Before you got later into your pregnancy it sounded really clear to know if you were leaking amniotic fluid or not, but it turns out that an amniotic fluid leak can be really sneaky. While some people rupture and have a HUGE gush (which is super clear), some people rupture their amniotic sac and only leak a little, so how do you know? Can you test at home? Let’s find out?
First off, hello! I’m Hilary — many people know me as The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have tested THOUSANDS of patients to see if their water is broken — and I am excited to share it with you today!
Note: This is just information on how we test for fluid, I have no medical recommendations in this post, just information. Please talk with your provider about you and your circumstances. Having your water broken but not being seen can have really serious consequences.
Can you do an amniotic fluid leak test at home?
Yes, and no. The gold standard to know if you are leaking amniotic fluid is Amnisure, which is not available to the home market. However, prior to Amnisure we all used Nitrazine paper to initially test (and can usually do a pretty decent job at telling if you have discharge, urine or an amniotic fluid leak).
Amazon has these pads, but as the reviews highlight there are a lot of false positives, and a false negative (where your water actually broke but it isn’t showing that it did) can have some really serious consequences. There are a few other amniotic fluid test strips out there, but they seem to just be fancy nitrazine strips.
Let me once again stress that a) If you think you have ruptured, you don’t have time to go find a test to see if you have or haven’t. b) If you’re thinking ahead, please talk with your provider before planning on this. Honestly, it’s not a horrible idea (I sort of wish I’d had some Nitrazine paper at home when I had my babies), but I want them in on your plan. 🙂
And, before we get deeper into this, you are clearly a person that likes autonomy, which I love. If you really want to feel autonomous in labor you really need this prenatal class. It’s cheaper than Amnisure and thousands of couples have taken it and loved it! Plus, it only takes a few hours!
How I used to test suspected amniotic fluid with Nitrazine paper:
Note: This is just a remembrance of how I used to do it, I am in no way recommending you do it. I have to say that the gold standard Amnisure is your best bet. I’m just sharing a little history here:
I would use a clean glove, get some of the paper (about a 3 inch strip) and bend it over my finger. Then I would place my finger gently into the vaginal canal (careful to hold onto the strip so I don’t lose it in there).
If the paper turns blue, you are likely ruptured. If there was any question our provider could use a speculum to check for pooling of fluid in the vaginal vault, or use a microscope to check for ferning (the fluid literally looks like a fern under the microscope, I’m not 100% sure why — just how amniotic fluid is made). Neither of these tests are done now, we just use Amnisure. If there is a question (if the patient has recently had sex or has a good amount of blood) we may use ferning or checking for pooling as a backup.
Why does Nitrazine paper work?
While Nitrazine did lead me to some false positives (most often when I’d test fluid on the pad on the bed vs checking it vaginally) it works pretty simply. It is a pH test. It is best at distinguishing between amniotic fluid and vaginal discharge.
Amniotic fluid is pretty neutral with a pH of 7.1-7.3
Vaginal discharge is usually a bit more acidic pH at 4.5-6 (remember the lower you go the more acidic something is).
Urine really varies (which is mostly why we don’t use this paper anymore — urine can cause some issues) with normal being 6.0-7.5 (obviously overlapping the amniotic fluid pH). However, you can always put a bit of your urine on the paper to see what it tests as — if your urine is blue, and the fluid in your vaginal canal is blue then you’re left with needing ferning or Amnisure.
However, if you’re testing INSIDE the vaginal canal, it should not have urine in it. If you’re testing on the outside of the vaginal canal it may have urine on it and can mess things up.
This study compared Nitrazine with a few other options.
And, before we keep going — grab my hospital packing list (sounds like you might need that soon):
How does Amnisure work?
I keep holding up this gold standard amniotic fluid tester — but how does it work?
Amnisure looks for proteins that are only in amniotic fluid called PAMG-1. So, it can’t be confused with urine or discharge — because that protein isn’t in there.
With Amnisure, we use a long q-tip and put it a couple of inches into your vaginal canal. We let it sit there for an awkward minute. Then, we mix it with some fluid and pop-in a tester that looks a lot like a pregnancy test. Two lines, your water is broken — one line it’s not — after about 10 minutes.
That’s why it’s the gold standard. This study shares a bit more about it.
Best Way to Check for an Amniotic Leak at Home
Most people aren’t going to have a test at home, but there is another simple self-test you can try:
If you feel a gush of fluid, put a pad on. I then recommend laying down for 5 minutes and then getting up. If you don’t have more fluid come out at that point it is likely your water isn’t broken, but I’d still call your doctor and see what they recommend. If there is wetness, it could still be discharge, but call your provider.
If you get up and feel another gush of fluid, it likely means that your water is broken. The gush happens because it collects in your vaginal vault while you’re lying down. When you get up, it comes out.
