Before You Let Anyone Break Your Water, You Need to Know This...

It is common in our system for a doctor or midwife to recommend that a woman's water (amniotic sac) be artificially broken during labor if it hasn't broken on its own. The idea is that it will quicken the labor and cause the baby to be born faster. Often, women will even be erroneously and unethically promised this.

This procedure is technically termed an amniotomy. Sometimes it's also referred to as AROM (artificial rupture of membranes), "rupturing her", or "breaking her waters". The process involves inserting an amniohook into the vagina (similar to a plastic crochet hook), using the hook to snag the amniotic sac, and then tearing the membranes with the hook at which point the amniotic fluid (her water) flows out of the vagina and the bag is now permanently opened.

Here's what women often don't know or aren't told about this procedure...

1. It puts you and your baby on a timeline.

Once your water is broken, if you are working within the system, your birth is now on a timeline. You will be expected to give birth within a certain amount of hours (12, 24, 48...it varies by place and provider). If it is not going fast enough, you will be pressured to take antibiotics, be put on Pitocin, or even have a cesarean.

2. It might make labor much more difficult.

Once that cushion of fluid is gone, many women feel contractions become much more intense and more difficult to work through. This can lead to other interventions that weren't wanted like IV narcotics or an epidural.

3. It might impede your baby's ability to move into the position they need.

This means it can have the opposite of the intended purpose...it can slow things down and obstruct baby from moving down. The baby is able to move and navigate the pelvis more easily when they have fluid around them. A baby that is trying to get in a good position but whose water is then artificially broken will have a much harder time (and so will mom).

4. It might speed things up...but that might not be a good thing.

There's a reason it hasn't broken yet. Your body might be laboring at the pace it is for a very good purpose. A faster birth than your baby is ready for can be more traumatic to them (and you!) and cause some babies to need more help transitioning.

5. It might cascade into many more interventions.

Artificially rupturing water often leads to more interventions, each one carrying its own short and long term risks. Things like narcotic pain relief, an epidural, antibiotics, more cervical checks, Pitocin use, fetal distress, internal monitoring, a cesarean...these things can all be the result of the mother's water being broken artificially. Each one has its own set of repercussions that can affect you and your baby.

6. It can cause a cord prolapse, which is a life-threatening emergency.

If the baby's head is not very low and "applied" to the cervix, the water rushing out can also bring the cord down in front of the baby, putting it at grave risk of being compressed and cutting off baby's oxygen. This almost always means a true emergency cesarean.

7. It might introduce an infection.

Once your amniotic sac is open, the uterus and baby are now vulnerable to infection. This means antibiotics, which carry their own short and long term risks, and an infection can become an emergency for either of you. An infection for baby means an automatic stay in the NICU.

8. It is not evidence-based!

Studies show that, on average, it does not actually speed labor up at all! Anecdotally, we often see that it can seem to work for the intended purpose of hastening the birth but we also can see the exact opposite, where it slows things down or causes an obstructed or much more

difficult labor.

9. You can't undo it.

Once it's ruptured you can't undo that decision. A critical component of ANY big decision should be evaluating whether it is permanent or not.

10. It can be quite painful.

Many women experience the procedure itself as quite painful as it requires a vaginal exam and especially if the woman is in very active labor during it.

11. It might work and cause the baby to come out quicker and you might be really glad you chose it.

In this case, great! This isn't about fear-mongering but about understanding, knowledge, and informed consent. If you do decide to take that intervention, for some women it can sometimes work out well and you might look back feeling like it was a really good decision.

In the end, artificially breaking your water is a really big deal.

You can’t undo it. Before you ever choose it, you should know why and you should know the potential repercussions of it. It is not something that should be offered routinely. It should never be done under pressure or coercion and it should only EVER be done with full informed consent. Your water is there for a reason, protecting both you and your baby! Rushing birth, especially without good reason, can compromise how it was meant to play out and cause complications for both mother and baby. Your physiology was designed by God, your body is wise, and you deserve all the pertinent information to make these big decisions.