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birthing with an intact bag of waters

post #1 of 27
Thread Starter 
Hey,

Just birthed my 5th child 3 days ago. Thought I'd share my personal take on birthing a BOW.

It hurt!

I figure I was at full dilation for 4 hours with a decent size bulge of forewaters. Really hard to push for me. Strange pinching, vibrating contractions with multiple peaks, all the while 1 and 2 minutes apart, but most right on top of each other. So mostly during all those hours of transition I just tried to cope.

I was thankful when I (finally) pushed out a huge bulge of the bag full of water. This was really like birthing another baby! I reached down and opened it with my fingernails and then began the effort to push out the baby. Which felt wonderful! He came (from still high in the birth canal) 4 minutes later in one big contraction. He weighed 10 lbs 12 oz.

My bottom is in great shape, baby had no moulding, had lots of fluid, he's a huge chubby thing.

This was just really interesting, having not done that before. My bags are tough, they have been artifically ruptured everytime in the past and my babies always follow very quickly. Could I have shortened my labor by 4 hours and skipped the intense pain of that part? Yes, I think so. Was I meant to expereince this? Probably!




What are your experiences with intact BOWs?
post #2 of 27
Both times my bags were not intact but I have head clients say that they bulging bag is painful. It seems like some people like the cushion from the baby's head and some people find the bag painful.
post #3 of 27
Thanks for sharing this! I've been curious about this as my family has a history of stubborn membranes...

Congrats on your new arrival!
post #4 of 27
Typically, my water is bulging and breaks during pushing, not always during the first push, but eventually. I can't say that it really hurt, because the worst part for me is always the baby's head crowning....now THAT stings.
post #5 of 27
Interestingly, the only 2 clients I've had birth with bag intact had very fast labors. One, something like 45 minutes total from first real contraction to baby. The other was an induction (pitocin) but less than 3 hours of active labor, and baby slid out in her bag with 15 minutes of barely pushing.
The lady with the whirlwind labor had not birthed with her bag intact before and this was her 3rd birth. She didn't feel much was different (except that she had birthed her first two with an OB in typical on back legs in air variety, and she felt this birth, where she first pushed sitting bolt upright [think chicken laying egg like position] and then flopped onto her side just as the head crowned. It was amazing as she quickly went from sitting up to side lying to see the bag bulging way out - I don't know how she was sitting on all that bag without it breaking! The bag of waters looked like a big squishy snow globe with bits of vernix swirling in it and then the head suddenly looked like it just floated into the bag, and the whole babe was born quickly.
The second mama felt her labor with her membranes intact was much gentler than her first labor which started with her membranes rupturing. She had an epidural, and barely pushed as the bag bulged way out, also looking like a snow globe, and then the baby slid out with almost no pushing. Her membranes were so strong that when the baby basically was out to her abdomen, she seemed stuck in the membranes, but I couldn't break them easily. Finally, the nurse pushed up a bubble over baby's head and I used a clamp to rupture the membranes and the rest of the baby splashed out. This baby had 2 tight wraps of cord around her neck, and I think the cushion of fluid definitely protected that cord from being compressed.
I rarely break anyone's water, but I've only had those 2 in the caul births in almost 300 births - lots of membranes rupturing only during pushing, one where the membranes ruptured one push before birth even, but only the 2 intact. Is that less than usual do you think?
post #6 of 27
I have only had 2 intact bags in my births too -- about 250 or so. Lots of bags that went right before the birth, but only 2 that were intact to the head or more out. I have heard clients tell me that the pressure of the bag causes intense sensation right above the pubic bone - so much so that they have requested AROM and then experienced intense relief when the bags were gone. Some people don't seem to have any unusual sensations.

Just a few days ago I went to a lovely waterbirth with a first time mom. Her bag survived until late in second stage. She still felt it 'pop' under the water, which I thought was neat. She didn't seem to feel any unusual sensations with it, even though the head was visible on the perineum (more or less, seeing as she was under water - ha ha) before the bag went.

The first time I had an intact bag I was really scared because the head came out and there were eye/mouth/nose like 'divots' in the baby's face, but no openings! The face looked like moulded clay, not like a normal baby's face! I panicked for about a second, then realized I was being a green midwife dumb$%@ because it was just taut membranes over the baby's face and the baby was totally fine!! I used a clamp to pull a little bit of membrane up ever so gently as the baby tumbled out (it was taut against the baby's face, no fluid visible actually) and the bag split open as the baby started to cry. I felt really dumb afterwards, but I share my story liberally to spare others the potential feelings of idiocy I felt if they find themselves looking at a 'moulded clay-faced baby' and can remember my story!
post #7 of 27
Quote:
The first time I had an intact bag I was really scared because the head came out and there were eye/mouth/nose like 'divots' in the baby's face, but no openings! The face looked like moulded clay, not like a normal baby's face!
That happened to me as a student! Baby came out in the tight bag, rotated, and when I saw his "face" I thought, "Oh, God! He has NO FACE!" For about a second, all these thoughts went through my mind, like, "how am I going to tell his parents he has no face? how is he going to breathe?!" then I realized it was his BOW, and I slipped it over his head (he was making gasping motions) and he was born right away. I asked my preceptor if I looked shocked when the head was born, and thankfully, she said no, I looked fine, why? I told her what I was thinking and she howled.

