Cynthia Luxford, LDM-CPM

E-News asked readers, what are the fetal benefits to labor with intact membranes?

I have made it a practice with all my laboring moms to never artificially rupture membranes. This is a result of a birth that I attended nearly 10 years ago. It was the mom’s first homebirth; at her two previous births her membranes had been ruptured during early active labor; she felt it was a necessary part of her labor and it helped her progress. She wanted me to rupture the bag this time. I really didn’t want to, but it was her birth so I agreed. At 6 cm there was not enough of a bulge to the bag to allow the amnihook to snag it, so I backed off. When she was 8 cm, I made my second attempt. Nothing! I looked carefully at the hook and realized there wasn’t a beak on it. I thought, I am not supposed to break this bag.
About 45 minutes later a nice big baby boy was born. When my mentor examined the placenta she said, “This baby is truly a miracle baby.” Coursing through the membranes were many vessels from the placenta (vasa previa) and a velamentous insertion of the cord–the Wharton’s jelly didn’t continue to surround the vessels of the cord all the way to the placenta. The vessels looked like bare wiring the last eight inches to the placenta. If I had been successful in rupturing the membranes, the baby would have been in danger of bleeding to death.
After this experience, I never rupture membranes. I feel the benefits of intact membranes are many: the amniotic fluid protects the cord from compression and prevents fetal distress. It protects the baby’s head from the pressure of the birth canal and the bulging bag helps dilate the cervix and birth canal as it presents before the baby’s head and opens up a space for the babe to come into. The baby continues to have its watery environment during the labor to continue drinking and breathing the fluid. I believe this helps the baby prepare for life outside the womb.
Leaving the membranes intact also allows the baby to change positions with greater ease, which prevents asynclitic and other cephalic positional challenges from occurring. If the mother’s labor stalls or stops, there is no time constraint because the membranes have ruptured. This intervention is irreversible and leads to more interventions and complications. I have seen many babies born in the caul and it is a truly amazing sight. I have seen many bags full of fluid crowning before the baby’s head, with vernix swirling around inside it, looking like a picture of the earth from outer space with the clouds moving upon its face.

– Cynthia Luxford, LDM-CPM

Found on Midwifery Today (