Remember: Amniotic fluid will keep coming out (vs a gush of urine or a blob of discharge). That is usually the best indicator between the two. If you continue to have dry underwear it likely isn’t broken. But again — ANY questions, ask your provider. They’re used to fielding this question over the phone! They may even have an easy way for you to come get tested in the office!
If you like simple tips like this one, you’re going to love this class!
Why do we care about leaking amniotic fluid?
It’s sort of easy to think that “maybe” your water being broken is not a big deal, but it really can be a big deal.
So, for all of your pregnancy your baby has been protected by a thick cervix and an intact bag of waters that basically makes your baby “sterile”.
Once that water is broken there is a chance of bacteria coming up the cervix from the vagina. That can cause an infection in the baby or the mom — called Chorioamnionitis – which can be a HUGE DEAL.
That’s why it’s really important to know if your water has broken or not.
That being said, most often if you wonder if it’s broken, but instead put on a pad and watch it for 15-20 minutes to see if you’re still leaking. That should be fine.
One caveat: (When you’re a nurse as long as I have been a nurse you have a lot of horror stories.)
If your water breaks be sure that nothing comes into the vaginal canal. The problematic ones would be a baby arm/hand or the umbilical cord. If you feel either one of those in your vaginal canal you need to get your butt in the air and call 911 — that could be an emergency. This is super rare, but it’s one of those things I have experience with.
Oh, and don’t forget about the stuff you’ll need for YOU after baby is born:
Leaking Amniotic Fluid FAQ’s
Here are a few questions we get a lot about leaking amniotic fluid:
Is PROM or PPROM dangerous?
First, the definitions:
PROM: Premature rupture of membranes — your water breaks before you start having contractions
PPROM: Preterm premature rupture of membranes — your water breaks before 37 weeks of pregnancy.
If your water breaks before baby is ready to be born that can be dangerous. If you have any question as to if you’re leaking fluid prior to being due you should call your doctor right away to see what they recommend.
Some people’s water does break before contractions have started, but studies show the VAST majority will start into labor within 24-48 hours.
Note: Some people seem to think that PROM is just when you don’t have a “gush” of fluid, but that isn’t correct. It has to do with if you are having contractions or not. Some people in labor can have a tiny trickle of fluid and that would not be PROM, it would be just a small amount of fluid.
What causes PROM or PPROM?
Honestly, we’re not really sure what makes water break.
Sometimes, obviously, is is contractions. But when it breaks without contractions we don’t really know what makes it break. I do have a post on signs your water might break that you might find helpful too.
Are there other reasons why my amniotic fluid might be low?
Low amniotic fluid, also known as oligohydramnios, can occur due to various reasons other than the rupture of membranes.
In the first trimester of pregnancy, low amniotic fluid may be caused by factors such as chromosomal abnormalities in the fetus or underlying maternal health conditions like kidney dysfunction or pre-existing high blood pressure.
In the second and third trimesters, other possible causes of low amniotic fluid include fetal urinary tract abnormalities, placental insufficiency, or certain medications taken by the mother.
Occasionally, a rupture of membranes can happen without contractions (usually just a small leak), which is referred to as preterm premature rupture of membranes (PPROM). In such cases, the amniotic fluid may gradually decrease over time until it reaches a critically low level, and can be an inlet for infection for mom & baby.
If you have any questions about your fluid levels do talk with your provider. There is a test called an AFI that can measure your fluid levels really easily. However, if they think your water is broken the Amnisure is a more accurate test to see if there’s just a small leak.
We actually talk a bit about the AFI and other 3rd trimester tests in my free prenatal class.
What does amniotic fluid smell like and look like?
Since I have been around amniotic fluid for YEARS I do think it has a distinct odor. However, most people can’t tell it apart from discharge or urine. So, you need a test to tell the difference.
And frankly if someone comes in saying they’re ruptured I don’t think I could “tell” if their water is broken. I just know the smell when I smell it around birth.
When does Amniotic fluid leakage stop?
Amniotic fluid is mostly baby pee — and as we all know, babies keep peeing. So, amniotic fluid keeps coming out. So, it stops when baby is out. 🙂
Should I call the doctor if I think I’m leaking amniotic fluid?
Unequivocally, yes. The test can often be done in their office (which is WAY faster than going into the hospital), so call them and see what they think you should do.
So, that’s the deal on an at home amniotic fluid test. Like I said — I guess it’s not a horrible idea to plan ahead to have at home but please talk with your doctor if that’s your plan. AND if you think you’re ruptured — it’s too late, call your doctor.
So, basically talk with your provider either way. 🙂
BUT, there’s one thing you DON’T need to call your provider about — and that’s taking a prenatal class. Come join me in The Online Prenatal Class for Couples where we get you prepared in just a few fun hours!
Or, if you’re not quite ready for the full class (although I’m not sure what you’re waiting for at this point), check out my free prenatal class — It’s your first step towards being your own birth boss.