Although you may have always envisioned your waters breaking with a sudden gush and signaling the start of your labor, it doesn't always work that way. In fact, more and more women are receiving amniotomies, or the artificial rupture of membranes (AROM), as part of the routine labor and delivery process.

According to the Childbirth Connection's second national "Listening to Mothers" survey, which was carried out in January and February of 2006, 47 percent of women who gave birth in U.S. hospitals in 2005 experienced an artificial rupture of membranes as part of their childbirth experiences. The Childbirth Connection, a national, not-for-profit organization founded in 1918 as Maternity Center Association, works to improve the quality of maternity care through research, education, advocacy and policy.

"The bag [of waters] is one of nature's ways of protecting the baby from potential injury or harm," says Dr. Judith Lothian, a childbirth educator who serves on the Lamaze International Board of Directors and co-author of The Official Lamaze Guide: Giving Birth With Confidence (Meadowbrook, 2005). "During labor, it has the same function. The bag of water molds with the baby's head as it moves down the birth canal."

Dr. Lothian, who is also a professor at the Seton Hall College of Nursing, believes doctors often perform amniotomies because a baby's head dilates the cervix better without the membranes. "Baby's head comes through a little faster, so it's become a routine procedure," she says.

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