The effect of childbirth no-one talks about (2022)

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The effect of childbirth no-one talks about

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The effect of childbirth no-one talks about (1)

By Sarah Griffiths24th April 2019

Giving birth can be one of the most painful experiences in a woman’s life, yet the long-term effects that trauma can have on millions of new mothers are still largely ignored.

It’s 03:00. My pillow is soaked with cold sweat, my body tense and shaking after waking from the same nightmare that haunts me every night. I know I’m safe in bed – that’s a fact. My life is no longer at risk, but I can’t stop replaying the terrifying scene that replayed in my head as I slept, so I remain alert, listening for any sound in the dark.

This is one of the ways I experience post-traumatic stress disorder (PTSD).

PTSD is an anxiety disorder caused by very stressful, frightening or distressing events, which are often relived through flashbacks and nightmares. The condition, formerly known as “shellshock”, first came to prominence when men returned from the trenches of World War One having witnessed unimaginable horrors. More than 100 years after the guns of that conflict fell silent, PTSD is still predominantly associated with war and as something largely experienced by men.

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But millions of women worldwide develop PTSD not only from fighting on a foreign battlefield – but also from struggling to give birth, as I did. And the symptoms tend to be similar for people no matter the trauma they experienced.

The effect of childbirth no-one talks about (3)

A traumatic delivery can be one of the causes that lead women to develop PTSD after they have given birth (Credit: Getty)

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“Women with trauma may feel fear, helplessness or horror about their experience and suffer recurrent, overwhelming memories, flashbacks, thoughts and nightmares about the birth, feel distressed, anxious or panicky when exposed to things which remind them of the event, and avoid anything that reminds them of the trauma, which can include talking about it," says Patrick O’Brien, a maternal mental health expert at University College Hospital and spokesman for the Royal College of Obstetricians and Gynaecologists in the UK.

Despite these potentially debilitating effects, postnatal PTSD was only formally recognised in the 1990s when the American Psychiatry Association changed its description of what constitutes a traumatic event. The association originally considered PTSD to be “something outside the range of usual human experience”, but then changed the definition to include an event where a person “witnessed or confronted serious physical threat or injury to themselves or others and in which the person responded with feelings of fear, helplessness or horror”.

This effectively implied that before this change, childbirth was deemed too common to be highly traumatic – despite the life-changing injuries, and sometimes deaths, women can suffer as they bring children into the world. According to the World Health Organization, 803 women die from complications related to pregnancy and childbirth every day.

Regardless of the statistics, for the women who go through these experiences, there can be a long-lasting impact on their lives

There are few official figures for how many women suffer from postnatal PTSD, and because of the continued lack of recognition of the condition in mothers, it is difficult to say how common the condition really is. Some studies that have attempted to quantify the problem estimate that 4% of births lead to the condition. One study from 2003 found that around a third of mothers who experience a “traumatic delivery”, defined as involving complications, the use of instruments to assist delivery or near death, go on to develop PTSD.

With 130 million babies born around the world every year, that means that a staggering number of women may be trying to cope with the disorder with little or no recognition.

And postnatal PTSD might not only be a problem for mothers. Some research has found evidence that fathers can suffer it too after witnessing their partner go through a traumatic birth.

Regardless of the exact numbers, for those who go through these experiences, there can be a long-lasting impact on their lives. And the symptoms manifest themselves in many different ways.

"I regularly get vivid images of the birth in my head,” says Leonnie Downes, a mother from Lancashire, UK, who developed PTSD after fearing she was going to die when she developed sepsis in labour. “I constantly feel under threat, like I'm in a heightened awareness.”

Lucy Webber, another woman who developed PTSD after giving birth to her son in 2016, says she developed obsessive behaviours and become extremely anxious. “I’m not able to let my baby out of my sight or let anyone touch him,” she says. “I have intrusive thought of bad things happening to all my loved ones.”

The effect of childbirth no-one talks about (4)

Nightmares that cause women to relive the fear, pain and helplessness they felt during childbirth are a common symptom of postnatal PTSD (Credit: Getty)

Not all women who have difficult births will develop postnatal PTSD. According to Elizabeth Ford of Queen Mary University of London and Susan Ayers of the University of Sussex, it has a lot to do with a woman’s perception of what they went through.

