Amniotomy Has Risks!
Let Your Water Break Naturally!
Many practitioners have started to routinely rupture the amniotic membranes to kick start labor. Many women call this procedure “breaking the waters.” It is formally called amniotomy. This procedure is done when a woman’s cervix is dilated and effaced but she is not in “active labor.” However, many doctors aren’t telling their patients the risks of this procedure.
How does a doctor break your water?
Your doctor will first ask for your consent. Then after explaining the procedure to you, your doctor will ask you to get into the same position you would be in for any other vaginal exam. Your doctor then will then insert an amniohook into your vagina and pass it through your already dilated (open) cervix. An amniohook looks much like a crotchet hook, with a flat handle. From there your doctor with scratch at the amniotic sac until it “breaks.” Many women say when their water is broken they experience a “gushing” sensation. After the waters have been broken you should experience intense contractions. Some women claim this procedure is painful and some claim that they felt no pain until the contractions began.
Naturally your water will break on its own any point after dilation begins. Some women have claimed their water broke at a mere two centimeters, while other women’s water didn’t break until nine centimeters dilated. Your body instinctively will pass the waters when your uterus is ready to make stronger contractions.
What is the amniotic sac?
The amniotic sac is what your baby lives in while inside your uterus. The amniotic sac is often called the amniotic membrane due to its composition of two membranes. The inner wall of the amniotic sac is called the amnion. The amnion holds the fetus and the amniotic fluids which are the “waters” that are released during an amniotomy. The chorion holds the amnion and is a part of the placenta. The amniotic fluids maintain a constant temperature and provide buoyancy. These fluids allow the baby to move within the amniotic sac.
Your doctor will first ask for your consent. Then after explaining the procedure to you, your doctor will ask you to get into the same position you would be in for any other vaginal exam. Your doctor then will then insert an amniohook into your vagina and pass it through your already dilated (open) cervix. An amniohook looks much like a crotchet hook, with a flat handle. From there your doctor with scratch at the amniotic sac until it “breaks.” Many women say when their water is broken they experience a “gushing” sensation. After the waters have been broken you should experience intense contractions. Some women claim this procedure is painful and some claim that they felt no pain until the contractions began.
Naturally your water will break on its own any point after dilation begins. Some women have claimed their water broke at a mere two centimeters, while other women’s water didn’t break until nine centimeters dilated. Your body instinctively will pass the waters when your uterus is ready to make stronger contractions.
What is the amniotic sac?
The amniotic sac is what your baby lives in while inside your uterus. The amniotic sac is often called the amniotic membrane due to its composition of two membranes. The inner wall of the amniotic sac is called the amnion. The amnion holds the fetus and the amniotic fluids which are the “waters” that are released during an amniotomy. The chorion holds the amnion and is a part of the placenta. The amniotic fluids maintain a constant temperature and provide buoyancy. These fluids allow the baby to move within the amniotic sac.
So what’s the risk?
Many practitioners still deny that there are any risks involved in this procedure. However, there have been numerous studies shown that when a woman’s waters are broken artificially her chances of having to endure an emergency C-section, are greatly higher. This is because women are only given 12 hours to deliver their baby after an amniotomy. (The typical time span for a woman to labor naturally with her first child is anywhere from 8 to 20 hours.) One trial study showed a marked increase in fetal distress, that quickly lead to an emergency C section, after an amniotomy was performed.
A study conducted by the Chinese Journal of Obstetrics and Gynecology in 2006 concluded with these findings “Risks (of amniotomy) include increase in abnormal fetal heart rate at second stage and possible rise in cesarean section rate.”
Another risk common with amniotomy is infections of the uterus and cervix. These infections are more likely to happen the longer a woman labors after her water was broken. This is why women are given the 12 hour limitation.
Women who are attempting to have a hospitalized natural labor should reconsider amniotomy. Due to the short amount of time given for a woman to labor, many interventions will be pushed to progress your labor. 57% of women who undergo an amniotomy are then given Pitocin to “speed up” their labors.
Another risk to the mother is uneven dilation. If an amniotomy is performed in the early stages labor a woman may dilate unevenly. The fore waters act to equalize the pressure on your cervix. Meaning the amniotic sac acts as a water balloon in between your baby’s head and your cervix. This allows the pressure of your baby to distribute weight evenly over your cervix, causing even dilation. This also leads to more tears to the perineum, as the amniotic sac provides gentler stretching. (Without the amniotic sac acting as a barrier, it’s common for babies head’s to swell in the places that held the most pressure against your cervix. This is the main reason for odd shaped heads at birth.)
