The fluid might contain white grits, which is normal and fat protecting the baby during the pregnancy. Sometimes the fluid can become a little pink which is all natural.

Approximately 15% will experience meconium-stained liquor.

The colour of the fluid is important for the midwife to know, so that you together can make the best plan for both you and your baby.

The midwife will determine if your water has broken, and how much your cervix has dilated. The midwife will make the further plan based on your situation - how was your pregnancy and have your contractions started spontaneously.

If no spontaneous contractions occur, the midwife will often recommend to stimulate your contractions on the basis of the result of this examination.

It is your choice if you prefer waiting for the contractions to occur naturally, or you can choose medically to induce contractions. You can read more about this offer under the section ”further information”.

The midwife will assess how to induce your contractions on the basis of the dilatation of your cervix.

Contractions can be induced with Angusta (tablet) or by intravenously administered medicine.

The tablets ”Angusta” (prostaglandin) is used to help the contractions to start up. Angusta is equivalent to the hormone produced by the body when the birth process is starts naturally. The tablets may mature ripe the cervix and create contractions. If contractions do not start from the tablets, then intravenous medicine can be administered.

First of all, the condition of the baby will be assed, by monitoring the fetus heart rate and the contractions of the uterus by a CTG for 30 minutes. You will swallow 1 or 2 tablets at a time, recommended by the midwife. You will take the first tablets at the labour ward. Then you and your partner usually can have a break from the hospital and go home. It is a good idea to try to rest at home.

We will hand out the tablets to be taken every 2- or 4- hours. You talk to the midwife, about when to go back to the labour ward for a follow-up. The follow up will usually be 8 hours after the 1 tablet.

It is individually when the effect of the tablets will occur. You will feel contractions and they become increasingly intense over time. They start as heavy menstruation-like pain also affecting your lower back.

It is common that when contractions occur, the amniotic fluid turns a little pink. Fetus movements will continue, similar to what you normally experience.

Contact the labour ward if:

• When labour contractions occur, you and the midwife will assess if you need to take further medicine.
• If very frequent contractions with short breaks occur, the midwife will asses If any changes in the plan should be necessary.
• Signs of infection: Increased body temperature, green or brown amniotic fluid, foul-smelling discharge or amniotic fluid.
• Heavy bleeding.

Oxytocin is an intravenous administrated drug, used to stimulate contractions once the membranes have ruptured.

Oxytocin is often considered if the cervix is fully effaced, you already have taken the tablets and strong regular contractions have not occurred, or if you had a previous caesarean section.

If oxytocin is recommended to stimulate contractions, you will be admitted to the labour ward and the fetus heartrate and your contractions will be monitored continuously with CTG.

When the membranes are ruptured, there is a risk that bacteria from the vagina can reach the uterus passing through the vagina. If it is more than 18 hours since the rupture of membranes, there is an increased risk of infection for both you and your fetus.

Studies have shown that if you stimulate contractions already 1-4 hours after rupture of membranes, the risk of infection for both you and your fetus is reduced as well as the use of antibiotics.

A bacteria called GBS (group B streptococci) is one of the most common bacteria from the vagina to pass on to the fetus. 14 hours after the membranes have broken we will offer you a test from your vagina and your rectum, to determine if this bacterium is present. If the GBS is present you will be offered antibiotics to prevent infection for you and your baby during active labour (regular and strong contractions and 4 cm dilatation of the cerix). If your GBS status is uncertain after 18 hours and you have reached active labour, you will be offered antibiotics as well.

When GBS is present we recommend that you and your baby is admitted to the hospital after the baby is born, usually 24-48 hours if there are no signs of infection.