"Women who feel lack of control during birth or who have poor care and support are more at risk of developing PTSD,” the researchers write.

The stories from women who have developed PTSD after giving birth seem to reflect this.

Women who feel lack of control during birth or who have poor care and support are more at risk of developing PTSD

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Stephanie, whose name has been changed to protect her identity, says she was poorly cared for during labour and midwives displayed a lack of empathy and compassion. A particularly difficult labour saw her being physically held down by staff as her son was delivered. “He was born completely blue and taken away to be resuscitated and I was given no information on his condition for hours.”

Emma Svanberg, a chartered clinical psychologist who is involved in the Make Births Better Campaign, says this is a common theme from the women she hears from.

“The factor which we hear about time and time again is lack of kindness and compassion from staff,” she says.

A study by researcher Jennifer Patterson, at Napier University in Edinburgh, suggests that while midwives are often aware that giving birth can be traumatic for women, they are often so busy they struggle to offer adequate support and information to mothers who may be at risk of PTSD.

The effect of childbirth no-one talks about (5)

Giving busy nursing and midwifery staff more time to care for mothers who have been through a traumatic birth could help to prevent PTSD (Credit: Getty)

Certain groups of women are also more likely to develop postnatal PTSD even before they give birth.

“For women who have a history of prior trauma – perhaps victims of sexual abuse in childhood, those who have previously had PTSD, or depression or anxiety – the risk of developing PTSD is significantly higher. They’re five times more likely,” says Rebecca Moore, a perinatal psychiatrist working for the NHS in East London.

Postnatal processing

The challenge of PTSD resides in the brain. Usually, memories are filed away in the brain’s hippocampus. But if an experience is traumatic, the mind goes into fight-or-flight mode and the part of the brain associated with fear, the amygdala, switches on. This causes memories to become stuck in this primitive part of the brain rather than being safely filed away.

It also means that when something reminds a mother of her experience – such as seeing birth depicted on TV or being in a hospital – the traumatic memories feel less like memories and more like the woman is still in imminent danger, triggering physical reactions like panic attacks or flashbacks.

This broken filing system means “you get a kind of looping of the memory in the mind all the time”, Moore explains.

It may cause structural changes in the brain too. Researchers at the University of California studied the brains of 89 current or former members of the military with PTSD using brain scans to measure the volume of various parts of the brain. It showed that the right amygdala in the brains of military-trained individuals with PTSD were 6% larger than their peers. The right-hand part of the amygdala is particularly associated with controlling fear and aversion to unpleasant stimuli.

“We wonder if amygdala size could be used to screen who is most at risk to develop PTSD symptoms after a mild traumatic brain injury,” says Joel Pieper of University of California, San Diego, who was one of those who led the study.

The effect of childbirth no-one talks about (6)

Millions of women may suffer from postnatal PTSD every year, but stigma surrounding the condition may lead many to try to hide how they are feeling (Credit: Getty)

Whether similar changes occur in the brains of women with postnatal PTSD is not yet known, but it could offer a way of diagnosing those who are affected. The complex mixture of symptoms experienced by women with PTSD after birth can often lead to delays and even misdiagnosis.

Another issue standing in the way of diagnosis is the stigma attached to the condition. Some women feel uncomfortable speaking openly about it for fear of being seen as a failure as a mother, or of seeming ungrateful for their baby.

Svanberg believes birth trauma is a feminist issue. “There is a huge body of research on the disbelief of women's pain, especially marginalised women, and often women's voices are silenced,” she says. Many experts agree that women are simply not listened to or given the information they need to make the best decisions for themselves and their family. (Read more about how women’s pain is more likely to be dismissed than men’s).

“Giving women the facts about different modes of delivery while they are pregnant isn’t scary, it’s empowering,” adds Moore. “Women are capable of making up their own minds, but rarely are they properly informed about risks and treatment when it comes to birth.”

She believes the problem is more of a societal one. “Women are often treated like princesses when they are pregnant, but once the baby is born, it’s all about the baby,” she says. “It’s not uncommon for new mothers suffering with mental illness to hear ‘You’ve got a healthy baby, why are you complaining?’ And it’s then even more difficult for women to pluck up the courage to ask for help.”

