What, exactly, gets broken when they break your water?

Breaking the Water

The amniotic sac extends from the placenta and completely surrounds the baby. It’s filled with amniotic fluid, which is basically water. It has a few loose cells from the baby in it, and other nutrients and things, but it’s mostly just water, When people talk about “breaking the water”, what they really mean is making a hole in the sac so that amniotic fluid can flow out.

Sometimes it’s done to try to induce or speed up labor, and sometimes it’s done to check the color of the fluid.

How it’s done

Most of the time it’s done with an amnihook, a small plastic rod with a tiny little hook on the end. You can see a close up of the end of an amnihook in the photo on the right. While doing a vaginal exam, the midwife or doctor will slide the hook between their fingers and use the tiny hook to tear a hole in the bag. It’s possible that you’ll feel a gush of water at that point, but generally it doesn’t hurt to do this, since there are no nerves in the sac. It’s possible to feel some pain, but most of the time I’ve seen this done the birthing person just feels pressure from the exam.

Occasionally care providers will use something called an amnicot instead. It’s like a latex glove for just one fingertip, with a small hook on the end, used very much the same way as the longer hook.

Pros and Cons

Pros

  • Might speed up labor or get contractions started. In my experience this is more of a benefit when there is a pool of fluid between the baby’s head and the cervix, as it can help bring the baby down more firmly against the cervix.
  • If the care provider is concerned about whether or not the baby has had a bowel movement before birth, they might suggest breaking the water to find out.

Cons

  • There’s a possibility of stressing the baby out by removing the cushioning of the fluid. Because of this, the care provider will be watching the baby’s heart rate carefully for a while afterwards to evaluate how the baby is handling the change. Sometimes the stress is so severe care providers have to give oxygen, restrict position, or even do a cesarean.
  • The amniotic sac is the last barrier between the baby and the outside world, so the risk of infection (either in the baby or in the uterus) is higher. The longer it’s broken the higher the risk is. Always ask about what might happen if it doesn’t work, as there’s no turning back.

Like everything else on the medical side, this is a tool that can be useful and can also be misused. Choose carefully and make sure you understand all the potential implications for the future.