Another Article from NYTimes

Childbirth: Purposely Breaking Water Does Not Speed Delivery


By NICHOLAS BAKALAR
Published: October 30, 2007

A large review of studies suggests that a common procedure in labor, intentionally breaking the water, has no effect in reducing the labor time or assuring the baby’s health.

The procedure, sometimes called amniotomy, involves rupturing the amniotic membranes to speed contractions. The procedure has been in use for at least 250 years, although its popularity has varied.

The researchers reviewed 14 randomized controlled trials involving almost 5,000 women and found little evidence for any benefits. Amniotomy did not shorten the length of labor, decrease the need for the labor-stimulating drug oxytocin, decrease pain, reduce the number of instrument-aided births or lead to serious maternal injury or death.

The report, published Oct. 17 in The Cochrane Reviews, did find that the procedure might be associated with an increase in Caesarean sections and a reduced risk of a lower reading on the Apgar scale, which rates the baby’s condition at birth. But neither finding was statistically significant.

“We advise women whose labors are progressing normally to request their waters be left intact,” said the lead author, Dr. Rebecca Smyth, a research associate at the University of Liverpool. “There is no evidence that leaving the waters intact causes any problems, and there is not sufficient evidence to suggest any benefit to either themselves or their baby.

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