Risks to your baby also include umbilical cord compression and prolapse. Umbilical cord compression is when the blood flow through the umbilical cord is obstructed. This often sends a baby into fetal distress and becomes a cause for an emergency C-section. Umbilical cord prolapse happens when the umbilical cord exits the uterus before the fetus. It is an obstetric emergency during pregnancy or labor that imminently endangers the life of the fetus. (Mortality rate of 11-17%) This also leads to an emergency C-section.
So all in all, is it really worth it?
Many practitioners still deny that there are any risks involved in this procedure. However, there have been numerous studies shown that when a woman’s waters are broken artificially her chances of having to endure an emergency C-section, are greatly higher. This is because women are only given 12 hours to deliver their baby after an amniotomy. (The typical time span for a woman to labor naturally with her first child is anywhere from 8 to 20 hours.) One trial study showed a marked increase in fetal distress, that quickly lead to an emergency C section, after an amniotomy was performed.
A study conducted by the Chinese Journal of Obstetrics and Gynecology in 2006 concluded with these findings “Risks (of amniotomy) include increase in abnormal fetal heart rate at second stage and possible rise in cesarean section rate.”
Another risk common with amniotomy is infections of the uterus and cervix. These infections are more likely to happen the longer a woman labors after her water was broken. This is why women are given the 12 hour limitation.
Women who are attempting to have a hospitalized natural labor should reconsider amniotomy. Due to the short amount of time given for a woman to labor, many interventions will be pushed to progress your labor. 57% of women who undergo an amniotomy are then given Pitocin to “speed up” their labors.
Another risk to the mother is uneven dilation. If an amniotomy is performed in the early stages labor a woman may dilate unevenly. The fore waters act to equalize the pressure on your cervix. Meaning the amniotic sac acts as a water balloon in between your baby’s head and your cervix. This allows the pressure of your baby to distribute weight evenly over your cervix, causing even dilation. This also leads to more tears to the perineum, as the amniotic sac provides gentler stretching. (Without the amniotic sac acting as a barrier, it’s common for babies head’s to swell in the places that held the most pressure against your cervix. This is the main reason for odd shaped heads at birth.)
Risks to your baby also include umbilical cord compression and prolapse. Umbilical cord compression is when the blood flow through the umbilical cord is obstructed. This often sends a baby into fetal distress and becomes a cause for an emergency C-section. Umbilical cord prolapse happens when the umbilical cord exits the uterus before the fetus. It is an obstetric emergency during pregnancy or labor that imminently endangers the life of the fetus. (Mortality rate of 11-17%) This also leads to an emergency C-section.
So all in all, is it really worth it?
I was induced at 42 weeks pregnant. I had fought induction to the very end even though I was miserable! Even my OB/GYN, the most midwife-like OB was planning to break my water. But I simply refused. In my hospital experience I realized that you're given very little chance to do things to break your own water. No one gave me the risks, no one had me sign a form of consent, nothing. I was appalled! I was given a list of things my OB would do to break my water, like I had no choice. When asked why she would break my water so early in labor no one could give me a practical answer. Truth is, breaking your water doesn't speed up labor. All it does is speed up the time that baby has to come out of your body, which makes for an early delivery by C-section. When I refused I was looked at like I was an alien. Then my CNA dared to ask "Well, don't you want it done and over with so it doesn't surprise you later during a contraction?" WHAT? I nearly slapped her. After that I was on my birthing ball, dilated at a 4, it literally took me ten minutes and my water broke on it's own.
There are many ways to getting your waters to break with out a long crochet hook ladies. Simply try walking, a birthing ball, a warm bath, a shower, simple stretches, or just simply giving it time! Do not rush this early part of your labor. This is the foundation of a long stretch ahead of you. This is the easiest part of your labor! Enjoy it. Use it to get to know your birth team and get some grub if your OB or midwife still permits it.
Happy Pushing Ladies!
-The Tickle Monster
There are many ways to getting your waters to break with out a long crochet hook ladies. Simply try walking, a birthing ball, a warm bath, a shower, simple stretches, or just simply giving it time! Do not rush this early part of your labor. This is the foundation of a long stretch ahead of you. This is the easiest part of your labor! Enjoy it. Use it to get to know your birth team and get some grub if your OB or midwife still permits it.
Happy Pushing Ladies!
-The Tickle Monster
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