After your waters break, when do contractions start?

There is no exact countdown that applies to every pregnancy. Your maternity team will consider how many weeks pregnant you are, whether labour has started, the fluid's appearance, your temperature, your baby's movements and any infection concerns when advising what happens next.

The waters may release as a noticeable gush or as a steady trickle that you cannot control. Amniotic fluid is commonly clear or pale, but it can be difficult to distinguish from urine or increased vaginal discharge. Contractions may feel like regular tightening, period-like cramps or backache, and they may become stronger and closer together as labour progresses.

Leaking fluid before 37 weeks needs prompt maternity assessment because the membranes may have ruptured before term. Assessment can check whether the fluid is amniotic fluid and whether you or your baby need monitoring or treatment.

Call your maternity unit or obstetric team and follow their instructions rather than waiting for contractions. Note when the leaking began, whether it was a gush or trickle, and the colour and smell of the fluid. Wear a clean sanitary pad so the fluid can be observed; do not use a tampon or insert anything into the vagina. Avoid sex after the waters break because the membrane barrier is no longer intact.

Keep noticing your baby's usual movement pattern and tell the maternity team about any change. If you know you carry group B streptococcus, have been given a specific birth plan, or have pregnancy complications, mention this during the call because it may affect the recommended timing of assessment.

Seek urgent maternity help if the fluid is green, brown, bloody or unpleasant-smelling; you have vaginal bleeding, fever, severe constant abdominal pain or feel acutely unwell; or your baby is moving less than usual. These signs need assessment even when contractions have not begun.

If you can see or feel the umbilical cord in the vagina, call emergency services immediately. Do not push the cord back. Get onto your knees with your chest lowered and your bottom raised while waiting for emergency help, as this may reduce pressure on the cord.

Ask where and when you should be assessed, what changes in contractions or fluid should prompt another call, and whether you should eat, drink or travel to your planned birth location. You can also ask what monitoring may be offered if labour has not started and how your pregnancy history changes the plan.