PPROM = Preterm Premature Rupture of Membranes (AKA your water breaking earlier than 37 weeks pregnant).

I was sitting on the couch with my fiancé, and we were about to watch an episode of Game of Thrones (we crushed the entire series during the pandemic). We had just finished a 2 hour online Postpartum Care class. I was indulging in my favourite Häagen-Dazs ice cream, chocolate peanut butter. Overall, it was a typical evening in my third trimester!

Except, when all of a sudden, I felt a really warm gush of fluid coming from down there. I got up and looked at the couch, and there was a small puddle of clear fluid where I had been sitting. As soon as I stood up, more liquid began dripping out of me. I looked at my fiancé in pure shock and horror and he already knew what I was about to say – “I think my water just broke!”

You see this in the movies and you hear about women having to go to the hospital early, but you never think it will happen to you. I was only 35 weeks and 5 days pregnant. I hadn’t even packed my hospital bag yet (I 100% should have had this done already, I don’t know why I put it off). Needless to say, I was not prepared for this moment!

The first thing we did – after panicking for a few minutes – was call Labour and Delivery at the hospital I would be delivering at. They answered promptly and instructed us to come in to check if my water had broken. We grabbed a few things and were on our way. At this point my fiancé and I thought we were having a baby that night!

When we arrived at the hospital, there was zero sense of urgency on behalf of the staff, and I eventually realized it was because my situation was not urgent. It just felt urgent to me because it was all so new and crazy!

The first thing they did was check if in fact my water had broken. Apparently, many women come in thinking their membranes have ruptured to discover it had only been urine. Somehow, I instinctually knew this was not the case. I am very in tune with my body and this felt really different.

Over the next hour, they took a swab, did a cervical exam, checked if I was dilated at all, and attached external monitors to my belly to make sure baby was okay. It was finally confirmed that my water had broken. I felt nervous, scared, excited, and overwhelmed all at the same time. This wasn’t part of the plan!! I was under the impression that once your water breaks, baby is coming. That’s what the movies make it seem like at least. Boy was I wrong.

An on call doctor finally came to see me with some options for us to consider. Unfortunately, she wasn’t all that informative and she kind of rushed through things. We ended up doing a bit of our own research after we spoke to her because we felt like we needed to. A very kind nurse named Linda also explained things in more detail, and essentially “told us without telling us” what she thought we should do. Since I was not yet 37 weeks, my baby was not considered full term, so there was a lot to consider.

Here were the options given to us:

-Be induced then and there, in an effort to avoid an infection which could lead to complications (once your water breaks, your body is susceptible to infection).

-Start on penicillin IV and take antibiotics for up to 10 days to prevent infection, while waiting for labour to start naturally. Stay in hospital until labour occurs.

-Plan to be induced at 37 weeks if labour does not begin naturally; antibiotics can’t be continued past this time (10 days was the max recommended) so risk of infection outweighs the benefit of keeping baby in the womb.

Nurse Linda explained that keeping the baby inside me even just one extra day closer to terms is so much better for the baby. So, we decided with option 2 and 3 if necessary. I was transferred to a private room a couple of hours later (I was so exhausted, by this point it was already around 2am). Carlo couldn’t stay with me so he went home to grab a few things for me and brought them back, and we said goodbye for that night! It was pretty emotional because we hadn’t spent a night apart basically our entire relationship. Not to mention I was scared and this was a huge thing that had just happened! I had no idea what was going to happen and I kept picturing labour starting any minute, and I never thought I would be alone for that. In the end, that’s not what happened, but I was still nervous!

Over the next few days, I was extremely uncomfortable. Being in a hospital 24/7 (with limited visiting hours because of COVID) is extremely boring and depressing. I was attached to an IV for penicillin, which actually burned going in. It made it super difficult to get a proper sleep. I also had to take antibiotics every 6 hours so I was woken up for that when it was time. Plus being attached to monitors throughout the day, and having vitals checked at any given time, was pretty annoying. The absolute worst part though, was leaking amniotic fluid the entire time. Again, another pregnancy thing you don’t really know about until you experience it. Your body naturally replenishes amniotic fluid, so it doesn’t stop leaking once your water breaks. I had to wear huge pads and even double them up to absorb all the liquid. I honestly had to change these pads pretty much every hour. The catch is, it’s a healthy sign and you want there to be consistent clear fluid. So I just had to keep telling myself, it’s good that this is happening. It means the baby is safe and healthy in there. Didn’t make it any less gross or uncomfortable!

