One of the things commonly recommended to help speed up a delivery is breaking water during labor. But does this actually help or hinder the entire process?
I’ve had my water broken manually twice, and then once it did so on its own. I got the same result each time. But that’s not necessarily what will happen to all mothers.
Breaking Water During Labor
Most of you, 80% or so, will start with your amniotic sack intact during the first few stages of labor. So it’s not like the movies where the frantic mother realizes her water has broken without warning–let alone with no fluids appearing from out of nowhere.
Your bag of waters will most likely break somewhere around transitional labor and when your baby starts to descend down the birth canal, or the second stage of birth.
But often when
- your doctor is eager,
- your anxious fears of childbirth cause your progress to slow,
- or not enough patience and acceptance of your labor is present,
the intervention of manually breaking your bag of waters happens.
Officially, it’s called artificial rupture of the membranes, or amniotomy. Your doctor goes up in there with a plastic thingy that looks like a crochet hook, gives a little twist, and then your amniotic fluid floods the room. Not really, but it sure feels like a flood.
The standard belief has been that when a mother’s amniotic sack naturally breaks, her body will rush through any transitional labor remaining and start bearing down in delivering the baby.
Reasoning behind this comes from the fact that when the cushion of water pressure surrounding the baby is no longer present, the pressure of the baby’s head against the cervix will cause it to dilate faster.
Makes sense really. All of the final events of late pregnancy leading up to the labor and delivery exponentiates continuously, and a major part of them is the pressure of everything connected down there.
This in turn leads to stronger contractions in order to dilate the cervix. It’s often used much more than even intervening with a pitocin drip to keep your labor augmented. But research is much clearer on the actual outcomes and effects this has on your body during labor.
There is one situation where artificially rupturing your membranes is clearly advantageous:
- when your baby is under duress, seeing the contents of the amniotic fluid may indicate the need for other assistance once born, such as
- meconium (baby stool) present or
- blood visible
From personal experience, this as never been a problem in my births. Apparently there was a little meconium in my fluid every time. But it was never an issue with my babies’ outcomes each time.
A number of resources will list the typical variety interventions that all lead to the same negative pathway, even with just breaking your water:
- often the start of more interventions, such as pitocin drip
- increased chance of c-section
- less cushion for the baby, making the contraction more difficult for them
- increased risk of infection
- increased risk of cord prolapse without the fluid support
I’ve read studies that argue on all of these aspects as having no effect or even having a significant effect. But the general regard is that all of these risks are on the negative end of the scale.
However, when we take a number of reputable studies and compare them simultaneously en masse, you can get a better picture of greater accuracy.
The Cochrane Library, an international organization devoted to evaluating medical research, put together a review in 2007 of 14 complete publications that studied the outcomes and results of having an amniotomy. Altogether, about 5000 women and multiple independent researchers were involved.
What they found was a number of things:
- The chances of a mother needing a cesarean may seem to increase with amniotomy, but the findings weren’t statistically significant.
- This means that although it may affect the chances of certain mothers ending up with a c-section, the risk overall for the majority of mothers is not worth considering. No statistical significance means that it’s not worth your worry.
- There was no evidence to suggest the increased risk of having a prolapsed cord.
One thing that is of note: A number of obstetricians involved in the review STILL believe that having an amniotomy DOES cause increased labor. Why? Because the review DIDN’T show that having an amniotomy SLOWED labor.
So there are still nuances we don’t understand about this procedure and whether or not it will greatly affect your birth experience or not.
Against all the negative press, I can tell you that MY amniotomies have sped up my labor–each time.
℘ First baby, I was at 9cm and was there for a few hours. We wanted to get things moving along and I was SO ready to not be in transitional labor anymore. Gosh! So we broke my water–and BAM! I was ready to push.
℘ Same thing nearly happened with my second baby birth. I was at 7cm I think and had been walking for a few hours with no change. We broke my water because I refused to consider pitocin. Result: I had one LONG contraction and went fully to 10cm.
℘ I didn’t have an amniotomy this third time around. But I don’t have any doubt that if I HAD elected for an amniotomy, it would have sped things up.
Maybe it’s just person to person and pregnancy to pregnancy that things like this so often vary–or not. It’s really hard to know unless you’ve had similar experiences or decisions with each labor & delivery.
So I’m NOT saying that you can walk into the hospital at 4cm, request an amniotomy, and that you’ll be ready to push out your baby in the next 5 minutes. Nor am I saying that you can have an amniotomy at 8cm and be guaranteed to end up with a c-section.
All these little factors come into play. You can only rely on what you feel is right for you when it comes to having you doctor break your water or not. I haven’t ruled the possibility out with any future births that I may have. But don’t feel self-conscious if you rule it out for yourself.
The right things will happen for your body at the right time. Just make sure you’re on board with it. 🙂
Have you ever had your water manually broken? Gotta say, having it break on its own was much more powerful, interesting, and such an amazing feeling.