Evidence does not support the routine breaking the waters
for women in spontaneous labour
The aim of breaking the waters (also known as artificial rupture of the membranes,
ARM, or amniotomy), is to speed up and strengthen contractions, and thus shorten the length of labour.
The membranes are punctured with a crochet-like long-handled hook during a vaginal examination,
and the amniotic fluid floods out. Rupturing the membranes is thought to release chemicals
and hormones that stimulate contractions. Amniotomy has been standard practice in recent
years in many countries around the world. In some centres it is advocated and performed
routinely in all women, and in many centres it is used for women whose labours have become
prolonged. However, there is little evidence that a shorter labour has benefits for
the mother or the baby. There are a number of potential important but rare risks associated
with amniotomy, including problems with the umbilical cord or the baby's heart rate
Declercq, E., Sakala, C., Corry, M. P., & Applebaum, S. (2006). Listening to mothers II:
Report of the second national U.S. Survey of women's childbearing experiences. New York: Childbirth Connection.