The human body is always a mystery, but never more so than during pregnancy. Sometimes it can be hard to tell between a symptom of something harmless and a sign that something big is happening, particularly the closer you get to your due date. One common question moms-to-be puzzle over: Am I leaking amniotic fluid or discharge? (Or pee?)
Why do you experience more discharge in general during pregnancy?
"An increase in vaginal discharge is common in pregnancy," Natalie Nix, CNM, MSN, Certified Nurse Midwife at Roswell OB/GYN in Atlanta, GA, tells Romper. "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 woman 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?"
Leaking amniotic fluid can be a sign of Preterm Premature Rupture of Membranes, or PPROM, which has a variety of causes and can lead to bedrest and fetal monitoring.
What's the difference between amniotic fluid and other types of vaginal discharge?
Even though regular vaginal discharge (also known as leukorrhea), urine, and amniotic fluid are all very different substances, it can be tricky to tell which is which.
"Amniotic fluid (also known as the bag of water) is the sterile fluid that fills the amniotic sac, surrounding the fetus," Nix says.
"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.
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.
What should you do if you think you might be leaking amniotic fluid?
"When I speak with patients concerned with rupture of membranes, I will have them use the restroom (sometimes 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."
"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," maternity nurse and childbirth educator Sun-lo Pak tells Romper. "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 adds. She says that amniotic fluid and urine closely mimic each other, but these differences can be concerning.
When it comes to discharge, let your healthcare provider know if there's been any change from how it's been during your pregnancy. Ultimately, they can help to answer the question of whether it's amniotic fluid you're losing or something else.
Natalie Nix, CNM, MSN, Certified nurse midwife at Roswell OB/GYN
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