After a few days they ended the penicillin drip, and I just continued on the antibiotics. Labour had still not begun and I was getting more anxious and restless by the day. I wasn’t on bedrest thankfully, so I would walk the halls to get some steps in. Carlo came pretty much every day during visiting hours. He was still working so he would bring his laptop and work from the hospital. It was just nice to have him around for company. I felt so alone most of the time.

After three days of staying in my private room (which I had gotten so used to), my doctor notified me they would be transferring me to the Postpartum Unit, because they were running out of space in this wing. Apparently they needed private rooms for COVID positive patients. I understood, but it was a major bummer, as the postpartum rooms were tiny and shared, with a shared bathroom. I took one look at the bathroom and knew I wouldn’t be able to feel comfortable changing my pads frequently in there. It was dirty and if you’ve ever been in postpartum, you know there’s bound to be blood. I felt like it was so ironic – they were trying to prevent an infection yet here I was in a dirty bathroom. It didn’t make sense! It was also super loud as the room was shared, and there were crying babies. Not to be a diva, but I was so stressed and needed rest and relaxation before giving birth. Postpartum should be exclusively for postpartum. It’s a completely different experience in there once you’ve had the baby. Nothing seems to bother you as much because you’re there recovering and you have your beautiful baby with you.

I was so misplaced and I felt very forgotten at this point. I became so anxious and emotional that I knew I had to get myself home. I made an extremely difficult decision to leave, against doctor’s recommendations, because instinctually I knew it was better for my mental health. I had to sign a waiver to leave – not going to lie, it felt very scary. But I had considered all the options and made my decision based on many factors:

⁃ I was not going to get any sleep or proper rest in this area

⁃ I was afraid of getting and infection merely from using this washroom

⁃ We live under 10 minutes driving distance from the hospital

⁃ I knew the signs of labour I was supposed to look out for

⁃ I knew to come back to the hospital immediately if the leaking fluid became discoloured or bloody or had a foul odour

⁃ I was given a prescription to continue the antibiotics until I reached 37 weeks

Considering all of this, I felt like going home was the best decision I could have made. And I was right. I felt so much more comfortable and was able to rest and sleep. I was extremely diligent with checking the fluid, keeping an eye on my temperature in case of fever, doing kick counts, and just being in tune with how I felt overall. I also went to the hospital every couple of days to do a Nonstress Test. Towards the end of my 36th gestational week, we were pretty much going to the hospital every day to get checked on. I really didn’t mind doing it, if it meant I could be at home the rest of the time. (Please note I am not encouraging anyone to leave a hospital against doctor’s orders. Every circumstance is unique and I simply had to make the best decision for myself).

Every day dragged on because essentially the baby could come at any moment. I have to say, that week felt like the longest week of my life! Not to mention, I had friends and family excitedly checking in daily wondering if there were any updates. In the end though, labour never did start naturally. I finished the course of my antibiotics and ended up being induced right at the beginning of my 37th week (on Super Bowl Sunday) – read my birth story for more details!

PPROM is obviously something nobody plans for. In a sense, I was lucky because it happened closer to me being full term. Apparently it can happen very early on and I can only imagine what that would have been like. I really only had to deal with it for a week and a few days.

Here are some things that helped me with PPROM:

⁃ Stay clean, and change pads as often as you need to. Now is not the time to ration. I hated the feeling of leaking so I would change my pads every hour (sometimes more).

⁃ I recommend Kotex or even Poise jumbo pads meant for incontinence. If you can somehow get your hands on hospital pads, those are great too.

⁃ Wear comfy underwear, likely a size bigger to accommodate the pads. Hospital underwear (disposable) are amazing, if you are able to get some.

⁃ Keep moving (unless your doctor tells you not to). I hated sitting in bed, so I would walk as much as possible. I stopped my prenatal workouts and yoga because that would have been too uncomfortable, but walking definitely helped me stay sane.

⁃ Drink a lot of water. It helps replenish your amniotic fluid and is good for the baby. It does make you leak more but it’s just one of those things you have to deal with for the benefit of the baby.

⁃ No baths! Only showers. (Unless doctor tells you otherwise).

⁃ Relax! Catch up on some reading, watch TV and enjoy the moment. Read some trashy magazines. Things you won’t have time for when baby is here!

If you are dealing with PPROM I wish you a safe, healthy, and comfortable journey with the rest of your pregnancy.

Maya