Let’s get straight to the point. As we near the end of pregnancy it’s difficult to know what’s what when it comes to leaking ‘down below’.

This can leave pregnant women with many unanswered questions.

Is it wee? Is it normal discharge? Am I leaking amniotic fluid? How much fluid is normal? Is amniotic fluid sticky?

Sometimes these questions are difficult to answer.

In this article we’ll answer 11 common questions about amniotic fluid, to help clear things up.

#1: What is amniotic fluid?

About 12 days after conception, the amniotic sac forms and begins to fill with fluid.

The amniotic sac is also known as the membranes, or bag of waters.

The sac consists of two membranes: the amnion and the chorion. Both are thin, but tough enough to withstand pressure and movements from your baby.

Usually, just before or during labor, the sac will rupture (the water breaks) and the amniotic fluid is released.

The amniotic fluid surrounding your baby is essential for your baby’s development. It has many other vital roles including:

Protection. The water acts as a cushion and shock absorber to protect your baby from injury
Umbilical cord protection. Being surrounded by liquid prevents pressure on the cord, ensuring adequate blood flow and oxygen to your baby. Have you ever wondered How Long Is The Umbilical Cord?
Temperature control. The fluid helps to insulate and maintain a steady temperature around your baby, preventing heat loss
Infection control. Amniotic fluid contains maternal antibodies that play a vital role in developing your baby’s immune system
Muscle and bone development. Being able to move freely in the fluid helps your baby develop strong muscles and bones
Development of lung and digestive systems. Breathing in and swallowing the amniotic fluid helps your baby practise using the muscles of these systems as they develop
Lubrication. The fluid protects parts of the body, such as fingers and toes, from sticking and then growing together during pregnancy.

To learn more about normal fluid levels, read our articles Amniotic Fluid Levels | What You Need To Know and Amazing Video Shows Baby Born In Amniotic Sac.

#2: What is amniotic fluid made of?

Before the 20th week of pregnancy, amniotic fluid is mostly made up of water and electrolytes from the mother’s body.

After 20 weeks of pregnancy it gradually contains a greater proportion of your baby’s urine. Your baby practises swallowing and eventually, because what goes in must come out, your baby will pee out the amniotic fluid.

The amniotic fluid is vital for normal development of your baby’s lungs and limbs. By full term it’s made up of a variety of hormones, carbohydrates, proteins, fats (lipids), electrolytes, enzymes, hormones and antibodies.

Related reading: When Do Babies Take Their First Breath?

#3: What does amniotic fluid look like?

Normal amniotic fluid is a watery clear or straw colored fluid, and looks similar to urine.

That’s why, as the end of pregnancy nears, so many women wonder whether they’ve weed themselves or it’s their water breaking.

The amniotic fluid might also contain flecks of vernix (which will look white), blood or mucus.

#4: What is the consistency of amniotic fluid?

As your pregnancy progresses, one of the more common symptoms is increased vaginal discharge (leukorrhea).

This is usually a milky-white or clear fluid and is similar in consistency to egg white.

At any stage of your pregnancy, if you experience discharge that looks yellow, green or brown or has a foul smell, speak to your healthcare professional for further advice. This might mean you are at a higher risk of an infection, or it could be a sign your baby has passed meconium.

For more information, read Meconium – What Is It? 9 Things You Need To Know.

Amniotic fluid, on the other hand, tends to have a more yellowish tint. It also has a thinner consistency than leukorrhea, similar to urine.

You can find out more in Discharge During Pregnancy – What’s Normal and What’s Not.

#5: What color is amniotic fluid when it leaks?

If you’re unsure about whether you’re leaking amniotic fluid, the color might give you a clue.

The water around your baby is generally clear or might have a faint straw-like color or a yellowish tint.

When your waters break (known as rupture of membranes), if they appear to be green or brown this is a sign that your baby has had a bowel movement inside.

The substance the baby passes is known as meconium, and it can cause complications, such as Meconium Aspiration. This is a condition where your baby inhales some of the meconium into the lungs. It can cause breathing problems, requiring close monitoring, and might also require further treatment options in the baby unit.

Meconium in your waters can be a sign that your baby is distressed and usually involves closer monitoring in the hospital during labor.

#6: Did my waters break or is it discharge?

One of the hardest things to tell in late pregnancy is whether leaking fluid is normal vaginal discharge or amniotic fluid.

Excessive discharge could be your waters breaking.

Usually, this is a constant trickle, or a small gush of warm fluid when you move.

Amniotic fluid is usually clear or has a pale yellow tint. Discharge is more milky white and slightly thicker.

