Study proves ‘breaking the waters’ does nothing to speed up or help labour

Hand’s up who’s had their waters broken by a midwife or consultant either before or during labour?

I’m guessing lots of you. Certainly, in at least one of the largest maternity hospitals in the country it is policy to break the waters artificially of every woman presenting to the hospital in the early stages of labour.

Lets take a look at what ARM or ‘breaking the waters’ is and why it would be done:

Lots of people think the first sign of labour is the waters breaking. You can thank Hollywood for this myth. A gush of water is about the best way of depicting the onset of birth in the movies as it’s something you can see and shoot easily without having to do too much explaining!

The truth is only about 10% of woman will experience their water flowing before labour begins.

The vast majority of women’s waters break when they are partly or fully dilated which means labour is well progressed before the gush. They experience intense contractions before hand and know they are in labour.

The act of ‘breaking the waters’ also known as ARM (Artificial Rupture of Membranes) or amniotomy is when a medic ruptures the amniotic sac. This makes the water flow out.

Hospitals will tell you you need ARM because:

• They need to see the amniotic fluid
• It speeds up labour
• Its makes labour start (if you are not already experiencing contractions)
• Its policy

However, a team of researchers looked at 15 studies involving ARM for Cochrane (an international organisation aimed at improving health care by providing evidence to support interventions etc.). Here’s what they found:

• No evidence to show ARM shortens or speeds up labour
• No evidence to show ARM improves the birth experience for mum or baby
• Evidence to suggest ARM increases the likelihood of C-section
• Evidence to suggest ARM could potentially increase the likelihood of complications such as cord problems, increase in babies heart rate and uterine infection

The studies did not ask women how they felt and what they experienced with ARM (no surprises there!!) however, the many women we look after here at the elbowroom, tell us ARM makes labour more painful and intense.

The Cochrane report concluded that:

Routine amniotomy is not recommended as part of standard labour management and care.

Breaking the waters has been found useful in the following circumstances:

• If a baby is in distress and the waters need to be investigated to see if meconium is present. In this case a c-section may be indicated.
• Towards the end of dilation if a bag of waters is bulging under the babies head and inhibiting their decent.

If you would like to learn more about the pros and cons of induction, why not come along to our Baby Led Labour workshop.

Here, our birth guru, mum and doula Lisa Wilkinson will take you through numerous ways you can help the process along without interventions, which will make sure you, your partner and your baby, have a great birth experience.