Answer
The wife is wrong, and the husband is mistaken. This is most likely a case of premature amniotic sac rupture , in which case she does not need to go to the hospital on an emergency basis.
A baby's head peeps out of the cervix ( crowning) in a late stage of expulsion. Before this stage the mother would have experienced several sets of contractions as the pelvis effaced, and the cervix dilated. But there is no mention of contractions (false or true), or of any kind of pain. This is a strange omission.
The so called "breaking of water" in a pregnant woman, means rupture of the amniotic sac and leaking out of some amniotic fluid. This can occur prematurely, or more typically in the transition phase of dilation when the cervix is about 6 cm wide. The patient's panic is to be expected, if this her first pregnancy.
Since there is no mention of contractions, it is unlikely that the patient is in the last phase of dilation and close to start expelling the baby, The report that the husband can see the baby's head, can probably be discounted since this only possible late in the expulsion stage when the cervix is fully dilated ( to at least 10 cm).
Work Step by Step
It is important to identify the nature of the fluid called "water" that is leaking from the vagina. It could indeed be amniotic fluid; it could be urine, or it could a mucous secretion tinged with blood -- the so-called bloody show: Urine is yellowish, and smells of ammonia; mucous secretion isl more viscous than amniotic fluid, and is likely to be blood-tinged. Amniotic fluid is usually clear or straw- colored, and has a sweetish rather than an ammoniacal smell.
The doctor by consulting with the patient wold be able to determine if the leaked fluid is really amniotic fluid. He/she would know if the leakage is premature. If these conditions exist the patient should get to the hospital as soon as possible, but there is no need to call 911 ; there would a risk of infection but it would not be an emergency.
If the husband's observation is valid, then the patient is in the expulsion stage of labor. The baby would have descended into the true pelvis, and turned around in preparation for exiting the
the birth canal. He/she be exhibiting what is calle crowning.. This is the only set of circumstances in which the baby's head could be seen by the husband. In such was the cas, the patient should get the attention of a doctor or midwife as soon as possible. It would not be prudent for her husband to drive her to the hospital. A fully equipped Emergency Ambulance ( with doctor or midwife) should be dispatched to the home .
In the final analysis, the husband is probably mistaken. Nevertheless, this could be a case of premature rupture of the amniotic sac, and precautions against Streptococcus infection should be instituted promptly.