It’s thought that half of women with perinatal mental health problems won’t be treated.

“There’s still shame in seeking help and women struggling often fear they will be judged and criticised,” says Moore.

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The effect of childbirth no-one talks about (7)

Postnatal PTSD can led sufferers to push away their partner at the time they needed them most (Credit: Getty)

Attempting to keep her condition hidden in this way started to harm Stephanie’s relationships with her husband and her older daughter. Her own PTSD manifested as hyper-vigilance, leaving her in a permanent and exhausting state of being alert and expecting the worst.

“I knew I wasn't OK but kept it hidden for months,” says Stephanie. “I wasn't eating or sleeping. I refused to let anyone look after my son. My other children relied on their dad as I was too focused on my baby.

“My relationship suffered with my daughter, who was just two. I lost all my confidence in my parenting ability when I was always calm and went with the flow before. I pushed my husband and family away.”

Nearly all women involved in the research reported initial feelings of rejection towards their baby

A study led by the University of Sussex confirmed women with postnatal PTSD reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for the events surrounding the birth. The mother-baby bond was also seriously affected.

Nearly all women involved in the research reported initial feelings of rejection towards their baby and while this changed over time, the study concluded that childbirth-related PTSD can have “severe and lasting” effects on women and their relationships.

For others, it is their career that suffers.

“PTSD has changed my whole life,” says Leonnie Downes, who used to work for the North West Ambulance Service. “I had a good career, and I've had to leave my job to become self-employed just so I can work from home. My wife has had to leave her job too and has become my registered carer. I'm now registered disabled and for the first time ever, we now have to live off disability benefits.”

The effect of childbirth no-one talks about (8)

Some mothers with postnatal PTSD find themselves struggling with exhuasting levels of hyper-vigilance where they feel they cannot leave their baby unattended (Credit: Getty)

Moore says she regularly meets women who are too traumatised to return to work, including paramedics and midwives.

Lucy Webber is one such midwife. “I quit because I couldn't cope with not being able to give women the support they need,” she explains.

But there is help available for women who are struggling with postnatal PTSD, provided they are able to access it. Treatment typically takes the form of medication or cognitive behavioural therapy (CBT) – a talking therapy designed to change the way someone thinks and behaves. Eye movement desensitisation and reprocessing (EMDR) can also be used, which sometimes involves tapping or music to help a patient’s brain remember they are in the present, not trapped in the moment of their flashback. Research also has shown that transcendental meditation can help war veterans with PTSD.

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Birth trauma is not that difficult to treat, but it is very difficult for women and partners to access appropriate support – Emma Svanberg

“Birth trauma is not that difficult to treat, but it is very difficult for women and partners to access appropriate support,” Svanberg says, warning that many women are misdiagnosed as having post-natal depression (PND) – another debilitating condition that can follow the birth of a child, but one with a different set of symptoms. In the UK, it can be hard to access treatment in some areas on the NHS, while in other countries, including the US, it can be prohibitively expensive.

But many people believe that mitigation is the answer and that better training for midwives and obstetricians could prevent women developing PTSD in the first place.

The effect of childbirth no-one talks about (9)

Wider acceptance of postnatal PTSD could help to ensure future generations of mothers can enjoy their new baby as a blessing (Credit: Getty)

“The whole system contributes to trauma,” Moore says. “Often women are being cared for by frontline staff, who are doing their job but not with much compassion, because they are burnt out.” The Make Births Better campaign focuses on offering training to medical professionals in an attempt to tackle this. Small changes that cost nothing, such as using kind language and less jargon, can make all the difference in stopping women developing physical and mental problems as a result of giving birth.

Most women would agree that giving birth is a defining and transformative event. And with the right support, good can even come from the most traumatic of births.

Lucy Webber says her experience has helped her become a gentler parent and Stephanie has even decided to become a midwife.

Almost two years on, my own life is gradually getting easier, but I approach my daughter’s birthday with a mixture of excitement and trepidation because of the memories and physical reactions it will undoubtedly trigger. She is the best gift I could ever hope for and her birthday will also be a celebration of how far we have come since her arrival.

