The amniotic sac has been protecting your baby throughout your pregnancy. But when your little one is finally ready to make an appearance into the world, the bag of waters' time has come to an end.
Often the contractions of active labor will provide enough pressure to rupture the membranes on their own, which is commonly referred to as a mom's “water breaking.” And some women have their water break before they feel any contractions at all.
Other times, and for a variety of reasons, your practitioner may opt to artificially break your water to speed up labor using a procedure called amniotomy.
Here's what you need to know about why and how your doctor or midwife might choose to break your water (also known as the artificial rupture of the membranes) to help labor along.
What is amniotomy?
Amniotomy (also known as artificial rupture of the membranes, or AROM) is a common procedure in which your practitioner helps give your labor a boost by manually breaking your water.
To do this, your practitioner punctures the amniotic sac with a sterile hook. The idea is that after your water has been broken, your body produces hormones that help kickstart contractions. Sometimes amniotomy is used in combination with oxytocin to speed up labor.[1]
However, the benefits and effectiveness of amniotomy have been up for debate, and the American College of Obstetricians and Gynecologists (ACOG) recommends that labor and delivery teams opt to wait longer to perform this procedure in low-risk pregnancies where mother and baby are progressing as expected.[2]
Why might your practitioner perform amniotomy?
If your doctor does decide to artificially rupture your membranes, it may be for the following reasons:[3]
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- To augment a labor that has stalled
- To induce labor
- To allow for internal monitoring of the baby
- To allow for a forceps- or vacuum-assisted delivery
- To see whether your baby has passed meconium (the first bowel movement), which may be a sign of fetal distress
The procedure may not be right for all laboring mothers, and in certain situations, your practitioner likely will choose not to perform amniotomy.
For example, prolonged ruptured membranes (for more than 18 hours) with multiple pelvic exams could increase the risk of a bacterial infection called chorioamnionitis.
How does your practitioner break your water using amniotomy?
Luckily, you won't feel much, if anything at all, when your membranes are ruptured, especially if you're already in labor.
“My doctor broke my water when I was induced with my second baby,” says What to Expect Community member jessman87. “It doesn’t hurt at all and goes super quick.”
If your practitioner decides that amniotomy is necessary, they will insert a thin plastic sterile tool called an amnihook into your vagina to puncture a hole in the amniotic sac.
If you haven’t had pain medication you may feel slight discomfort, but the procedure is safe and doesn’t hurt your baby in any way.[4]
An amniotomy is a procedure that’s sometimes performed to help speed up labor for moms-to-be. It involves manually breaking the bag of water, also known as artificial rupture of the membranes, to help prompt contractions.
After your water has been broken, your body produces hormones that might help kick-start contractions. An amniotomy is sometimes used along with oxytocin to help speed up labor even more.
If your practitioner decides that an amniotomy is necessary, they’ll use a thin tool called an amnihook to puncture the amniotic sac. This can be slightly uncomfortable, but usually isn’t painful and doesn’t hurt your baby.
The benefits and effectiveness of amniotomy are debated. ACOG recommends labor and delivery teams wait longer to perform this procedure in low-risk pregnancies.
What happens before and after your doctor breaks your water?
While there’s nothing you need to do to prepare for an amniotomy, be sure to discuss any concerns you have with your doctor. You may notice a gush of water after the rupture, which is totally normal. Your practitioner will have also placed absorbent pads or towels to soak up the fluid.
“This was done with my last baby,” says What to Expect Community user lmtaran. “I was 41 weeks and 5 days pregnant, and I was scheduled to be induced. The plan was to break the water and wait for one hour to see if I went into labor. The doctor broke my water (like popping a balloon!) and my baby was born 45 minutes later.”
Soon, you may also feel contractions building in intensity and you’ll be able to clock them closer and closer together. Don’t be surprised if your practitioner notes your cervix is dilating more quickly, and then soon … your little one will be here!
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