![]() ![]() When she did break them there was some fresh meconium, which was expected. He was a bit stressed during labour – his heart rate was dropping lower than normal during contractions, but apparently recovering well. The midwife finally broke them immediately before his head emerged. When my son was born my waters didn’t break at all. The baby’s heart rate was fine so there was no need to interfere. As it was she birthed her baby in a quiet environment without being rushed. If the membrane had been artificially ruptured previously she would have ended up with a different birth story (continuous monitoring, possible augmentation etc). I ruptured the membranes with the suction on the perineum so I could clear the nose and mouth. She birthed her baby 20 minutes after I took over, baby born in the caul.Īs the membranes bulged through the introitus I could see meconium so the resusitaire was brought into room and the paediatrician called for. She was 4cm dilated, membranes intact on vaginal exam one hour previously, fetal heart was fine. I had a birth the other night, woman having her second baby, contracting strongly when I took over. After the lecture, one of the students in my group was horrifed that a midwife would not perform ARM as it was so dangerous not to know if there was meconium! A few of us had a chat with her…. We recently had a midwife in giving a talk about home birth and leaving the membranes intact. There is no indication for it in normal labour. It speeds things up for her, and also gives her peace of mind as she can see whether or not there is meconium in the liquor so she can get a paediatrician ready to be present at delivery. ![]() In my (limited) experience, ARM usually benefits the midwife. ![]() This can lead to need for more pain relief and possibly more interventions.Īnother reason is to check the colour of the liquor (amniotic fluid) if there are signs of distress, or to apply a fetal scalp electrode. The reason often given for performing an ARM is to speed up labour but if I remember rightly it only shortens labour by about an hour but it does tend to increase pain as the baby’s head is now directly on the cervix. The second twin’s membranes ruptured as the breech was at the vulva. In retrospect I could have let the baby be born in the caul. They were pretty tough and I wasn’t sure that I could wipe them off the baby’s face. Having said that I did rupture membranes last week – it was a first twin and when we had a grapefruit-sized bag of membranes hanging out and I could feel the head at the vulva I did rupture them with a hook. It is a method of inducing labour but that is another story. The research indicated that it does not shorten labour by any significant amount. ![]() I still don’t know of any reason to rupture membranes. In the animal kingdom the offspring are very often born in their amniotic sacs. Very often the membranes will rupture just before birth. But it really has no place in nomally progressing labour. It is useful if there is delay in progress. Unfortunately artifical rupture of of membranes has become “routine practice”. What exactly is the purpose of ARM (Artificial Rupture of Membranes)? Is it just to speed up birth- in which case who exactly does it benefit? Is it potentially dangerous? I’ve always pondered why this was done to me with my first baby – I never consented but that another argument! All I can remember was agony and losing control of the pain after it was performed. Born in a Caul – when the membranes do not break until birth. ![]()
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