Wednesday, December 29, 2010


To me, the amniotic membranes are an amazing and beautiful thing. They embody the concept of strength in flexibilty. Being so incredibly thin and yet such a tough defender of the babe. Keeping the baby tucked inside; encompassing the salty, warm, nurturing environment of the womb. When I do vaginal exams during labor, and I feel that filmy, slippery membrane I am constantly in awe of its power. The veil at the doorway that separates our two worlds.

Working as a nurse in the hospital, I was constantly shocked at the often flippant way the membranes were regarded. So easily ruptured with little to no explanation to the mother as to why. Sometimes, even 'just done' and not even mentioned until after the break! Such a routine intervention, to the point of not really being considered an intervention.

As a midwife, I have used AROM (artificial rupture of membranes), but very sparingly. To me, it is a serious intervention and one that significantly impacts the babe's experience....a sudden, potentially jolting change. Don't get me wrong, sometimes it is an appropriate and helpful intervention. I just don't like the 'routine-ness' of it. When I have done it, it has been after careful consideration and thoughtful discussion with Mama and her partner. I have had several couples, after this discussion, decline the AROM. In my experience, the membranes most often release on their own, in their own time...and sometimes they don't release and the babe is born with them intact. I have caught 3 little ones this way. (see a previous post about the significance of this) I have had some Mama's who, from previous experience, have thought that the membranes had to be ruptured for the birth to happen...that they would hold things up and get in the way. A very popular question from family members when they feel things are 'taking too long' is "aren't you gonna break the bag?" This has become part of our culture of birth and cultures are a hard thing to overcome. Let's see if we can work on this one....

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