What Is an En Caul or Mermaid Birth? Here’s What to Know About These Spectacular Deliveries

All births are magical in their own way, of course, but en caul births are particularly enchanting—and said to be a sign of good luck, too. They are also highly unusual. But what are they, exactly? We spoke with Dr. Banafsheh Kashani, MD, FACOG, OB/GYN to find out what these spectacular births are really all about.

What is an en caul birth?

Simply put, an en caul birth is when a baby is born still fully enclosed within the unruptured amniotic sac (caul). Also known as “mermaid birth” or “veiled birth,” this is a highly unusual occurrence (especially in vaginal births, due to the amount of pressure involved in squeezing a baby out of the birth canal). In fact, this phenomenon occurs in less than 1 in 80,000 births. As such, when an en caul birth does go down, it’s a pretty magical thing to behold—a rare glimpse into a baby’s sheltered world within the womb.

Babies born en caul emerge in the very same gelatinous sac that protected and nourished them throughout their time in utero. Aside from the fact that this event is just objectively fascinating, an en caul birth is all the more intriguing because so few people ever witness one. In fact, most labor and delivery nurses and doctors never see a single one throughout their careers. But according to Dr. Kashani, when a baby is born with the amniotic sac completely intact, it looks like “a clear film or balloon that surrounds the baby and is filled with amniotic fluid.” Pretty cool, right?

Why Does An En Caul Birth Happen?

Per Dr. Kashani, an en caul birth can occur whenever there has not been a rupture of membranes during labor. OK, got it...but how? In vaginal deliveries, en caul births are most likely to occur in preterm or premature births, since the baby is smaller and labor is, well, less laborious (relatively speaking, that is). But these rare births tend to happen more often during cesarean sections—namely because there are instances when the scalpel doesn’t rupture the amniotic sac during surgery. It’s also important to note that vaginal deliveries in which labor is induced preclude the possibility of an en caul birth, as this procedure involves the physical rupturing of the membrane and the administration of pitocin, a synthetic hormone that kicks labor into a high enough gear that an en caul delivery is all but impossible.

Can you request an en caul birth?

Maybe...but you probably shouldn’t. We hate to burst your bubble (sorry) but if you have a planned cesarean delivery, your medical team probably won’t take the request too seriously since there’s no evidence that there’s any benefit to having an en caul birth (aside from the obvious cool factor). Of course, you are more than welcome to ask your practitioner.

What Happens After An En Caul Birth?

Good news: En caul births, strange though they may be, are completely safe. When a baby is still sealed in the amniotic sac, she’ll be perfectly content, regardless of whether she’s inside or outside of the mother’s womb. In fact, said baby will behave just as she was before delivery—taking practice breaths by drinking in amniotic fluid and staying nourished through the umbilical cord. Alas, this must ultimately come to an end: “At some point, the amniotic sac must be opened, to allow separation of the baby and the placenta by cutting the umbilical cord,” Dr. Kashani explains. The amniotic sac and placenta are separated from the baby and from there the medical team does what it would do during any other birth—namely making sure the baby takes its first breaths outside the bubble and shows stable vital signs.

Caul vs. en caul: what’s the difference?

These two might sound like the same thing but they’re actually quite different. “A caul birth involves delivery of the baby, as well as a portion of the amniotic sac,” says Dr. Kashani. “Often, there may be a clear film that is the membrane from the amniotic sac. This can cover a portion of the body of the baby, and it must gently be separated from the baby.” In other words, the amniotic sac is present but there’s no water balloon spectacle in a caul birth because it has already been broken. This type of birth is far more common than an en caul birth, but pretty special, nonetheless. Babies born with a caul (not en caul) are said to be born with a veil, helmet or bonnet—all ways of describing the thin piece of amniotic membrane that managed to stay attached to the baby throughout labor and delivery, only to be gently removed shortly thereafter.

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