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Baby Born in the Caul (Amniotic Sac)

These three photos are of a baby being born in the caul (in the amniotic sac). Pure luck had me in the right place at the right time with a camera in my hand.

This is close to birth. I have photos from right as the sac began presenting until the birth of the baby. While I've seen several babies born en caul, this was the "heaviest" I've seen to date.

It is hard to see if the amniotic sac was still on the face, but from what I remember, it was. As a midwife, I was trained to pull the sac off, using a sterile gauze so you can get a good hold of it, and pull from chin to brow. One midwife who was teaching me said she watched a baby inhale the sac as the student pulled it down from brow to chin. Even if that is an urban legend, it made sense to me and didn't seem harmful, so that's how I do it and teach it.

Most doctors have never seen a baby born in the caul; the amniotic sac is ruptured routinely in the hospital (Artificial Rupture of Membranes... AROM). I heard about a doctor who wanted to see if babies could be born in the sac and challenged fellow docs to try and accomplish this. He offered a $50 bounty for every baby born with the membranes intact. Suddenly, there were plenty of babies born without AROM! I'd love to see a doctor do the same bribing now.

There are plenty of midwives who also do AROM; I do not. I have ruptured membranes twice in the last 5 years, once because mom insisted and the other for a mama who was heading to the hospital for an induction and she was already about 5-6cm dilated. Again, it was her choice and, once I AROM'd, she delivered easily three hours later.

Some reasons for believing AROM is a good idea include allowing the head to put more pressure on the cervix, helping a baby to fall deeper into the pelvis (a variation on the pressure idea) and because it speeds up labor. There are numerous studies that show that AROM only hastens labor by a mere 30-60 minutes or so. To me, not worth the risk of infection or prolapsed cord (if the baby is high).

When a mom is GBS positive, it can be an even greater reason to not AROM. Once the membranes are ruptured, many start the time clock, wanting the mom to deliver (or be in active labor) by 18 hours post-rupture. The risk of GBS infection in the baby grows when 18+ hours of time have elapsed.

Definitely, informed consent and the risk/benefit ratio must be weighed when deciding to AROM.

References (8)

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    - Navelgazing Midwife Blog - Baby Born in the Caul (Amniotic Sac)
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Reader Comments (14)

I attended my first birth in which the baby was born in the caul several months ago and wrote about it ( http://doularama.com/tag/caul/ ). I will be linking to this informational and beautifully illustrated post. Thanks!

January 4, 2010 | Unregistered CommenterDoulaRina

I loved reading this post - it brought back memories as our youngest (4 wks old) was born in the caul. I had always read about it but was tickled pink to actually have it happen.

January 12, 2010 | Unregistered CommenterPampered_Mom

I to am a lucky mum, Suzie was born on the 28th of feb 2010 in the caul i had never heard of it before but have found it fascinating. My first was born in a birthing pool and as the hospital was full this time i had to have a homebirth so suzie was still born in water lucky hey!

March 26, 2010 | Unregistered Commenterlucy

these pics are so amazing!!! thanks for posting them! As a doula, I agree that AROM can definitely be the gateway to a cascade of interventions when done "routinely" and for no true medically-based reason. OBs and MWs definitely need to consider these caul births to be safe and beautiful births and allow them to occur!

April 19, 2010 | Unregistered Commentermassagedoula1

Sorry, but the membranes have ruptured in these pictures. Certainly the membranes are there, and the fluid is visble, but the babies face is NOT beneath the mebranes. I

October 9, 2010 | Unregistered Commentercarysisla

I was born with a caul but have never experienced anything amazing. Although others, including a psychic, have said I am different. I do have a small hole on the palm of my left hand and I have read that some caulbearers have a small scar on their spine. I have just started a website for caulbearers. www.caulbaby.com

November 2, 2010 | Unregistered Commentertom

My son was born in 1981 with a midwife in attendance and was born totally in the caul. It is supposed to have special meaning.

May 4, 2011 | Unregistered CommenterKathy Robinson

Amazing photos! I got to 9 1/2 cm or so with my membranes still intact. I had researched just about everything so I could be prepared to give (or deny) informed consent for any intervention that came up, but hadn't looked into risks associated with en caul birth, or a lack thereof at all. My doctor said that there was a concern with birthing a baby at term en caul, because they could inhale a portion of the sac. This sounded ridiculous to me, but not knowing for certain that she was wrong, I decided that since I was so close anyway, trusting her and allowing AROM at that point was a small thing. I still question what the difference would have been, and am frustrated that I didn't know better!

September 5, 2011 | Unregistered CommenterMelissa

My 2nd baby was born in the caul - he is now 12mo and the most joyful, happy baby ever. My delivery was under 3 hours and my OB didnt make it on time. He was born naturally by two nurses, one being Phillipino. She was doing backflips and had said that in her country he was a miracle - he had been given the gift of foresight. I am now just investigating babies being "born in the caul" a bit more, seems really interesting. There is a line of women in my family that has a sort of gift of precognition, I wonder if he will carry on this line? I can't wait to watch as the years unfold in my little one's life! :)

December 10, 2011 | Unregistered CommenterLindsay

I was born with a veil over my face and would like to learn more about it. Also had 2 out of body experiences.

May 7, 2012 | Unregistered Commentermsvegas218

WOW Look at that cheesy baby! So amazing to me how scrubched they get birthing. So cool the way we are made!!

June 21, 2012 | Unregistered CommenterMegan Casey

my brother was born with which they call veil back in 1966 the midwife was so excited, she had delivered 100s of babies and this was the first one that she had seen ! she asked my mum if she could have it, my mum being unaware of its meaning ,or of all the excitement was all about, but has been told since a baby born with this would never drown, and a sailor would of paid lots of money to have one!! also the babies have been known to be physic, which is true in our cause , ive never really looked into this until my mum cut out a artical from a magazine to give to my brother.... ive found it all very interesing......

October 15, 2012 | Unregistered CommenterAlison Gray

as an LDR nurse I notice you didn't mention the benefit of ARM as knowing the amniotic fluid colour. which can indicate the occurrence of meconium, and potentially fetal distress. When an ARM occurs during active labour and mec is noted it gives time to ensure a paediatrician/ or additional staff can be present in the case of a non vigorous babe, who may have meconium aspiration syndrome ( a serious condition).
In my opinion the value of this knowledge is valuable. Although I agree that early AROM is not a good practice.
I have been the primary nurse to a rapid delivery where baby was born en caul, and broken the amniotic sac with the head on the perineum. The physician was not yet in attendance and there was mec present.
Although it was amazing to see the en caul delivery I would have preferred the knowledge of the meconium present.

May 31, 2015 | Unregistered CommenterLDR NURSE

My youngest was my second VBAC and occurred so quickly I delivered her in the passenger seat of our vehicle. Anyways, while my water was leaking I was feeling the pressure of her coming out. I reached down (partly from pain, partly from fear of my baby falling) and felt the amniotic sac when I expected a head. My husband said it looked like a balloon. Haha. She wasn't completely encased with the unbroken sac, but with it just hanging over her head and face. She's 4 months old and I found out today it was quite rare. I didn't even know it was called a caul before today. Knowing what I know now, I wish I had pictures. Thank you for sharing this.

December 29, 2015 | Unregistered CommenterAmelia

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