Water Birth

June 17, 2007

Water birth is the process of giving birth in warm water.

Relaxing in a warm bath to relieve pain has been used for everything from backache, aching muscles, strenuous exercise, or menstrual pain. More and more women are discovering how wonderful a pool of warm water can be during labour and birth.

water-birth-pros-and-consSome women choose to labour in the water and get out for delivery. Other women decide to stay in the water for the delivery as well. Note that whether or not you chose to give birth in the water, water can provide wonderful relief during labour.
The theory behind water birth is that the baby has been in the amniotic sac for 9 months and birthing into a similar environment is both gentler for the baby as well as less stressful for the mother. It is the belief of midwives, birthing centres and a growing number of obstetricians, that reducing the stress during labour and delivery also reduces foetal complications.

History of water births

The use of warm-water pools for labour and childbirth is a relatively recent phenomenon in Western culture. During the 1960s, Russian researcher Igor Charkovsky undertook considerable research into the safety and benefits of waterbirth in the Soviet Union. In the late 1960s, French obstetrician Frederick Leboyer developed the practice of immersing newly-born infants in warm water to help ease the transition from the womb to the outside world, and to mitigate the effects of any possible birth trauma.

Another French obstetrician, Michel Odent, took Leboyer’s work further and used the warm-water birth pool for pain relief for the mother, and as a way to normalize the birth process. When some women refused to get out of the water to give birth, Odent started researching the benefits for the baby of being born under water — and the potential problems in such births. By the late 1990s, thousands of women had given birth at Odent’s birth centre at Pithiviers, and the notion of water birth had spread to many other western countries.

What are the potential benefits of water birth and water labour?

* Speeds up labour
* Reduces blood pressure but increases oxygenation in the blood- additionally the buoyancy promotes more efficient uterine contractions and better blood circulation, resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby.
* Gives mother more feelings of control
* Provides significant pain relief – Water seems to alleviate stress-related hormones, allowing the mother’s body to produce endorphins, which are pain-inhibitors.
* Promotes relaxation – Water is soothing, comforting, relaxing.
* Enables the mother to assume any position which is comfortable for labour and birth – The buoyancy lessens her body weight, allows free movement and new positioning.
* Conserves her energy – In the later stages of labour, the water seems to increase the woman’s energy.
* Reduces the need for drugs and interventions – As the labouring women relaxes physically she is able to relax mentally, concentrating her efforts inward on the birth process.
* Gives mother a private protected space –
* The water provides a sense of privacy, which releases inhibitions, anxiety, and fears.
* Reduces perineal trauma and eliminates episiotomies – Water causes the perineum to become more elastic and relaxed, which reduces the incidence and severity of tearing and the need for an episiotomy and stitches.
* Reduces caesarean section rates
* Is highly rated by mothers – typically stating they would consider giving birth in water again
* Is highly rated by experienced providers
* Encourages an easier birth for mother and a gentler welcome for baby – Provides a similar environment as the amniotic sac. Eases the stress of the birth, providing reassurance and security.

Won’t my baby inhale water?

Water babyIn short NO.

There are 5 inhibitory factors, which prevent a baby from inhaling water when born:

1. The baby in utero is oxygenated through the umbilical cord via the placenta. When a baby breathes air, the intercostal muscles and diaphragm move in a regular and rhythmic pattern. 24 to 48 hours before the onset of labor the prostaglandin E2 levels form the placenta cause a slowing down or stopping in the fetal breathing movements (FBM). The diaphragm and intercostal muscles become suspended and there is a decrease in the FBM. At the birth, the baby’s muscles for breathing simply don’t work.

2. Babies are born experiencing acute hypoxia or lack of oxygen. This is built in response to the birth process. Hypoxia causes apnea and swallowing, not breathing or gasping.

3. The temperature differential is another factor. When a baby is born into water so close to maternal temperature the baby doesn’t detect a change so no breathing is initiated. In some places where an oceanbirth occurs, the water is much cooler than maternal temperature. This is an area for reconsideration since lower temperatures do not seem to stimulate the baby to breathe while immersed either.

4. Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. Hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence. Thus, as water passes through the larynx it does not pass into the lungs.

5. The ‘mammalian dive or autonomic reflex’ built into all newborns is present at birth and mysteriously disappears around 6 to 8 months. This reflex is associated with the taste buds along the larynx. When a solution hits the back of the throat and crosses the larynx, the taste buds interpret what substance it is and the glottis automatically closes: the solution is then swallowed, not inhaled.

(*These five inhibitory factors are from Waterbirth Basics, From Newborn Breathing to Hospital Protocols by Barbara Harper, Midwifery Today with International Midwife, Summer 2000, Number 54. www.midwiferytoday.com)

What situations are not ideal for water birth?