Besides the little toy guitar we will be giving her, perhaps the best gift I can offer is to play my own small part in challenging the norms of what it is to give birth and be a mother, so birth trauma and postnatal PTSD can be dealt with in the open.

--

This story is part of the Health Gap, a special series about how men and women experience the medical system – and their own health – in starkly different ways. Do you have an experience to share? Or are you just interested in sharing information about women's health and wellbeing? Join our Facebook group Future Woman and be a part of the conversation about the day-to-day issues that affect women’s lives.

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FAQs

What are the negative effects of giving birth? ›

The most common complications women report after giving birth include pain after sex, incontinence, pain at the incision site following a cesarean section, and postpartum depression, Gunter said. Once the baby is born, a woman's blood pressure may spike dangerously. She may hemorrhage or develop egg-sized blood clots.

What is mother's birth trauma? ›

What is birth trauma? 'Birth trauma' is distress experienced by a mother during or after childbirth. While trauma can be physical, it is often emotional and psychological. Birth trauma is not just about what happened during labour and the birth. It can also refer to how you, as the mother, are left feeling afterwards.

Does birth trauma affect personality? ›

Early Trauma and Long-Term Psychological Effects

Psychologists believe children who had difficult births are more likely to be angry, aggressive, and anxious compared to children who had easy births. Babies with birth complications are frequently placed in a NICU (neonatal intensive care unit).

What causes PTSD after giving birth? ›

Approximately 9% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth. Most often, this illness is caused by a real or perceived trauma during delivery or postpartum. These traumas could include: Prolapsed cord.

Can your personality change after having a baby? ›

Many people who have given birth will experience mild mood changes after having a baby, known as the "baby blues". This is normal and usually only lasts for a few days. But postpartum psychosis is very different from the "baby blues". It's a serious mental illness and should be treated as a medical emergency.

Will your body ever be the same after pregnancy? ›

Body shape

During pregnancy, our body changes. Our hips widen, our breasts grow, and we find a little extra weight in places it wasn't before. Over time, our bodies will go back to normal, but it takes just that time.

How many bones are broken during childbirth? ›

There were 35 cases of bone injuries giving an incidence of 1 per 1,000 live births. Clavicle was the commonest bone fractured (45.7%) followed by humerus (20%), femur (14.3%) and depressed skull fracture (11.4%) in the order of frequency.

Can you have PTSD from giving birth? ›

Postnatal post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It is also known as birth trauma. You may develop postnatal PTSD if you experience traumatic events during labour or childbirth.

Do mothers bones break during childbirth? ›

Fractures. Fracture of the clavicle or collarbone is the most common fracture during labor and delivery. The clavicle may break when there is trouble delivering the baby's shoulder or during a breech delivery. A baby with a fractured clavicle rarely moves the arm on the side of the break.

Can trauma as a baby affect you later in life? ›

Are infants too young to experience and remember painful emotions or traumatic events? A growing body of research suggests no, and researchers believe that if left untreated, trauma experienced in infancy can sometimes result in lifelong health consequences.

Do babies remember a traumatic birth? ›

Many people wrongly believe that babies do not notice or remember traumatic events. In fact, anything that affects older children and adults in a family can also affect a baby, but they may not be able to show their reactions directly, as older children can.

What is considered a difficult birth? ›

Birth canal issues can result in prolonged labor or failure for labor to progress. Prolonged labor is when labor lasts longer than 20 hours for a first-time mother and longer than 14 hours for a woman who's given birth before. Nurses and doctors will monitor your baby's progress through the birth canal during labor.

What is psychological birth trauma? ›

Psychological birth trauma, also known as traumatic childbirth, refers to the maternal severe psychological harm caused by the events occurring during labor and birth [3, 4]. Psychological trauma caused by childbirth is a universal phenomenon and has an extensive effect.

What does giving birth feel like? ›

While the experience is different for everyone, labor usually feels like extremely strong menstrual cramps that take your breath away and make you unable to talk. As labor continues and the pain worsens, the pregnant person tunes out stimuli and adopts a tunnel vision, focusing on the labor and getting the baby out.

