Pregnancy is a time of lots of bodily changes.
Sometimes, it can be hard to know what’s going on with your body!
Even if you’ve been pregnant before, every pregnancy can be incredibly unique.
You might find yourself wondering how this could be pregnancy number two or three and yet you’re experiencing something new.
During pregnancy, your baby is surrounded by amniotic fluid. This fluid helps to protect and keep baby well cushioned and helps in their overall development, especially early lung development.
One of the biggest ways the amniotic fluid and amniotic sac (the membranes keeping the fluid inside your uterus) protect your baby is by keeping germs out to reduce their risk of infection while they’re growing.
If your water breaks with a big gush, it’s often quite noticeable what’s happened.
However, sometimes small bits of fluid and mucous are discharged and you might be wondering if it’s amniotic fluid, an accidental urine leak, or even just the unpleasant increase of vaginal discharge during pregnancy.
Signs Of Leaking Amniotic Fluid
It can sometimes be difficult to tell what you’re finding on your undergarments or while wiping after using the toilet.
Amniotic fluid is a bit different from urine or vagina/cervical discharge, however.
Amniotic fluid is:
- Generally odourless
- Continues to leak, sometimes a steady flow
- Your undergarments and liners/pads will need to be changed often as the leak is steady
- You have no control over the flow, unlike urine
- The fluid is mostly clear, possibly tinged with white specs and mucous or a bit of blood
- If there’s a greenish to brownish tint, contact your doctor immediately as it could be a sign baby had a bowel movement in utero
You might also experience a bit of cramping and discomfort, but many don’t notice anything beyond the steady leak of fluid.
It’s unlikely to be leaking amniotic fluid if:
- There’s a urine like odour
- It’s thick, like mucous, requiring you to switch your liner/pad for hygiene purposes, but it’s not soaking through – most likely heavy vaginal/cervical discharge
- A sudden leak with movement, a baby kick or when your bladder feels full but after the initial leak there isn’t a steady flow
- Yellow tinged like urine
When Should I Call My Midwife Or Doctor?
Anytime you are unsure of what’s going on, or if you think you’re leaking amniotic fluid, it’s important to call your maternity care provider. They can help you determine whether or not it sounds like you have an amniotic leak, and whether or not you need to be seen.
You should call or go in immediately if:
- You are preterm (less than 37 weeks gestation) and believe you have a leak or you’re uncertain
- You have an amniotic leak and/or heavy vaginal discharge and a fever
- The fluid is tinged greenish suggesting meconium (in utero bowel movement)
- The flow remains steady and/or increases and you’re continuing to soak through your undergarments
- Anytime you’re uncertain and concerned
What Causes Amniotic Fluid Leaks?
If you’re at term (37 weeks of pregnancy or later), an amniotic fluid leak could simply be part of your body preparing for labour.
A leak might become a full membrane rupture, known as spontaneous rupture of membranes (SROM). If you’re at term, this is a normal process and rarely something to be concerned about.
If you’re preterm (less than 37 weeks gestation) and/or your body hasn’t begun labouring, it’s not always clear why the amniotic sac may begin to leak. Some possible causes include:
- An untreated infection
- Previous cervical surgery
- Lifestyle choices which cause health complications, such as cigarette smoking, recreational drug use or a very unbalanced diet
- An injury or trauma to the amniotic sac (e.g. car accident, fall, etc)
- A history of amniotic sac rupturing prematurely
How Are Amniotic Leaks Treated?
If you’re full term, your maternity care provider could take a wait and see approach to see if labour begins on its own.
During this time, it’s important to not put anything in your vagina to reduce the risk of infection. Limiting vaginal exams, avoid intercourse, and refrain from douching or using tampons.
If you’re preterm and suspect a leak, your maternity care provider will likely want to see you sooner rather than later. They will test the fluid to see if it is actual amniotic fluid. They may or may not do an ultrasound to determine the level of fluid remaining.
If it’s a slow leak, especially from higher up in the amniotic sac, they might take a wait a see approach to see if the leak seals. During this time, you’re likely to be on limited or even full bedrest, and definitely on pelvic rest (nothing in the vagina).
You may also be tested for infections, including group b strep. If anything returns positive, your maternity care provider is likely to begin antibiotics.
Find out more about group B strep.
If you are less than 34 weeks gestation and not in labour, many maternity care providers will aim to prolong your pregnancy, especially if it’s just a small leak with the potential to seal. They will monitor you and baby for infection and be sure baby is tolerating low fluid levels.
If you’re greater than 34 weeks, and especially over 37 weeks, your maternity care provider might take a wait and see approach or they might recommend encouraging labour naturally or via induction.
Be sure to discuss the benefits and risks of waiting or an induction with the risk of infection (if you didn’t already have an infection, avoiding all vaginal exams can greatly reduce the risk of acquiring one).
Anytime you’re uncertain of what your body is doing, or how you or baby are doing, it’s important to contact your midwife or doctor. It’s also important to keep an open line of communication and discuss the benefits and risks of continuing pregnancy with a leak, or encouraging/inducing labour.