There's a lot that happens "down there" when you're pregnant. Let's be honest, you can have tons of discharge, you might pee when you laugh, you could bleed after sex, and then there's the amniotic fluid that can sometimes show up when you're nearing the end of your pregnancy. With all that going on, how can you tell the difference in what you're seeing in your underwear when you go to the bathroom? Fluids are normal, but it can be panic-inducing to wonder if you're leaking amniotic fluid or discharge.
It can be pretty difficult to determine whether you're experiencing regular vaginal discharge (also known as leukorrhea), leaking urine, or if you have a leak in your amniotic sac, causing fluid to drain from the area around your baby. Still, each one of these substances is very different, as Natalie Nix, CNM, MSN, Certified Nurse Midwife at Roswell OB/GYN in Atlanta, GA, tells Romper.
"Amniotic fluid (also known as the bag of water) is the sterile fluid that fills the amniotic sac, surrounding the fetus," Nix explains.
"The amniotic sac attaches to the placenta (think of a flat pancake with a balloon attached). In the entire sac/ placenta unit is the fetus, cord and fluid. There are approximately 1-2 liters of fluid in that sac. The fluid is the consistency of water (very thin, not mucous-like)," Nix says, adding that this fluid ranges in color from clear to a straw-like hue and "typically does not have an odor."
Comparatively, "regular" vaginal discharge (or leukorrhea) is often thicker and more opaque, ranging from whitish to yellow in color.
"An increase in vaginal discharge in common in pregnancy," says Nix. "This is how the vagina 'keeps itself clean' in preparation for labor." However, she adds, "towards the end of pregnancy that increased leukorrhea can pool in the vagina while a women sleeps or sits. Because her body temperature is slightly higher (because she is pregnant) that discharge can liquify and then pass when she stands up posing the question, did my water just break?"
To tell the difference, the first thing to pay attention to is the consistency of the "discharge." Anything "mucous-like" is probably leukorrhea versus amniotic fluid, says Nix, adding that once the "bag of water breaks," a woman will usually have a consistent drip.
"When I speak with patients concerned with rupture of membranes, I will have them use the restroom (sometime leaking urine can be confused with amniotic fluid), put on dry undergarments, a peri-pad and evaluate what comes out over the next 30-60 minutes," Nix says.
"If nothing comes out, it is probably just leukorrhea. If she continues to feel leaking, then she would need to be evaluated for rupture of membranes. At any point if the discharge has a strong odor or green color, she would need to be evaluated."
When I was pregnant with my daughter, I noticed around 35 weeks that I was experiencing more discharge than what was normal. OK, by "experiencing more discharge," I mean that it felt like I could've drowned. When I called my obstetrician, understandably in a bit of a panic, she had me come in right away. As it turns out, I was beginning to leak what she referred to as "a small amount of amniotic fluid" and she placed me on bedrest. I had to come in every few days for monitoring, but eventually delivered a healthy baby at 38 weeks.
On the phone with me, she was very specific in her questioning. She asked me for color (light yellowish), smell (almost none), and if I had filled a pantyliner, and how fast that happened. Since I had soaked through a pantyliner after about four hours, it was determined that I needed to be seen. When I got to her office, I was measuring smaller than I should, and upon ultrasound inspection, it was determined that my daughter was quite anxious to exit her happy home in my uterus and make her debut topside.
I spoke to registered maternity nurse and childbirth educator, Sun-lo Pak from Hawaii to get even more information about all that leaking and how to spot if something's wrong. She tells Romper, "Normal discharge during your pregnancy should be mild smelling, white or clear, and maybe a tad mucus-y, like sinus drainage when you come inside from a cold environment," adding that any derivation from this is abnormal. "If there's a lot of it, like if there's more than a teaspoon or so a day, or if it's chunky like curdled tofu, smells bad, or is tinged with blood, that's a problem." She says that amniotic fluid and urine closely mimic each other, but that amniotic fluid can sometimes have a green or brown tint to it, or it can be streaked with blood, which might be concerning.
Sun says that when it comes to discharge, if you notice a change from how it's been during your pregnancy, you need to put a call into your provider. You can definitely ask them if it's amniotic fluid or discharge, as they'll have a better idea of what's going on. They'll also want to know all of your symptoms in conjunction with what's going on in your underwear. Discharge and fluid are just a part of the daily reality of pregnant women, and while figuring out what it is may be panic-inducing, it's better to be safe than sorry.
Natalie Nix, CNM, MSN, Certified nurse midwife at Roswell OB/GYN
This post was originally published on 7/18/2019. It was updated on 8/17/2019.
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