"As I was going very slowly, they broke my bag." This phrase is sure to be spoken by thousands of women because there are thousands of people who have heard it from a woman who explains her birth.
The bag break by the midwife or obstetrician, who receives the name of artificial amniorrexis or amniotomy, is one of the most common procedures in hospitals.
Continuing with the list of possible routine interventions in hospital delivery Today we will talk about this practice to know what scientific evidence is behind and what is recommended in this regard.
Why the bag is broken artificially
The objective of breaking the bag so that the woman “breaks water” artificially is to increase the contractions so that the birth evolves more quickly and therefore lasts less time. It is, as we have said, a very common practice, which, however, is not exempt from controversy when faced with the question of whether it could harm the mother or the fetus in any way.
AdvertisingWhat does the scientific evidence say
A Cochrane review of 14 studies with a total sample of 4893 women assessed the extent to which amniorrexis decreased labor time in women who were giving birth spontaneously and also in those who had also given birth spontaneously prolonged delivery
The results showed that there was no significant difference in the time it took to give birth to women who broke the bag with respect to those who did not have such an intervention, since the data show a weighted average of -20.43 minutes for women with a broken bag (their deliveries lasted on average 20.43 minutes less), obtaining this average from a time interval between -95.93 to 55.06 (Some, with the broken bag, had births up to 95.93 minutes shorter, but others, with the same intervention, took up to 55.06 more minutes to give birth).
There were also no differences in satisfaction with the experience of childbirth between some mothers and others, or in the Apgar score of babies at five minutes (this is positive, because at least it does not seem to affect the baby).
But nevertheless a possible association was observed between bag rupture and the risk of delivery with caesarean section (RR of 1.26), although it was considered not a statistically significant difference.
Recommendations
In the light of the data, the recommendation cannot be other than to ignore a practice that does not seem to improve either the duration of the birth or the personal satisfaction of the woman.
As we can read in the Clinical Practice Guideline on Normal Delivery Care:
It is recommended not to perform artificial amniorrexis ... routinely in vaginal deliveries that progress normally, since tests show that this does not improve the results.
What is your opinion?
As many of you were likely to have this technique, I would like to know what do you think about it: if you had the feeling that the delivery was accelerating or if on the contrary you did not notice too much difference.