I've seen about 15 or more in the caul births, last month I saw three in a row! I love telling the mamas how special it is to be born in the caul...

Mostly, the BOW breaks either in transition, or pushing, and I have done AROM a handful of times. Quite often I can ask the lady nicely to "let your bag of waters go" and it will just release within a few contractions. I've only seen ROM before labour begins a handful of times.

That said, if the bag is taut and not bulging dramatically, most women don't feel any related discomfort, but when it's bulging, really bulging, sometimes they ask to have it broken and feel quite relieved to be rid of the pressure. (I prefer to put a little leak in the bag instead of rupturing it, it's much gentler) If there's a lot of fluid in front of the head, sometimes it keeps the baby from descending or that last bit of cervix from dilating and it's a big help to have it broken. Nothing like a hard little head to finish the job.

I do notice a tendency for in the caul births to be associated with a low-lying placenta and a Duncan presentation, and often get an exciting bleed after.
post #8 of 27
I love this thread. I had no idea it was that common for the BOW to stay intact. After 60 hours of labor and making it to 9+ cm.... mine never broke.
post #9 of 27
Thread Starter 
I think had it gone on longer I may have found a way to get a hold of the bag inside and broke it-it was that intense!
post #10 of 27
My second baby was born in the caul. That was my first natural birth. With my next two I experienced SROM at 7cm and requested AROM at 8 cm (22 hours into the birth). My easiest birth was the one with the intact bag.
post #11 of 27
I gave birth to my 2nd in with intact bag. It didn't hurt at all and didn't realize she was until after the birth. It was very quick she basically just fell out but then again she was born at 25 weeks, she was tiny.
post #12 of 27
Quote:
Originally Posted by sevenkids View Post
:

I do notice a tendency for in the caul births to be associated with a low-lying placenta and a Duncan presentation, and often get an exciting bleed after.
Oh wow--that is exactly what happened to me! Or pretty much so--I had a super bulging bag and requested AROM b/c it was DRIVING ME CRAZY!! And then had a Duncan presentation and quite a bit of bleeding afterwards. Wonder what the connection is??
post #13 of 27
Quote:
Originally Posted by octanebeetle27 View Post
And then had a Duncan presentation and quite a bit of bleeding afterwards.
What is a Duncan presentation?
post #14 of 27
With my first I had a huge bulging bag. The nurse was content to leave it as it but the OB ruptured it when she got there. I'd had an epi by that point so I can't say if it hurt "extra". The nurse told me that in some countries it's considered very good luck for a baby to be born in an intact bag.

With my second my bag broke on its own, probably while I was laboring in the tub. I didn't know it at the time but when the midwife said it was gone that was all we could figure. I did not have pain medication with that birth but since I'd had the epi with the first I can't really compare them.
post #15 of 27
Not sure what Duncan presentation is, but my baby had a compound (hand/head) presentation and I did bleed heavily afterward.
post #16 of 27
A Duncan presentation means the placenta comes out maternal side first (the meaty side) instead of fetal side (shiny, "tree" side) first.
post #17 of 27
With my first (3 hours) bag broke early on and it didn't hurt too badly. Second time I was in the water. I was feeling so much pressure like the baby was about to come out my butt, but when I checked myself I could feel a bulging bag and no head behind it. Next contraction I felt the bag come all the way down and out and then it EXPLODED right at my introitus. That hurt badly like a small bomb went off there but the relief of pressure was fantastic. Then baby came all the way down and his head was born in one really really long contraction. Placenta was Duncan but no bleed. There was something next to his head that at first I thought was a hand but now I wonder if it wasn't a loop of cord hence the 2 minute second stage.
post #18 of 27
I have many, many pictures of my intact bag - my MW and doula thought it was so cool. It looks like a giant double bubble coming out of my girl parts!!
post #19 of 27
Quote:
Originally Posted by MomToKandE View Post
The nurse told me that in some countries it's considered very good luck for a baby to be born in an intact bag.
I've heard that too, and think it would be very special and unique to have an in the caul birth!

Quote:
Originally Posted by sweetsadie77 View Post
A Duncan presentation means the placenta comes out maternal side first (the meaty side) instead of fetal side (shiny, "tree" side) first.
S.o. said there is often heavy bleeding associated with this presentation. Does anyone know why? Is it a normal variation or cause for concern to have a Duncan presentation?
post #20 of 27
"S.o. said there is often heavy bleeding associated with this presentation. Does anyone know why? Is it a normal variation or cause for concern to have a Duncan presentation?[/QUOTE]"

It's usually just a variation of normal. It can look like more blood because the blood that usually collects behind the placenta (retroplacental clot) comes out before the placenta. Whereas, if it comes out fetal side first (schultze presentation) the blood is usually collected in the membranes behind the placenta in a neat package.
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