When your bag of waters breaks: what to do next

Amniotic fluid may come as a gush or a continuing trickle that you cannot control. It is often clear or pale, but urine and vaginal discharge can be difficult to distinguish from it without assessment.

The bag of waters is the membrane containing amniotic fluid around the baby. It can rupture before contractions start or during labour. When it happens before the pregnancy has reached term, it may be associated with preterm labour and requires prompt maternity assessment.

Once the membranes have opened, the maternity team considers labour signs, the baby's movements and wellbeing, the pregnancy stage, the fluid's appearance and possible infection. Management depends on that full picture rather than the amount of leaking alone.

Put on a clean sanitary pad, not a tampon, so staff can assess the colour and smell. Record when leaking began and whether it continues. Pay attention to the baby's usual movement pattern and mention contractions, pain, bleeding or fever. Avoid sex and do not insert anything into the vagina while awaiting advice.

Follow the maternity unit's instructions about where and when to attend. Assessment may involve checking your temperature and pulse, listening to the baby's heartbeat, examining the pad and, when needed, using a speculum to look for fluid.

Go for urgent maternity assessment if the fluid is green, brown, heavily blood-stained or foul-smelling; the baby is moving less than usual; you have fever, feel unwell, have significant bleeding or constant severe abdominal pain; or you can feel or see something in the vagina. Call emergency services if a cord is visible or felt, and avoid touching or pushing it back.

Suspected waters breaking before term also needs immediate contact even if there is no pain or contraction.

Ask how they will confirm whether the membranes have ruptured, what monitoring you and the baby need, which changes should bring you straight back, and what the plan is if contractions do not begin. If discharge home is advised, make sure you know how to check temperature, fluid and fetal movement.