Amniotomy or artificial rupture of the membranes (AROM) is when a healthcare provider intentionally breaks a pregnant person’s amniotic sac. Your provider may recommend AROM to speed up your labor and encourage dilation of the cervix.
An amniotomy or artificial rupture of membranes (AROM), is a procedure to break your amniotic sac. An amniotic sac (or bag of waters) is a fluid-filled sac that surrounds the fetus during pregnancy. Your amniotic sac contains liquid called amniotic fluid. Amniotic fluid protects and cushions the fetus and softens its movements while in the uterus.
When it’s time for your baby to be born, the amniotic sac ruptures, and amniotic fluid comes out. This happens naturally as labor contractions progress for some people. However, for others, the amniotic sac doesn’t break despite being in labor. Therefore, your healthcare provider may recommend amniotomy to intentionally break your water.
Rupturing or breaking your amniotic sac can cause your uterus to contract and help dilate your cervix.
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In most cases, your healthcare provider performs an amniotomy to speed up your labor. There are risks associated with AROM, and it may not be ideal for everyone. Reasons for AROM are:
The effectiveness of AROM is often debated by healthcare providers and medical researchers. Some studies show that it doesn’t necessarily advance labor in low-risk pregnancies and that a natural labor progression is preferred. However, some data shows that it can speed up labor.
First, your healthcare provider will evaluate your cervix to see if it’s softened or thinned and if your baby’s head is in the correct position. Your baby should be low in your pelvis and pressed against your cervix. Next, your healthcare provider will place pads or towels under you to absorb the fluid from the amniotic sac once it's broken.
A thin, plastic tool called an amnihook ruptures your membranes. An amnihook is about 12 inches long with a curved hook at the top. It resembles a hook you’d use to crotchet a blanket. To break your water, your healthcare provider inserts the amnihook through your vagina. Once they find the bag of water or amniotic sac, they scratch or tear a hole in it to allow the fluid to escape.
You don’t need to prepare for an amniotomy. Be sure to discuss any concerns you have about the procedure with your healthcare provider.
You may see either a gush or a trickle of fluid from your vagina. Your healthcare provider will use several absorbent pads or towels to soak up the fluid. You may feel more intense contractions that come closer together. If the procedure is successful, your healthcare provider may tell you that your cervix is dilating more quickly.
Most people don’t feel anything, especially if you are already in labor or got an epidural to manage painful contractions. Your baby also doesn’t feel an amniotomy, and it doesn’t hurt them in any way. People who haven’t taken any pain medication may feel slight discomfort when the amnihook is inserted.
The advantages of having your water intentionally broken are:
There’s no guarantee that an amniotomy will shorten your labor or cause your labor to speed up. Complications of an amniotomy may include:
It’s unsafe to have your water broken if:
Not always. Healthcare providers have mixed feelings about the benefits of amniotomy. Some studies show it can shorten labor by about an hour. Other evidence shows that intervening with labor isn’t effective, and the risks may outweigh the benefits in an otherwise healthy pregnancy. You and your healthcare provider will make the best decision based on your pregnancy and your medical history. It’s always good to be informed so you feel comfortable with your options.
A note from Cleveland Clinic
An amniotomy can speed up labor during delivery. Every pregnancy is different, and there’s no guarantee an amniotomy will progress your labor. In some cases, your medical history or stage of labor can make this procedure dangerous. Make sure you understand the risks and benefits of artificially rupturing your membranes. Being informed about the procedure will help you feel confident that it’s the safest and healthiest decision for your baby.
Last reviewed by a Cleveland Clinic medical professional on 10/10/2022.
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