Having Your Waters Broken by a Midwife
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While the baby is in the uterus, they are protected by amniotic fluid. This is contained in the amniotic sac, which tears during the onset of labour. When the fluid exits the body via the vagina it is referred to as the 'waters breaking'.
Having your waters broken by a midwife or doctor is one way to help kick-start or induce your labour. It's also a technique used to augment labour, which means it speeds up or restarts a labour that has slowed down or stopped.
Reasons for having your waters broken
There are several reasons why your carers might want to induce labour, but the most common reason is that you have gone beyond your expected due date. This can be of concern because the placenta may begin to deteriorate once you have gone past full term, which can lead to your baby not getting the necessary amounts of oxygen and support. If you go over your due date by a week, then the doctors will monitor you to make sure your placenta remains healthy and the baby is not at risk.
Other reasons for induction include the baby measuring large, any mild health conditions that could affect labour, or more worrying conditions such as pre-eclampsia (high blood pressure), or complications with diabetes.
It's hoped that breaking the waters will give a signal to the body to start labour naturally. If you had planned to have as natural birth as possible, then you may find it upsetting to have an early intervention. This is understandable, but if you do need to have your waters broken and it is effective, then there is no reason to think that the rest of your labour won't progress normally.
The steps to breaking your waters
The first steps to encourage your body into labour will probably involve a membrane sweep followed by a dose of synthetic prostaglandins drugs. These drugs mimic the body's birthing hormones, which leads the cervix to shorten and soften. At this point, it's a good idea to keep mobile as that can help to encourage labour, so don't be tempted to lie down.
If after several doses the prostaglandins don't work, the next stage will be to break your waters. This is a standard procedure and one your doctor or midwife will have done many times before.
Your waters can be broken as long as your cervix is ripe and has begun to dilate. To break the waters, the midwife or doctor will insert a thin instrument called an amnihook into the vagina and through the cervix to tear, or break, the amniotic membranes. This process can be uncomfortable, but should not be extremely painful. In theory, the waters breaking should act to stimulate labour because rupturing the membranes triggers the uterus lining to naturally release prostaglandin.
However, if breaking your waters does not lead to the onset of labour within a few hours, then you will most likely be put on an oxytocin drip.
More reasons for having your waters broken
The other reason to have your waters broken is augmentation of labour. Most women will find that once in labour, it will progress normally and through the different stages to birth. Occasionally, however, labour slows down or even stops completely. If this happens, you may need what is called 'augmentation of labour' which is when the midwife or doctor will try to speed your labour up or help it to resume. Breaking your waters is one method of augmentation.
Whether a woman has had her waters broken to augment labour or to induce labour, the midwife should check the baby's heartbeat after the procedure to check that it hasn't caused him or her any distress.
The result of breaking waters
Breaking the amniotic sac can unleash large amounts of fluid, so you may want to sit on towels or the midwife may place a bucket underneath you to collect them. It's important not to feel embarrassed at this stage, as this is a vital part of labour and every woman experiences it. It's a good idea to use the breathing techniques you've learned for labour to help you relax while your waters are being broken.
The result of having your waters broken should be the start of contractions. If the aim was to augment labour, then ideally the intensity of contractions will increase or restart if they had stopped. Of course, in some cases there is no difference, in which case the medical team would recommend the next stage of care needed to deliver your baby safely.
Any kind of interference in your pregnancy or labour, even if it's minor, can be worrying for both mother and father-to-be. Don't be afraid to ask the midwives and doctors exactly what's going on and ask them to explain why they are recommending a certain course of action. Continue to use your breathing techniques to stay relaxed and focused. Remember that no labour is stress-free, and having your waters broken at this stage should not affect the rest of your labour.