Is breaking your waters really necessary?

Breaking your waters

charlotteI always thought my labor would start with a huge dramatic gush of water in the middle of the street while running errands, like Charlotte from Sex and the City. I never actually thought about the possibility that my waters wouldn’t naturally break at all. And in stead, I would need my midwife to pop in a crotchet pin to do it for me… I supposed statistics were stacked against me from the get-go: only 8-10% of labors start with waters breaking!

When my midwife told me she was going to break my waters, I had the idea that it was kind of a routine procedure and assumed that there was no alternative. I recently came across an interesting article about artificial water breaking written by a midwife (in Dutch, sorry non Dutchies), and decided to share some of the things I learned with you guys!

Check out the pros and cons of breaking your waters below!


How does it work?

break your waters

How your waters are broken during an amniotomy.

Amniotomy is when a midwife/doctor/other care provider deliberately breaks the amniotic sac (breaks your waters). A sort of crochet pin is inserted in your you-know-what and the balloon like sac your baby has called home for about nine months is “popped”. If you are already in labor, the procedure is done during a contraction. It doesn’t hurt (disclaimer: in most cases and when done right!), but it is uncomfortable and awkward. Once your health care provider breaks your waters you will start leaking amniotic fluid.

This is usually done to speed up labor, but it can also be done to induce, or in order to attach a fetal monitor to the baby’s head when there are signs of foetal distress (baby is not amused). Sometimes the sac is broken so the amniotic fluid can be tested for meconium (baby pooped in the water).

Pros to breaking your waters

Some of the pros to having the sac broken artificially include:

  • breaking your waters allows your amniotic fluid to be checked for meconium (baby poo, which can be inhaled by the baby (meconium aspiration), potentially causing problems for the baby).
  • By the time a woman is dilated 8 cm or more, it might speed up the last three centimeters of dilation. There is no scientific evidence supporting this claim however.
  • break your waters

    Baby born en caul (in the amniotic sac). This photo was shot by Greek doctot Aris Tsigris after assisting in the en caul birth.

    If your waters are not broken, chances are that they will break spontaneously due to the pressure when the baby is passing through the birth canal (or earlier). If this doesn’t happen the baby is born en caul (aka: in the veil or with a helmet). In some cultures this is said to be good luck, but it also means the baby misses out on the bacteria of moms birth canal. This, in turn, can impair the formation of the baby’s immune system (slightly). The baby is than more prone to have asthma, allergies, eczema, type 1 diabetes and celiac disease. Baby’s born via c-section miss out on moms awesome vaginal bacteria as well, and recently an interesting trend has sparked among planned c-section moms who resort to a practice called seeding. Read more about seeding here!

Cons to breaking your waters

There are a number of cons to breaking your waters for both mom and baby:

  • Oftentimes, amniotomy is the start of labor and birth interventions.
  • Research shows that women who have their water broken artificially have an increased chance of having a c-section.
  • Once the water is broken, there is no cushion for the baby’s head and contractions become harder for the baby to handle: “The increased pressure differentials around the fetal head may lead to deformities of the skull.” Human Labor and Birth 5th Edition, by Dr. Harry Oxorn. (Via Childbirth.org)
  • A mother’s risk of infection dramatically increases.
  • Once the bulk of the water gushes out, the umbilical cord has a greater chance of being compressed and cutting off oxygen to the baby.
  • It stops a woman’s body from acting naturally and sometimes can take away the feeling of control from the mother.
  • It is very dangerous when a woman has undetected vasa praevia: when one or more of the blood vessels of the placenta or umbilical cord are located under the baby (not to be confused with placenta praevia: when your placenta is in front of “the exit”). Women with vasa previa are recommended to deliver their baby by elective c-section prior to their waters breaking, because when the waters break chances of infant mortality are between 50-90%. Given that the timing of waters breaking naturally is difficult to predict, elective c-section at 35-36 weeks gestation is recommended.

Conclusion

In most cases breaking your waters is not necessary, and can even cause dangerous complications. The decision to break your waters should be your own decision. If you have doubts about your health care providers’ suggestion to break your waters, ask him or her to substantiate the decision to break your waters! Looking back on my own delivery I regret trusting my midwife to make this decision for me instead of trusting my own body to make the decision.



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