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. And some women break their water before having any contractions at all.
Other times, and for a variety of reasons, however, 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 this procedure.
What is amniotomy?
Amniotomy (also known as artificial rupture of the membranes, or AROM) is a procedure in which your practitioner helps give your labor a boost and speed up contractions by manually breaking your water by puncturing the amniotic sac with a hook. The thought is that after your water has been broken, your body produces hormones that help kick-start contractions. Sometimes amniotomy is used in combination with oxytocin to speed up labor.
However, the benefits and effectiveness of amniotomy are debated, 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 normally.
Why might your practitioner perform amniotomy?
If your doctor does decide to artificially rupture your membranes, it may be for the following reasons:
- 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, amniotomy should not be performed. For example, prolonged ruptured membranes (more than 18 hours) with multiple pelvic examinations could increase the risk for chorioamnionitis in a patient with a history of group B strep (GBS) and/or bacterial vaginosis.
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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.
If your practitioner decides that amniotomy is necessary, he or she will insert an amnihook, a long plastic device that looks like a big crochet needle, into your vagina (though you may not even catch a glimpse of it at all) and puncture a hole in the amniotic sac.
You may notice a gush of water after the rupture, and usually, your contractions will start coming stronger and faster once it's done.
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