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4 Reasons to avoid an AROM during labor

Sometimes the most innocent interventions can start a cascade of interventions that you were not expecting. Having a medical provider break your bag of water or artificially rupture your membranes also known as AROM is one of those innocent interventions.

Often, it is recommended to speed up labor. And when you are in the thick of labor, sister, that is going to sound like a fantastic idea. There are no pharmaceuticals involved and your bag of water will rupture at some point anyway. So no big deal, right??

Well, it may be a bigger deal than you might expect. Here are four reasons you may want to decline a recommendation of breaking your bag of water during labor.

  1. Your bag of water creates a cushion between you and your baby’s body during each surge. Imagine, if I were to put a hard ridged rock into a water balloon and have you squeeze the water balloon with both hands. You would not likely feel the hard ridges of the rock floating in the middle. Now, if I were to get a sharp pin and make a tiny hole in the bag, so that all of the water runs out and then again, ask you to squeeze the balloon with both hands, you would definitely feel all of the hard ridges of the rock and you might even say it hurts to squeeze the balloon now. This is the same as what is happening in your body. Your bag of water is creating a cushion between you and all of your baby’s tiny hard bones. When our bag of water breaks we now feel contractions that press up against our baby’s bones rather than soft cushiony water.

  2. Your bag of water helps create space for your baby to move into the optimal position for being born. During labor, you will sway your hips through contractions and your baby will wiggle and wiggle making its way down to engage your pelvic canal in preparation for birth. If our bag of water breaks before baby has wiggled its way into an optimal fetal position, then the baby may have a difficult time moving into an optimal birthing position. This is a very common reason that cesarean birth occurs. Sometimes baby’s engage moms pelvis a bit wonky or asynclitic and can no longer be born vaginally.

  3. Did you know that your bag of water will typically break naturally close to the end of labor or while you are pushing, with the exception of a person who is GBS pos.? This is important, because at this point your baby will arrive very soon, typically within 1-4 hours. Once your bag of water breaks, bad bacteria can begin to colonize your uterus. This means that from this point forward, time is precious. If your baby is not born within 4-8hrs the risk of developing a uterine infection begins to rise. Baby should be born within 12-24hrs after the bag of water ruptures. In the case where your baby takes longer than 4-8hrs after rupture of membranes to be born, antibiotics will be administered to help prevent a uterine infection.

  4. This last one is purely based on my experience. I have attended hundreds of births and have seen providers artificially rupture membranes to speed up labor many times. In my opinion there is a 50/50 chance that this intervention will achieve the intended goal. If you are considering this intervention, ask for a minute to consider this, take a breath, consider your personal situation and circumstances, way out the risks and benefits, then make your decision. There is never a reason to be rushed into this particular intervention. It is never medically necessary, meaning, this intervention, on its own, does not save lives.

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