How do you overcome birth trauma? ›

Recovering from a traumatic birth
  1. Do not judge yourself. ...
  2. Seek practical support. ...
  3. Seek out and accept emotional support. ...
  4. Acknowledge the feelings you may have toward your baby. ...
  5. Talk to someone. ...
  6. Consider the impacts upon your relationship. ...
  7. Try and obtain details of what actually happened. ...
  8. Do not blame yourself.

What happens to women's brains after giving birth? ›

A 2017 study published in Nature Neuroscience found there is a decrease in gray matter in the area of moms' brains that is responsible for social cognition. This shrinkage was still present two years after childbirth, suggesting that having a baby may lead to permanent structural changes in the brain.

When does your life get better after pregnancy? ›

Fully recovering from pregnancy and childbirth can take months. While many women feel mostly recovered by 6-8 weeks, it may take longer than this to feel like yourself again.

Why do husbands change after baby? ›

Physical relationships

The physical side of a relationship can also change dramatically — thanks to exhaustion, dealing with the physical and emotional impact of the birth, and the demands of life with a newborn. It can take time to feel like having sex again after birth (Brotherson, 2007).

Do hips stay wider after childbirth? ›

Your ribs may have expanded, and your hips will often widen to make it easier for the baby to exit the birth canal. For some women wider ribs and hips will be permanent. As your baby grows during pregnancy you will gain weight . This helps to support your baby before and after birth.

Do boobs stay bigger after pregnancy? ›

Some mothers will see their breasts bounce back to their pre-pregnancy appearance, but the majority of women will notice lasting changes. In general, breasts will typically revert to their baseline volume when a mother reaches her pre-pregnancy weight.

Why do I look older after having a baby? ›

Our telomeres shorten and our epigenetic age increases

Given that there is hyper cell production during pregnancy, it makes sense that those telomeres would shorten and, therefore, appear to age dramatically.

What is the pain of giving birth equivalent to? ›

The most common description of the level of pain experienced was extreme menstrual cramps (45 percent), while 16 percent said it was like bad back pain and 15 percent compared it to a broken bone.

Whats the most painful part of labor? ›

Most women find the most painful part of labor and delivery to be the contractions, while some others may feel pushing or post-delivery is most painful. Pain during labor and delivery may also be caused by pressure on the bladder and bowels by the baby's head and the stretching of the birth canal and vagina.

How does birth trauma affect brain development? ›

Trauma-induced changes to the brain can result in varying degrees of cognitive impairment and emotional dysregulation that can lead to a host of problems, including difficulty with attention and focus, learning disabilities, low self-esteem, impaired social skills, and sleep disturbances (Nemeroff, 2016).

Why does it hurt to sneeze after giving birth? ›

Episiotomy. If your perineum (the area of skin between the vagina and the anus) was cut by your doctor or if it was torn during the birth, the stitches may make it painful to sit or walk for a little while during healing. It also can be painful when you cough or sneeze during the healing time.

How can you tell if a female skeleton has given birth? ›

The ligaments connecting the pubic bones must stretch; they can tear and cause bleeding where they attach to bone. Later, bone remodeling at these sites can leave small circular or linear grooves on the inside surface of the pubic bones. These parturition pits show that a female has given birth vaginally.

Will a baby cry if they break a bone? ›

They may cry and not use the affected area, but there may be no obvious injury. If you think your child has a fracture, they may have the following symptoms: pain or tenderness at the injury site. swelling or redness around the injury.

How does unresolved childhood trauma manifest in adults? ›

Other manifestations of childhood trauma in adulthood include difficulties with social interaction, multiple health problems, low self-esteem and a lack of direction. Adults with unresolved childhood trauma are more prone to post-traumatic stress disorder (PTSD), suicide and self-harm.

What are the signs of childhood trauma? ›

Traumatic experiences can initiate strong emotions and physical reactions that can persist long after the event. Children may feel terror, helplessness, or fear, as well as physiological reactions such as heart pounding, vomiting, or loss of bowel or bladder control.

Can anyone remember being born? ›

It is generally accepted that no-one can recall their birth. Most people generally do not remember anything before the age of three, although some theorists (e.g. Usher and Neisser, 1993) argue that adults can remember important events - such as the birth of a sibling - when they occurred as early as the age of two.

