This 2-hour webinar examines AROM as an evidence-based tool for community midwives, not a routine or forbidden practice.
Learn when it supports labor, when it increases risk, and how to assess safety accurately. Covers membrane function, true vs. perceived risks (including cord prolapse), and clinical criteria for use. For midwives seeking a confident, informed framework beyond blanket avoidance.
This course is designed for students and practicing midwives who want a clearer, more confident, evidence-informed framework for deciding if, when, and why AROM belongs in community-based practice.
Agenda
February 23, 2026
2-Hour Clinical Outline
Naming the Reality
Why Community Midwives Don’t Use AROM
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How AROM became culturally labeled as “hospital-only”
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The difference between physiologic care and intervention avoidance
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What students are not being taught about AROM
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Why lack of understanding ≠ safety​
Physiology of Intact Membranes
What the Membranes Actually Do
Evidence domains referenced:
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Biomechanics of the amniotic sac
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Cervical dilation and hydrostatic pressure
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Fetal head molding and descent​
What the Evidence Actually Says About AROM
Separating Data From Dogma
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Research covered (at a high, teachable level):
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Cochrane reviews on AROM in spontaneous labor
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Effects on labor duration
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Effects on operative birth rates
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Infection risk relative to duration of ROM
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Neonatal outcomes
Indications for AROM in Community Birth
When It May Actually Help
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Clinical prerequisites that must be met before AROM is even considered
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How to determine whether intact membranes are still contributing to labor progress
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Distinguishing physiologic patience from true protraction
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Situations where AROM clarifies the clinical picture versus adds risk
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Common misuses and why they’re dangerous in community birth
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Why selective second-stage use is categorically different from early AROM​
Risk Tradeoffs, Not Fear
Cord Prolapse, Infection, and Loss of Optionality
This section corrects misinformation directly.
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Mechanism of cord prolapse
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Actual incidence of cord prolapse with planned AROM
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Why station and engagement not setting determine risk
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Infection risk as a function of time, not AROM itself
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What is lost once membranes are ruptured
Meet your Mentor
FAQs
Who is it for?
This session is designed for community-based midwives, student midwives, birth workers, and educators who want a clearer, evidence-informed understanding of AROM.
Is this webinar promoting routine use of AROM?
No. This course does not promote routine or early AROM. Instead, it examines AROM as a selective clinical tool clarifying when it may be useful, when it increases risk, and why blanket avoidance is not the same as physiologic care.
Will research and evidence be discussed?
Yes. The session reviews current research at a practical, teachable level, including Cochrane reviews and data on labor duration, operative birth rates, infection risk, neonatal outcomes, and cord prolapse incidence. The goal is to separate evidence from cultural fear or dogma.
Will we discuss cord prolapse and infection risk in detail?
Absolutely. One section specifically addresses risk tradeoffs, including:
The actual mechanism of cord prolapse
Real incidence rates with planned AROM
Why fetal station and engagement matter more than setting
Infection risk as a function of time since ROM
Is this appropriate for students?
Yes. The content is structured to support both students and practicing midwives. Students will gain foundational physiology and decision-making frameworks. Experienced midwives will gain deeper clinical clarity and risk assessment tools.
Clinical Integration & closure
Reclaiming AROM as a Tool in your Toolbox
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Why over-avoidance is not neutral
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How selective AROM fits within physiologic community birth
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Expanding clinical capacity without becoming intervention-driven
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Final synthesis for students: knowing when not to act requires knowing when you could
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Q &A​