What should you know about symptoms before water break?

Labour may involve tightening that becomes longer, stronger and more regular, along with period-like cramps, low backache, pelvic pressure or a change in vaginal discharge. These symptoms can also have causes other than labour. A small leak of fluid may be mistaken for urine or discharge, and a gush is not required for the waters to have broken.

If the pregnancy is before the expected time of birth, contractions, pelvic pressure or persistent fluid leakage may be linked with preterm labour and need prompt advice. Symptoms alone cannot confirm whether the membranes are intact.

Call your maternity unit if you think fluid is leaking, contractions become regular, bleeding occurs or you are unsure what you are feeling. Record the time, colour and smell of any fluid and monitor the baby’s movements according to your care plan. Use a pad, not a tampon, and avoid putting anything into the vagina until assessed.

Rest where you are while arranging advice, and follow the team’s instructions about coming in. If you feel faint or severely unwell, ask someone else to help and use emergency services.

Seek urgent maternity help for reduced baby movements, fresh bleeding, green or brown fluid, fever, severe or persistent abdominal pain, regular painful contractions or a visible cord. Emergency help is needed for collapse, heavy bleeding or breathing difficulty. Do not wait for waters to break before reporting these warning signs.

Could my cramps or backache be early labour? How can I tell fluid leakage from urine? How should I monitor movements? Which symptoms mean I should come in immediately? What number should I call outside clinic hours?