Chorioamnionitis and fever in labour: signs, treatment and care for mother and baby

The baby develops inside the amniotic sac, whose membranes (the chorion and amnion) and fluid act as a protective barrier. Chorioamnionitis is infection and inflammation of these membranes and the fluid, often from bacteria travelling up from the vagina. Tommy's explains that after the waters break, the membranes no longer form a protective barrier and there is a risk of infection getting into the womb.

NICE, in its guideline on neonatal infection, calls chorioamnionitis a serious infection that needs to be treated with antibiotics to prevent maternal harm. NICE also notes that fever in labour has other possible causes, so a fever on its own does not prove chorioamnionitis.

Tommy's lists the symptoms of infection after the waters have broken as a raised temperature, an unusual vaginal discharge with a bad smell, a fast heartbeat and pain in the lower tummy. The baby's heart rate may also be faster than normal, which midwives pick up on monitoring. NICE notes that diagnosis during labour is usually based on clinical signs rather than a single test.

If you are pregnant and your waters break, or you have a temperature, shivering, smelly discharge, a racing heart or tummy pain at any time in pregnancy, contact your maternity unit or call NHS 111 straight away rather than waiting. If you feel very unwell, are confused, have difficulty breathing or have blue, pale or blotchy skin, call 999 or go to A&E. The NHS says that people who are pregnant, have given birth or have had an abortion or miscarriage in the past 6 weeks have a higher chance of sepsis.

There is no single test. Midwives and doctors combine your temperature and pulse, signs of tenderness or discharge, and the baby's heart rate. Tommy's says that when waters have broken early you will have temperature, blood pressure and pulse checked regularly and blood tests to look for infection. NICE notes that the wording used in its risk factor list was reverted in 2026 to 'suspected or confirmed chorioamnionitis' after concerns that a baby was not assessed because the infection was suspected but not confirmed. That reflects a cautious approach in which a suspected case is treated as a risk factor.

NICE recommends antibiotics given during labour for chorioamnionitis. It says that gentamicin and metronidazole are also now recommended, because the infection can be caused by Gram-positive or Gram-negative aerobic and anaerobic bacteria, so a broad-spectrum combination is needed. For people with a non-severe penicillin allergy it considers that the benefits of cephalosporins outweigh the small risk. NICE also notes that, at the time of the review, units varied in which antibiotics they gave.

The timing and mode of birth depend on how well you and the baby are. Tommy's says that if there are signs of infection the baby may need to be born straight away to stop you and the baby from becoming more unwell. After birth, NICE advises assessment of the baby for early-onset infection, using chorioamnionitis as one of the risk factors; some babies are given antibiotics and observed on the postnatal ward or neonatal unit.

With prompt treatment most mothers recover well, but the infection can spread and lead to sepsis, which the NHS describes as a serious reaction to infection that develops quickly and needs urgent treatment in hospital. Recovery from sepsis can take weeks or months, and the NHS suggests being patient, resting, eating well and building up exercise gradually. If you have had a fever in labour, tell your midwife or health visitor if you develop a fever, wound or womb pain, or offensive discharge after the birth.

For the baby, the outlook depends on gestation, how early infection is treated and whether the baby is premature.

Labour and delivery for suspected chorioamnionitis is hospital-based, usually on an obstetric-led unit with neonatal support. Whether you are booked on the NHS or privately, the same national guidance applies. If you have any worrying symptoms, contact the unit where you are booked straight away, or go to the nearest emergency department if you cannot reach them.