Can yelling hurt my newborn? ›

“Infants are fairly resilient, but we are concerned about harm when yelling out of anger around an infant or towards an infant happens at a significant level of intensity or commonly in the home,” says Horvitz. “This will likely increase infant anxiety, which overtime may have an impact similar to trauma.”

Are babies in pain when they are born? ›

The results confirm that yes, babies do indeed feel pain, and that they process it similarly to adults. Until as recently as the 1980s, researchers assumed newborns did not have fully developed pain receptors, and believed that any responses babies had to pokes or pricks were merely muscular reactions.

How long is too long labor? ›

Prolonged labor, also known as failure to progress, occurs when labor lasts for approximately 20 hours or more if you are a first-time mother, and 14 hours or more if you have previously given birth.

Can you go into shock during labor? ›

Maternal shock is something that happens to expectant mothers during pregnancy, labor and delivery or up to six weeks after a child is born due to complications. It can be fatal, but is thought to be highly preventable as signs and symptoms often foreshadow serious risks, allowing for proper treatment.

How long after 10cm do you give birth? ›

Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. In a 1st labour, the time from the start of established labour to being fully dilated is usually 8 to 12 hours. It's often quicker (around 5 hours), in a 2nd or 3rd pregnancy.

Does childbirth leave permanent damage? ›

In up to half of all women who give birth vaginally, there are permanent changes to the pelvic floor due to over-stretching or tearing (avulsion). Pelvic organ prolapse — if the pelvic muscles are damaged or weakened, the organs inside the pelvis can drop down towards the vagina, causing bladder and bowel problems.

What is the most common complication of childbirth? ›

By far, the most common complication during childbirth is labor that does not progress. Sometimes, labor starts fine but over time the contractions slow down, the cervix doesn't dilate enough, and the baby's descent in the birth canal is hindered.

What are the long term effects of being pregnant? ›

There is an increased lifetime risk of chronic hypertension, cardiovascular disease (CVD), and stroke in women who experienced preeclampsia during pregnancy. The risk is related to the severity of the hypertensive disorder during pregnancy and the gestational age at the time of onset.

Is giving birth hard on the body? ›

Share All sharing options for: Giving birth can be as hard on your body as running a marathon. According to new research, giving birth can be as traumatic to a woman's body as hardcore sports like running a marathon — but doctors often don't treat it that way.

Does a woman's pelvis break during childbirth? ›

Conclusion: Pelvic ring fracture is a rare occurrence during childbirth. The mechanism involves hormonally mediated ligamentous laxity of the pelvis combined with the forceful movement of the fetal head.

How long is too long labor? ›

Prolonged labor, also known as failure to progress, occurs when labor lasts for approximately 20 hours or more if you are a first-time mother, and 14 hours or more if you have previously given birth.

What is considered a difficult birth? ›

Birth canal issues can result in prolonged labor or failure for labor to progress. Prolonged labor is when labor lasts longer than 20 hours for a first-time mother and longer than 14 hours for a woman who's given birth before. Nurses and doctors will monitor your baby's progress through the birth canal during labor.

How many pregnancies are healthy? ›

Reality Check: About 97 of every 100 babies born in the U.S. arrive without a major birth defect, such as spina bifida or Down syndrome.

Will I be loose after having a baby? ›

Your vagina may be looser after giving birth.

The muscles may improve over time, but often do not. Kegel exercises and pelvic floor therapy can help strengthen these muscles. If it continues to be a problem, Vaginoplasty can dramatically improve a loose vagina. See if Vaginoplasty is right for you.

What does giving birth feel like? ›

While the experience is different for everyone, labor usually feels like extremely strong menstrual cramps that take your breath away and make you unable to talk. As labor continues and the pain worsens, the pregnant person tunes out stimuli and adopts a tunnel vision, focusing on the labor and getting the baby out.

Can your water break while sleeping? ›

It happens often when you are in bed sleeping. You may wake up and think you have wet the bed. Sometimes women feel or even hear a small “pop” when the bag breaks. Sometimes there is a gush of fluid from the vagina that makes your underwear wet; or maybe just a trickle that makes you feel damp.

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