How A Baby Can Be Born With The Amniotic Sac Intact
Summary: New mom Chelsea Philips thought she had a special baby when Silas, born at 26 weeks, came out happy and healthy — but she didn't know how special her birth really was. Baby Silas was born "en caul", meaning he was still encased in the amniotic sac at birth. While this birth is extremely rare, it's safe for mom and baby. Here's why it happens, and why doctors don't rupture the sac before delivering baby.
During pregnancy your baby is surrounded by the cushioning of a fluid-filed pillow called the amniotic sac, which, in addition to the mucous plug blocking your cervix, is an extra layer of protection from bacteria and viruses in the outside world during fetal development. The amniotic sac also encases both the placenta and the umbilical cord; oxygen and nutrients pass from your bloodstream through the placenta and to your baby via the umbilical cord — it's how your baby survives and thrives in utero. Sometimes — but not always — a mom knows she's about to go into labor when her water breaks, or the the fluid-filled amiotic sac bursts. But in some highly rare births, the sac never ruptures and the baby is born with a fully-intact amniotic sac. That's exactly what happened when baby Silas was born "en caul" at Cedars Sinai Medical Center this month.
"It felt like slow-motion," neonatologist Dr. William Binder of Los Angeles' Cedars Sinai Medical Center said to local news station khon2, "but realistically it was probably about 10 seconds that we had to sort of quickly pause and be able to do this, because at the same time, we want to get the baby out of that sac and start helping the baby to begin breathing."
New mom Chelsea Philips had no idea how special her baby actually was until hours later when she saw a picture.
"It was definitely like a clear film where you could definitely make out his head and his hair," she said. "He was kind of in a fetal position and you could see like his arms and his legs curled up. It was actually really cool to see, and when I heard that was actually really rare, I was like, oh my gosh, you're a special little baby."
According to Dr. Susan Benson, an OB/GYN with St.Vincent Medical Group in Indianapolis, Ind., while there's no danger in a baby being born with the sac intact, it is rare. It almost never happens with vaginal births, and it's still pretty exceptional with C-sections because the scalpel normally pierces the sac when the doctor is making an incision in the uterus.
Premature babies, as in baby Silas' case, are smaller, which means they're therefore more likely to be born without the sac bursting. If the baby happens to make it into the world still in the sac, it's a sight to behold, but then the doctor will within seconds rupture the sac so that she can get to work making sure that baby is healthy.
So can baby stay safe in the amniotic sac outside of the womb? Here's how it works: Before the sac is ruptured, baby continues to receive nutrients and oxygen from mom via the umbilical cord, and she practice "breathes" the same amniotic fluid she was breathing throughout pregnancy. That same principle is in work even if baby has already been delivered to the world but is still in the amniotic sac. In an "en caul" birth, baby only takes that first real breath of air once mom's sac is ruptured, the cord is clamped and the pracitioner has suctioned out mucus from her nose and mouth.
"It's completely safe," Dr. Benson, who has seen three of these cases in 12 years of delivering babies, said. "Babies are always swallowing and drinking amniotic fluid [in the womb], so they're accustomed to it. And once the baby is born it's a matter of moments until the bag is broken and the umbilical cord is clamped."
And why wouldn't a doctor artificially rupture the sac before delivery? Often it happens because the delivery itself is so quick the practitioner doesn't even notice the sac is still intact. Or if she does notice it's there, she doesn't rupture it because it's perfectly safe to do so after baby is delivered. In fact, some research has even shown that among extremely premature babies, it may actually be preferable to be born in the amniotic sac, as it can protect these extra-delicate preemies from bumps and bruises on the way out.
Bottom line: When a baby is born without the sac rupturing it may make for exciting news, but really all it means is that the sac ruptured outside of the uterus — a neat phenomenon, but completely safe for mom and baby.