Most of the time when the amniotic sac breaks it doesn’t result in a huge gush of fluid like you see on TV.

Most often, it feels like a steady trickle or a leak of fluid in your underwear. It depends where in the amniotic sac the membranes have ruptured. If you’re leaking amniotic fluid, you might notice more loss when you feel your baby moving around.

If the break occurs in the pocket of fluid in front of your baby’s head by the cervix, this can result in a gush of fluid.

If the membrane rupture occurs somewhere around the baby’s body, however, it will normally feel like a slow leak, as your baby’s head acts as a plug above the cervix.

When the waters break some women describe feeling a ‘pop’ sensation.

#7: How do I know if I’m leaking amniotic fluid?

If you’re not sure whether or not you’re leaking amniotic fluid, call your health care provider to discuss it further. There are a few ways to tell the difference between amniotic fluid and anything else.

Firstly, put on a sanitary pad (not a panty liner, or a tampon) and observe the amount and the color of the fluid you’re losing.

After a couple of hours, if there’s very little on the pad, it’s unlikely to be your waters.

If there’s a lot on the pad, and it feels heavy, it’s likely you’re leaking amniotic fluid.

#8: What does amniotic fluid smell like?

Some women leak urine towards the end of pregnancy or as they approach their due date; this is due to the increased pressure on the bladder and pelvic floor muscles.

Many women also have increased discharge in the third trimester.

All this can be confusing and some women are not sure whether their waters have broken.

If you’re unclear, try the ‘sniff test’.

This might sound disgusting, but it can give you a clue as to whether your membranes have gone.

Amniotic fluid doesn’t smell like urine. Urine smells as you would expect, but your waters shouldn’t have a strong odor.

If anything, they might have a slightly metallic, or a slightly sweet smell. Either way, it’s definitely noticeably different from the smell of urine.

#9: Is amniotic fluid sticky?

Amniotic fluid shouldn’t have a sticky consistency.

If you notice something sticky or a thick whitish residue in your underwear, it’s unlikely to be your waters.

It’s more likely to be heavy vaginal discharge or signs of your mucus plug.

If your waters have broken, it feels like you are soaking through your underwear, rather than feeling just a bit damp.

#10: Is there a test to confirm rupture of membranes?

If you suspect your waters might have broken, there are several tools your midwife or doctor might use to make sure.

For most women a diagnosis is mostly confirmed by discussion of symptoms and a physical examination, which might include:

Sterile speculum examination. This is a visual assessment to see if there’s any evidence of amniotic fluid pooling around the cervix, or any signs of infection. A speculum exam will also be performed if any swabs or cultures need to be collected
Digital examination (a vaginal examination using fingers). This should be avoided, if possible, as it can introduce bacteria with the potential to cause infection. This is particularly important in the case of suspected premature rupture of membranes or onset of premature labor.

For more information, read Premature Labour – Signs, Symptoms And Management.

Vaginal examinations (VE) can provide helpful information, but they are not mandatory.

Read our article Vaginal Exams And The Right To Say No to learn more.

If a VE appears inconclusive, subsequent tests can be performed to check for leaking of amniotic fluid.

Tests might include:

A pH test. A sample of vaginal fluid is tested to assess the pH level. Normal vaginal fluid has a pH of between 4.5-6, whereas amniotic fluid is more alkaline and therefore has a pH of around 7.1-7.3. If the pH is higher than usual it’s likely that the membranes have ruptured
Nitrazine paper dye test. This involves dropping a sample of fluid on to the special paper strips containing nitrazine, which will show as a blue dye in the presence of amniotic fluid. However, there are drawbacks to this test as it can produce false positives if contaminated
Actim PROM test. This is highly accurate and isn’t affected by other contaminants, such as blood, urine or semen. It’s a dipstick test that detects a specific protein present in high concentrations in amniotic fluid. A positive Actim PROM, shows the presence of amniotic fluid and confirms rupture of membranes.

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#11: When should I call my healthcare provider?

Call your doctor or midwife straight away if you have any of the following warning signs or symptoms in pregnancy:

Water breaking before 37 weeks pregnancy (known as premature rupture of membranes)
Green or brown fluid
Fever
Offensive odor to discharge or fluid
You see or feel any part of the umbilical cord, or any pulsing sensation in the vagina after the waters have broken. This is the sign of an Umbilical Cord Prolapse.
Group Beta Strep (GBS) positive
Reduced fetal movements at any point in pregnancy. For more information about this, read Do All Babies Go Quiet Before Labour?