* If you have Herpes: Herpes transfers easily in water, so you will want to discuss this thoroughly with your health care provider.
* If your baby is breech: Though water birth has been done with bottom or feet first presentations you will want to discuss this thoroughly with your health care provider.
* If you have been diagnosed with one of the following: excessive bleeding or maternal infection.
* If you are having multiples: Though water births have been successful with twins around the world, you will want to discuss this thoroughly with your health care provider.
* If preterm labour is expected: If a baby is pre-term, two weeks or more prior to due date, water birth is not recommended.
* If there is severe meconium: Mild to moderate meconium is fairly normal. Since meconium floats to the surface in a tub, your health care provider will watch for it and remove it immediately, or help you out of the tub. Meconium usually washes off the face of the baby and even comes out of the nose and mouth while the baby is still under water. If the water is stained and birth is imminent, the woman can lift her pelvis out of the water to birth the infant.
* If you have toxemia or preeclampsia: You will want to thoroughly discuss this with your health care provider.

How do I prepare for a water birth?***

First, ask some questions about yourself:
– How did you decide on a waterbirth?
– Was this a decision you came to on your own?
– Who else impacted your decision for a waterbirth?
– How did they impact your decision?

Picture yourself labouring and giving birth immersed in water.
– What about this picture comforts you and what about this picture makes you uncomfortable?
– How do you feel about nudity? (You do not necessarily need to be nude in the tub; it is possible to wear a large t-shirt.)
– Which scenario makes you most comfortable?

Then think about how you might react to various situations:
– Plan for the possibility of a birth different from your current expectations. Are you comfortable releasing some control? It is key to remain flexible.
– Prepare yourself mentally to go with your instincts at the time and to accept the decisions you make during the birth.
– For instance, think about how you might feel if the baby was not born into water or if you decided to get out of the tub before the actual birth.

Personal and practical preparation of body/mind/spirit:
Spend time in the water, swimming for fun, or join a water exercise class. Mothers have greater mobility, increased endurance, feel virtually weightless, stay cool, feel a decrease in fluid retention and feel better emotionally. It is also a great networking environment.

Feel free to engage in nightly warm, not hot baths. Light some candles; drop in 8 drops of lavender essence oil. Massage your belly and breasts with pure almond oil. Talk to your baby. Prenatal bonding is as important as postnatal bonding.

It is important to identify your fears about labour and birth.
– Educate yourself by gathering as much BALANCED information as possible.
– Examine the various viewpoints and various “sides” to an issue.
– Read books and articles, watch videos of actual births, peruse the Internet and talk to people you trust.
– Set-up a consultation with a waterbirth consultant.
– Finally, make sure that your birth attendant (whether a midwife or a physician) and labour support people are both supportive of and knowledgeable about waterbirth.

Finally, make the necessary preparations:

* Check first with your health care provider. They may already be equipped for water birth with a special tub, or know where to refer you in your area.
* If you plan to give birth at a hospital, make sure their policies are water birth friendly. More and more hospitals are welcoming parents who want to try water birth.
* You can rent a birthing tub. Check online or in the phone book. Be sure to ask if fees include delivery and collection and any other extras to make your birth experience more enjoyable. Check with your insurance company to see if they will reimburse the expense of the rental.
* Contact a local birth centre to see if they provide water birth options.

Jane had a midwife assisted waterbirth with her son Quinn, and thoroughly enjoyed the experience.

Waterbirth Video Clips:

  • ‘Lyle’s Birth’ – mom labours and gives birth – catching the baby herself – in a birth pool at home, with dad in the pool with her. The mid-wife hasn’t even arrived yet and gets told the baby is born on the phone. Your body really does know what to do!
  • ‘Birth1′ – a very short video of a mom giving birth in water, without making any noise at all.
  • ‘Christian’ – This is the water-birth of a Spanish speaking mum. She vocalises a lot through the birth (not a BAD thing at all, it helps a lot). See how the contractions come and go and her body tells her what to do as each contraction starts and relaxes completely after each one finishes. The mid-wife helps her to birth the head slowly, so she doesn’t tear.

Waterbirth International
Gentle Birth Org – Waterbirth
Waterbirth Info

*** Medical disclaimer: Note that this web site is not a substitute for medical advice. The content provided here is for informational and educational purposes, and is not intended as advice or instruction. It is provided to help you to make informed choices for yourself. You should consult your primary care provider regarding your specific medical symptoms or advice. Birth Buddies is not engaged in rendering medical advice, diagnosis or treatment. Any medical decisions should be made in consultation with your caregiver or other trained medical personnel. We will not be liable for any complications, injuries, loss, or other medical problems arising from, or in connection with, the use of, or reliance upon any information or products on this web site.