If your water – your amniotic sac – doesn’t break on its own during labor, your OB may rupture it manually. Here’s how it happens.
Not soon after going into labor with my daughter, I sat down on my couch only to hear an audible “pop,” followed by a release of fluid. With my son, my water never broke on its own.
In fact, I was nearly a week overdue when my doctor suggested we induce. Before starting Pitocin, the medicine often used to rev up contractions, my OB broke my water to jumpstart my labor.
Induction is very common with 1 out of 4 women in the U.S. starting labor with induction, according to WebMD. Manual breaking of the water, also known as artificial rupture of the fetal membranes (AROM), is typically performed to induce the onset of labor or to increase contractions in a sluggish spontaneous labor.
Despite the name, “breaking the water” causes little to no discomfort for the mother. Therefore, no anesthesia is used. However, most doctors will not begin the induction process until the mother has reached a certain stage in labor.
“If your water hasn’t broken on its own when you arrive at the hospital, and you’re five or more centimeters dilated, your OB might recommend bursting the bag by hand,” says The Bump. “Especially if your cervix seems to be making slow (or no) progress.”
What the Experts Say
Breaking the water means that your doctor makes a hole in the amniotic membrane, the sac that surrounds the baby. The bag of water is found inside the uterus and the doctor must reach through the vagina and cervix to get to it. Here’s what some experts have to say about artificially breaking the water.
“If her water doesn’t break on its own during labor, her medical team might decide to break it, which can cause labor to progress more rapidly. Why? Because amniotic fluid eases pressure on the cervix, and when the watery cushion is gone the baby presses more firmly on the cervix, signaling it to open up.”
Don’t Just Stand There, Elissa Stein, Jon Lichtenstein
“Breaking the waters is a crude but sometimes effective way to start labor when a woman is about to go into labor on her own. This method alone will initiate labor within twenty-four hours in seventy to eighty percent of women.”
Ina May’s Guide to Childbirth, Ina May Gaskin
“Television would have you believe that most women start labor with their water breaking. This is wrong. In fact, less than 10 percent of women have their water break before labor. For most women it doesn’t happen until quite late in the process.”
Expecting Better, Emily Oster
“If your cervix has already started to dilate, your doctor may strip your membranes to get you to go into labor. This is done by sweeping the examining finger over the membranes that connect the bag of water to the lower part of the uterus. This causes your body to release chemicals that ripen the cervix and may cause contractions.”
The Christian Woman’s Complete Guide to Health, Scott Farhart, Elizabeth King
“When a woman nears or passes her due date and grows tired of being pregnant, her doctor may suggest inducing labor, usually by breaking the bag of waters, at a time convenient for both doctor and client. Hurrying the onset of labor this way often results in a very long labor, the use of Pitocin to speed contractions, and finally, birth by cesarean.”
The Expectant Parents’ Companion, Kathleen Huggins
Steps to Breaking Your Water
When your water breaks, the amniotic sac that protects your baby in the womb tears, releasing a trickle (or gush) of amniotic fluid from your cervix and vagina. Most women’s water breaks during labor and after contractions have already started.
If you are overdue or want to speed up labor, your doctor may offer to break your water for you. Stripping the membranes does not always mean that labor will start right away, according to Parents Magazine. It can still take hours or even days for labor to begin.
Monitoring the Baby. Before breaking your water, your doctor will have some precautions in place in the rare event that something goes awry. A nurse will keep a good eye on your baby’s heartbeat before, during, and after the procedure.
Finding the Cervix. Next, your doctor will ask you to pull your knees up and apart. With a sterile glove and lubricant, the doctor will reach into the vagina and locate the edges of the cervix. You should try to relax as much as possible to prevent your muscles from tensing which can cause the process to be more uncomfortable.
Checking Baby’s Position. Once the doctor has located the cervix, he will most likely discover what feels like a slippery balloon if the cervix is opened. This is the amniotic membrane. Before breaking the water, the doctor will ensure that the baby’s head is down and covering the cervix to prevent the umbilical cord from slipping past.
Breaking the Water. If everything feels as it should, the doctor will use his hand to slide an amnio-hook into the cervix. This hook looks similar to a crochet hook but is not sharp and will not injure you or the baby. As the hook punctures the amniotic sac, it creates a hole in which amniotic fluid is released. Sometimes there is a lot of fluid and other times there is very little.
Monitoring the Fluid. Once the water is broken, the doctor will check the color of the fluid to ensure that it’s clear. The presence of blood or meconium (baby poop) could signal trouble.
Whether you’re about to give birth or are preparing for the future, you may be wondering what it’s like to have your water break. If you are induced at the end of your pregnancy, know that the breaking of the water is a fast and virtually painless procedure that can safely help kickstart your labor.