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.
Amniotomy Pros
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.
Amniotomy Cons
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.
My Experience
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.
Learn About All Of Your Options With A Natural Birthing Course
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.
I’m currently 40+6 (I know the dates are pretty darn accurate since I was fertility tracking), I’m 37 years old and this is my second baby. I’ve had some waves of irregular contractions following sex. I’m having a home birth with the same midwife that delivered my son. Yesterday I was checked by my midwife and I was at 6cm, 90% effaced and at -1 station. Since I’m approaching late term, she offered to do a membrane sweep and I agreed.
Yesterday I did also do nearly all the natural labor induction recs (minus castor oil and cohosh). Sex, breast pump four times 20-30 minutes, foot/leg massage, pineapple smoothie, mega dose red raspberry leaf tea, oil of oregano, eggplant parmesiana. Had a few here and there contractions, but nothing that became anything regular.
Today no “real” contractions, but lots of pelvic pressure that sort of comes in waves, but often are so gentle I hardly notice them. They don’t even feel like my early labor contractions of my first birth. So, just some pressure and often accompanied by Braxton-Hicks like tightening of my uterus.
My midwife did mention the AROM. I hate the idea of it as it seems to medically interventional. I read this. What do you think in terms of AROM with a very natural midwife and delivering at home?
For reference, my first came at 39+5 and it was a textbook labor and birth (although faster than most first births), totally natural (no IV saline lock — I refused), and no complications.
I think it’s a completely personal option. For me, breaking my waters always helped greatly. But others it does not. So knowing your own history is beneficial here as well. You’re still on time just fine as far as baby growth goes. All of the effort to try and induce yourself can actually be causing stress, which in turn inhibits going into labor.
Take a break, decide if breaking your sac is fine for you, and you’ll be fine either way. Let us know how everything goes!
I am expecting my fourth baby, and I am terrified of giving birth a fourth time. For all three of my boys, the Dr manually punctured my membranes after being 5-7 cm dialated and then boom, my contractions were so strong that my epidural did not help at all! I am thinking this time around to wait it out until the very end (9-10 cm) maybe painful labor will not last as long.
Any suggestions?
You doctor does not have to break your sac at all. If you’re getting an epidural, then the only reason he did that was to speed things along. Your baby can be born inside of the sac even.
Hi, your article was very informative and I learnt a lot from it. My first child was born via c-section. I remember during my routine check up on my 9th month, my doctor told me that I was already dilated up to 5cm so I had to remain in the hospital. At that time, I had high blood pressure (caused by pregnancy) and I had a difficult time pushing my baby out so the doctor advised me to go for a c-section. I can’t remember whether I had an amniotomy as it was more than 10 years ago but I know that I had amniocentesis done for my 2nd and 3rd child.
Hi Yvonne. That’s interesting that you were dilated to 5cm and hadn’t gone into labor yet, especially for your first baby. And where you say that you were full term, it’s likely that they did an amniotomy to help get your labor going if they didn’t give you pitocin to start contractions.
But yes, preeclampsia (high blood pressure and other things during pregnancy) can cause a few other problems during labor and delivery. So it may have been the safest option for you to deliver. I’m glad to hear that your children are all well though.
Have a great Thanksgiving this week!
What an interesting article! I have to admit that I too thought that labor began with the water breaking. It was very educational to read this article, and I gained a lot of knowledge! The video you placed in this article was relevant and helpful as well. I’m not quite in the stage of life where I’m ready to be pregnant, but when I am I will definitely refer to your site for advice!
I’m glad you liked it, Rachel. Keep in mind that even before you start having children, there are risks your doctor won’t even mention. Like those associated with lack of folic acid or if your over age 35. Be sure to keep those things in mind. Let me know if you have any questions. Best!
Hi Sarah,
I’m sure many mums and mums-to-be would appreciate your insight on how to know if breaking water during labor is right for you. I always thought it’s a standard procedure to speed up a labor and it never crossed my mind that may cause complications. My waters broke naturally around 8 am and my baby wasn’t born till 10.30 pm the same day so in my case that didn’t speed up anything really. However, I was told in the hospital that my labor was very quick.It all differs from person to person I suppose.
PS. I love your youtube video 🙂
Kasia
Hi Kasia. If your water broke before you were in active labor, that may have been a reason why you were told that your labor was quick. Did you start having contractions before your water broke? Western medicine considers a labor under 12 hours to be a quick one. But in reality, most natural labor & deliveries that have no physiological problems in the way, happen in under four to five hours, or a precipitous labor . So it really depends on the perspective you’re talking about.
Glad you like the video. 🙂 You’ll enjoy these TED talk for moms too, very enlightening. Thanks!
I was quite surprised myself how quick it was. Regarding all the stories I’ve heard about how your first labor is supposed to be long.My husband’s sister’s lasted 30 hours.
