Breaking The Waters During Birth

Ever wondered what actually happens when a midwife or doctor breaks your waters?

This procedure is called an artificial rupture of membranes (ARM), also known as an amniotomy.

During a vaginal examination, a midwife or doctor uses a small sterile instrument called an amnihook to make an opening in the membranes (amniotic sac) surrounding your baby, allowing the amniotic fluid to escape.

But why might your waters need to be broken?

According to NICE guidelines, there are two main situations where an amniotomy may be recommended:

To induce labour: If your cervix is favourable (a Bishop score above 6), NICE recommends offering an amniotomy alongside an oxytocin drip to start labour. You can choose to delay or decline the oxytocin drip after discussing the implications.

To help labour progress: If you're already in established labour but progress has been slower than expected, an amniotomy may be offered if your waters are still intact. NICE advises that this can shorten labour by approximately one hour, although contractions may become stronger and more painful.

Does having your waters broken hurt?

The membranes themselves don't have pain receptors, so breaking them shouldn't cause pain. However, the vaginal examination can be uncomfortable, and you may notice your contractions becoming more intense afterwards.

Does everyone need their waters broken?

Absolutely not!

NICE specifically advises against routinely breaking waters when labour is progressing normally and there are no concerns.

Like any intervention, an amniotomy carries potential risks, including infection, changes to your baby's heart rate and, rarely, umbilical cord prolapse.

Your midwife or doctor should explain why they're recommending the procedure, discuss the benefits, risks and alternatives, and obtain your consent.

Remember, just because an intervention is offered doesn't mean you have to accept it. You have the right to ask questions and make an informed decision about your care.

Did you have your waters broken during labour? What was your experience?