along with coughing, some other issues that increase risks for PROM include:

• Smoking, drug use
• Carrying multiples like twins
• History of preterm births or PROM
• Structural problems with the uterus or amniotic sac
• Too much amniotic fluid
• Bleeding in early pregnancy
• Nutritional deficiencies
• High blood pressure, preeclampsia

Make sure your doctor is aware of any of these risk factors so they can monitor you closely for potential early rupture of membranes.

When to Call the Doctor

Notify your healthcare provider any time you experience symptoms of PROM, including:

• Leaking fluid or uncontrolled loss of fluid from the vagina
• Menstrual-like cramps in your lower abdomen
• Pelvic pressure, like the baby is pushing down
• Low, dull backache
• Wetness or bleeding in your underwear
• Change in the color or smell of your vaginal discharge

Even if you are unsure your water is leaking, it's better to call. Your doctor can examine you and test the fluid to determine if your membranes have ruptured.

Preventing PROM

While you can't always prevent PROM, you can lower your risks by:

• Getting early prenatal care
• Eating healthy foods and taking your vitamins
• Staying hydrated
• Reporting any symptoms of infection right away
• Getting rest and avoiding physically strenuous activity
• Stop smoking, using drugs, or drinking alcohol
• Treating underlying health conditions like diabetes or high blood pressure

Your doctor may recommend additional steps like avoiding sexual intercourse if you have risks for preterm labor or PROM.

What to Do if Your Water Breaks

If you suspect your water has broken:

1. Put on a pad to absorb the fluid
2. Note the time, amount, and color of the fluid leakage
3. Avoid using tampons, douching, or having intercourse
4. Contact your healthcare provider right away
5. Go to the hospital if you were advised or if you have any warning signs

Your doctor will confirm whether your water broke and check for any complications. You may be given medications to induce labor if it doesn't start within a certain timeframe after PROM. Delivery is recommended once PROM occurs near term.

Preterm PROM

If your water breaks before 37 weeks of pregnancy, you have preterm PROM. Warning signs include:

• Bright pink or bloody fluid leakage
• Fever, chills, nausea
• Severe abdominal pain
• Foul-smelling vaginal discharge
• Uterine contractions

Preterm PROM can lead to serious complications, so prompt evaluation and treatment is important. You will likely be hospitalized so your baby's condition can be monitored and labor induced if needed.

PROM Close to Your Due Date

When membranes rupture near term at 37 weeks or later, it is usually safe to take a more conservative approach. Inducing labor is often recommended within 24-48 hours to reduce infection risks.

You can likely remain home in the meantime while waiting for labor as long as you don't have any warning signs. Your doctor will closely monitor you and the baby and schedule induction or cesarean delivery if labor doesn't start on its own.

Recovering From PROM

If your water breaks long before your due date, you may need to spend time in the hospital before delivery. Make your hospital room as comfortable as possible and rest as much as you can.

Your doctor will prescribe antibiotics to reduce risks of maternal infection after PROM. Limiting exams and avoiding sexual activity can also lower infection risks before birth.

Make sure to watch for any warning signs of problems, like changes in fetal movements, uterine pain or cramping, bleeding, fever, or foul vaginal discharge. Report any concerns immediately.

In most cases, women recover well after PROM and go on to have normal deliveries. However, there are some potential complications to be aware of:

• Infection - Chorioamnionitis after PROM can cause serious complications for mom and baby. IV antibiotics and early delivery are used to treat infections.
• Fetal distress - Loss of cushioning fluid can lead to umbilical cord compression and changes in the baby's heart rate.
• Preterm birth - Early PROM often results in preterm delivery, which raises risks for developmental issues.
• Prolapsed cord - When fluid is gone, the umbilical cord may descend and get pinched by the baby's head.
• Stillbirth - Preterm PROM is associated with slightly higher risks of stillbirth.

Make sure you understand these potential complications and get medical care immediately if you have any concerning symptoms.

When to Call the Doctor After PROM

Notify your healthcare provider if you have any of the following in the days or weeks after PROM:

• Fever over 100.4F (38C)
• Foul-smelling or yellow/green vaginal discharge
• Heavy vaginal bleeding
• Severe pain or cramping
• Decreased fetal movement
• Contractions that don't ease up with hydration and rest
• Sudden leaking or gushing of fluid if it has slowed/stopped
• Strong urge to push or bear down during contractions
• Cord prolapse (cord exits vagina before baby)

Prompt medical care is needed if you have any signs of infection, placental abruption, umbilical cord issues, or fetal distress. Don't wait until your next scheduled appointment if you have any concerns.

Coping With PROM

Having your water break too early can be worrying and frustrating. Here are some tips for coping physically and emotionally after PROM:

• Communicate with your healthcare team about any concerns.
• Ask your doctor how much activity is safe and about warning signs to watch for.
• Drink plenty of fluids to stay hydrated.
• Get as much rest as possible and avoid physically demanding tasks.
• Wash hands frequently and avoid sick contacts to reduce infection risks.
• Wear a pad and change it often to keep the perineal area clean and dry.
• Shower daily and avoid tub bathing or swimming.
• Limit vaginal exams, ultrasounds, and sexual activity.
• Find relaxing activities like reading, listening to music, or guided imagery.
• Talk with other moms who've experienced early PROM.
• Join a support group to connect with others facing similar challenges.
• Confide in loved ones about your feelings and ask for help.
• Focus on your baby's movements and milestones.
• Practice mindfulness techniques to lower stress.

Getting the right care and support can help you cope physically and emotionally until it is time to deliver your baby.

When to Go to The Hospital

You should go directly to the hospital or call 911 if you have any of the following after your water breaks:

• Bleeding from the vagina
• Prolapsed umbilical cord
• Severe pain or cramping
• Fever over 100.4F (38C)
• Foul vaginal odor
• Difficulty breathing
• Decreased fetal movement
• Contractions coming less than every 5 minutes

Delaying medical care with these urgent warning signs can jeopardize the health of you and your baby. Always err on the side of caution and go in or call 911 if you have any major concerns.

You should also go to your scheduled hospital check-ups after PROM and follow your doctor's advice about when to go to the hospital either for induction or labor support.

Questions For Your Doctor

If you experience PROM, make sure to ask your healthcare provider:

• What tests will be done to check my health and the baby's?
• How much amniotic fluid is left?
• What signs or symptoms should I watch for?
• What activities are safe for me now?
• Do I need bed rest or activity limitations?
• What treatments or interventions do you recommend?
• When do you advise coming to the hospital and having labor induced?
• If I don't go into labor by my due date, what happens?
• How often will you monitor me and the baby?
• What delivery plans or options do I have?

Don't hesitate to reach out to your healthcare provider if you have any other questions or concerns. Planning ahead and staying informed can help you have the best possible outcome after PROM.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.