Born “In the Caul”: Why They Might Not Need to Break Your Water


During pregnancy, the amniotic sac has many roles. It holds the fluid that protects the baby, provides cushioning and allows him or her to move freely for much of the pregnancy. The fluid contains important electrolytes, proteins, and more for the growing baby; it also gives the baby a way to breathe and swallow in utero. But this amazing, protective bubble plays possibly an even greater role during childbirth!

I think Rachel at Midwife Thinking says it best:

During a contraction, the pressure is equalised throughout the fluid rather than directly squeezing the baby, placenta and umbilical cord. This protects the baby and his/her oxygen supply from the effects of the powerful uterine contractions. When the membranes have ruptured, the placenta and baby get compressed during a contraction. Most babies can cope well with this, but the experience of birth for the baby is probably not as pleasant. When the placenta is compressed, blood circulation is interrupted reducing the oxygen supply to baby. In addition, the umbilical cord may be in a position where it gets squashed between baby and uterus with contractions. When this happens the baby’s heart rate will dip during a contraction in response to the reduced blood flow. A healthy baby can cope with this intermittent reduction in oxygen supply for hours (it’s a bit like holding your breath for 30 seconds every few minutes). However, this is probably not so great for an extended period of time, or if the baby is already compromised through prematurity or a poorly functioning placenta.

Eventually, the force of the contraction and the movement of the baby will rupture the sac as the baby’s body is born. You don’t need to worry about the sac holding the baby back. A baby and uterus are stronger than the membranes.

Despite this wonderful truth, many membranes have “help” rupturing (this was true with both my first and second births, and neither were necessary).

Artificial Rupture of Membranes (AROM) or Amniotomy

Most women do not have their water break spontaneously at the onset of labor (only 10-20% do), but many have it artificially broken by a doctor or midwife at some point. According to Wikipedia, there are four main reasons for performing an amniotomy:

  1. To induce labor or augment uterine activity.
  2. To enable the doctor or midwife to monitor the baby’s heartbeat internally.
  3. To check the color of the fluid.
  4. To avoid having the baby aspirate the contents of the amniotic sac at the moment of birth.

While these may be necessary for some, there is (at least) one major issue with AROM: it often leads to more interventions. It rarely, if ever, stands alone and results in a med-free, natural birth. Once a woman’s water has broken, she is on the clock; most doctors will give 24-48 hours before they will insist her baby(ies) be delivered. If her labor stalls or “fails to progress”, she is likely to be given the man-made version of oxytocin (pitocin or syntocinon) to cause contractions, but these artificially-induced contractions are no joke! She is likely to need an epidural to cope with the pain. Also, after hours of these contractions, the baby may struggle with a repeated drop in heart rate. If she still fails to progress, is unable to effectively push, or the baby’s heart rate continues to drop, they may start discussing the need for a cesarean.

Born in the Caul

Many women have their water broken during labor because they are under the impression that it needs to be broken and/or it might not do it on its own, but that’s just not the case. It is normal for a woman to have her water break as she is pushing (this happened to me with my third) but there are even some babies who are born en caul, which means with all of the amniotic sac still intact. My friend, Kerry, from Winding Road teamed up with me today and has posted her story, in which she gives birth to her daughter in the caul. Check out her great post. :)

Because so few babies are born this way, there have always been beliefs on the significance of it. Some say that a child born this way may have special intuitive powers, be destined to be a midwife, have extraordinary luck or never die by drowning.¹ In medieval times the appearance of a caul on a newborn baby was seen as a sign of good luck. It was considered an omen that the child was destined for greatness.²

♦ ♦ ♦

Whether our babies are born in the caul or our water breaks at some point during labor, I know one thing: we need a lot fewer interventions and a lot more trusting to let our bodies do what they are designed to do.




Image creditDavid Roseborough

29 thoughts on “Born “In the Caul”: Why They Might Not Need to Break Your Water

  1. You’re right about drug induced contractions are no joke! Mine weren’t pleasant but luckily no other interventions were needed. The contractions were powerful enough!!

  2. Pingback: In the Caul | Winding Road

  3. I had PROM with both pregnancies. With my twins, one sac broke and the other didn’t. They manually broke the second during my csection. The first twin came our swollen, battered and bruised. It was really sad. I have a feeling if her sac would have lasted longer 1. I wouldn’t have been in labor at 31 weeks but 2. She would have been better protected!

      • With my first pregnancy, they suspected an infection although all the tests came back negative. She was still treated in the nicu and I had iv meds because everything pointed that direction.

        With my second pregnancy, I was in labor for 8 weeks so I imagine the sac just gave up. I don’t know the science on how strong they are or anything but it was put through the wringer, that’s for sure.

  4. An interesting read. I had no idea that some babies were born without the amniotic sac ever breaking. My water broke at home so I’m part of the 10%, that lead to many interventions. I agree that a birth with fewer interventions should be what we shoot for. Giving birth shouldn’t be rushed and interventions should only be made if there is a genuine concern for mom and baby’s well-being.

    By the way, I love the new photo in your sidebar ;)

  5. I didn’t even realize that we had a choice. My first childs dr broke my water-then immediately gave me pitocin and then my epidural. My second childs water broke in the hospital on its own-and my third was an induction so again the dr broke the water….this is so interesting. maybe if we have a fourth, this will be something to think about….thanks for sharing this!

    • Definitely something to look into more. :D Inductions and interventions have become so common-place that many women don’t realize they have a choice. :/

  6. My youngest was born in the caul. My labor progressed very quickly and I was pushing him out as the doctor came running in. No one had a chance to try to break my bag of waters. When he came out still in the sac, we all thought it was pretty cool. I looked it up later and found out he’s destined for greatness ;) All I know is that it was really cool to see!

  7. There seem to be a lot more babies born in the caul these days with women making the decision to have natural births with as few interventions as possible. It’s truly amazing! I would love to see that in the reals!

      • I sure hope so! I absolutely plan to educate my daughter from the start. I didn’t even know what ovulation was really until I started trying to conceive–how ridiculous is that?! We were never taught these things!

  8. Great to chance on your blog. I have 3 kids. With the first I had AROM as he was in a posterior postion and I had already laboured longer than 24 hours. He was a natural birth with epidural. The second was a waterbirth and my water broke a few pushes before he was born. My third was a waterbirth and he was born in the caul. Quite an unusual event and I think even the midwife was surprised! Just wish I had a photo of it.

  9. Pingback: Natural Childbirth: Not Just for Homebirthers | Atlantamomofthree

  10. It’s probably no surprise to you that I’m not a fan of AROM – artificial rupture of membranes. I prefer a hands off approach. In my labors, when my water breaks, you’d better be ready to catch a baby! :) My OB offered to break my water with this last baby, but I declined, and had him 30 min later.

    I love all these baby and childbirth posts you’ve been linking up at The Thoughtful Spot! Warms my heart!

    • Haha, that’s awesome! I will never agree to AROM again. After researching babies born in the caul, I now understand (even more clearly) the purpose of the amniotic sac.
      Thanks for reading!

  11. The photo is great!
    This was a fantastic post. I had no idea some babies were born in the sac still!
    Thank you for stopping by the Thoughtful Spot Weekly Blog Hop this week. We hope to see you drop by our neck of the woods next week!

  12. Pingback: A Woman’s Body is “Made” for Childbirth – Changing My Stance | Atlanta Mom of Three

Please join in the conversation! I'd love to hear your thoughts.

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s