I didn’t have any contractions before my waters broke but when they started they were like 2-3 min apart and it was like that till my baby was born – 7.5 hours or so.
I hope my next one is even quicker 🙂
Kasia
I hope it’s quicker for you too, Kasia. And it most likely will be. 🙂
Look at how my three pregnancies and births were the same and different. I don’t resent having a two-hour labor with this last one, I’m glad it happened that way, absolutely. It’s just now, if we have another, and we likely will, we’ll have to expect things to happen just as fast, if not faster. Even where you had a 7 hour labor with your first baby, that’s pretty awesome in terms of timing. My sister in law had something like a 30 hour labor too, but I know she had an epidural too, which certainly slowed things down. Anyway, thanks for chatting! Have a great weekend.
Hi! Sarah I find very interesting your website for a young woman. You have good tips, I wish know At your age what I know now, your page will help a lot of woman..
I enjoyed reading this article, because it brought back some memories. I had an unpleasant labor and birth with my first child. She was born via forceps — horrible what for a baby to be born and they also artificially broke my water at that time as well.
So, when my spouse and I discovered I was pregnant with our second child, I wanted to take precautions. So I researched for days and hours and came up with a birthing plan with my obstetrician.
He agreed to it, but unfortunately I still had my water artificially broken by him and his reason was not because of the baby being under duress, but because I was getting tired and I admitted I was tired, but most moms who are in labor are tired.
He took my admittance of being tired as permission to do the procedure and before I had a chance to say “no” I felt my water being punctured.
So I like this article because it brings to light a very important topic for mothers-to-be.
Steph
No matter how long or short, intense or calm things are, mothers are ALWAYS tired during and after their births. That’s interesting that your doctor broke your water anyway. Usually bringing things on even quicker that way makes us even more exhausted. It’s not so much the length of time we’ve been through the labor, but rather the intensity of it that determines how much strength we seem to have left. But that’s definitely up for discussion. 🙂 Thanks for sharing Stephanie. I know that it’s very helpful for others who may read it. Best!
Hi Sarah! I thoroughly enjoyed reading & searching your website on Natural Childbirth! You are very knowledgable. You have credible sources & recommendations everywhere I clicked! 😉 So many moms are finding value & reassurance in the decision of natural baby birth. I would definetly direct my mom-to-be friends to your site! keep up the great work.I am so impressed with the professional look/style of your site. Would appreciate pointers! Best of luck to you.
Kimberely
Thanks so much Kimberely! You’re a gem. 🙂
I appreciate all the shares and likes from great supporters like you. Have a great weekend!
Hi Erashalibe,
Very thorough blog post about water breaking. You did a good job breaking this topic down for beginners to clearly understand. I will be bookmarking your site to refer back to as my girlfriend has been looking for a resourceful site on this topic. I wish you the best in your future endeavors in online marketing.
Best Regards,
Stephen
Thanks Stephen. Best to you and yours!
Hi Sarah!
You have a beautiful site! 🙂 This post was a very informative read for me. As a woman who hasn’t had children yet, it was awesome to ‘browse’ around and be able to read about your personal experiences. I’m at an age where I’m thinking about having a child, and I need to learn these things! I didn’t even know doctors manually broke your water! Which way is more painful, if you don’t mind me asking? Or does that even hurt? (HA!) Anyways, keep the good information coming!
When your water breaks, naturally or manually, it’s not painful at all. It’s almost a relief of pressure actually from the huge ballooning feeling you have during your pregnancy. But then it’s followed by more intense contractions because the fluid is no longer there to act as a buffer for those contractions. Does that make sense? But having the transitional labor contractions and the bearing-down contractions of your baby descending can be the same intensity whether your water has broken at all or not. Hope that answers your question.
Let me know if you ever have questions or need help when you are expecting. Thanks, Tonya!
Interesting! I didn’t even know that manually breaking water during labor was a thing. I thought it was always like those movie scenes you described where the water breaks suddenly and unexpectedly.
Not sure if I’d be comfortable with the idea or not, but I’m glad to be aware of it! It’s going to be a few years yet before I am ready to have children, but that’s no reason not to start getting educated now.
Thanks for sharing this information! I look forward to reading more from you in the future. I know for sure that when the time comes, natural birth is the only way I want to do it.
That’s great, Angela. You’ve already made a decision for yourself and even though you’re not even expecting yet, you’ve started down the right path. Let me know in the future if you ever need help with anything. I always recommend taking a birth course or two, plus learning how to master your relaxation and you’ll find joy in your entire experience. Best to you!
Hello there!
I haven’t visited your website in a while but I am impressed by all the great work you have done!
This is a very informative post. Honestly I had no idea that you could have your water broken manually.
It makes sense that it can help speed up your labor though.
I don’t know whether I would want to do this or not but I loved reading this anyway.
Thank you for sharing!
You’re welcome, Katerina. Either way, I believe your body is going to get rid of that amniotic fluid one way or another. 🙂