Waterbirth
A Gentler Approach in Birthing Options
Muscle aches, menstrual cramps, a hard day at home or at work are all reasons women head to a nice warm bath for soothing and relaxation. Water has been a mystical source of comfort since the beginning of time. A natural progression of the power of water translates to the birthing process. Women use water for comfort, and infants float in a watery cocoon while growing and waiting for birth. The birthing pool can be a welcoming environment for the mother and infant to begin life together.
Waterbirth is receiving growing interest in the United States. Warm water immersion for labor and delivery has been a routine option in many reputable European nations for years. The first waterbirths started in the 1970s and the trend continues with proponents of natural childbirth. Women can be offered alternatives to traditional intravenous or epidural pain relief for labor and birth. The birthing tub can replace drugs. The relief as you sink into a warm pool of water is a mental image all of us can recall.
The safety of waterbirth has been well researched and findings indicate that with proper preparation and high standards of care and protocols, waterbirth is just as safe as more traditional methods.
When deciding to waterbirth, women should consider several factors:
- The commitment she and her support system have for drug free, natural childbirth process. In the face of actual labor pain, the temptation to accept more traditional pain relief measures may become overwhelming in comparison to the desire for a medication free natural birth.
- The experience of the facility and the practitioner who will be guiding mom and baby through the waterbirth. Experienced nursing staff and certified nurse midwives or physicians can enhance the positive of waterbirth for women and their families.
- The availabilitexperiencey of the birthing pools at the facility and if there is a back up plan for waterbirth. If the tub is often occupied with someone else - waterbirth may not be possible for incoming laboring women.
- The appropriateness of each woman’s pregnancy for waterbirth. High-risk pregnancies or certain maternal or baby complications may result in the need for a traditional birthing plan.
The benefits of waterbirth affect the mother-to-be, the infant waiting to arrive, and the family involved. Comfort and relaxation, ease of movement due to buoyancy, diminished pain, improved sense of well being and control, reduced perineal trauma, and decreased length of labor are all benefits for the mother. Entering a familiar watery environment, easier second stage (the actual birth), and less physical manipulation during the birthing process are benefits for the baby. The family also benefits by being able to have a family centered birth with involvement in the experience, and may even choose to be in the tub with the mother for the labor or birth.
The risks involved in waterbirth can occur for both mother and baby. Similar risks can develop whether the laboring woman is in or out of the birthing tub for a variety of different reasons. Risks to the mother include elevated body temperature and/or heart rate, decreased blood pressure, dizziness, or dehydration. Risks to the baby can include breathing fresh water into the lungs at time of birth, difficulty breathing in the first hour after birth, increased body temperature or heart rate, and newborn infection.
The actual waterbirth occurs in an oversized tub, similar to a hot tub or Jacuzzi. There are inflatable, portable tubs with an external source of water and there are installed tubs with an internal source of water. The water level in the tub is generally high enough to cover the pregnant abdomen when a woman is in a semi-reclining position. The temperature of the tub generally should not exceed 150 degrees. While in the tub a woman may try many different positions to find which one gives her the best comfort level. The practitioner attending the birth often leans over the side of the tub to assist in the baby’s birth and then places the baby on the mother’s chest to assist in spontaneous breathing and baby/mother bonding.How does a woman know if waterbirth is an option for her pregnancy and birth?
The following criteria are guidelines in helping a woman decide if waterbirth could be the birth plan suited to her needs:
- Low risk pregnancy – not complicated by diabetes, high blood pressure, multiple gestation, fetal stress or distress in labor, or other factors that could cause high risk status to the mother or baby during the pregnancy
- Normal vital signs during labor
- Full term gestation – greater than 37 weeks of pregnancy have been completed
- Baby is head down in the birth canal and labor has started
- Commitment of mother and partner to natural childbirth and waterbirth
- No signs of fetal distress on admission to birthing unit and no need for drugs to supplement labor
The Cleveland metropolitan area has the availability of waterbirths in a limited number of facilities. Certified nurse midwives are usually supportive of women planning a waterbirth in the hospital setting. Health providers and hospitals are realizing that a gentle approach to childbirth, natural birth, and waterbirth are all options that need to be available to the women they serve. Our community will continue to show interest in childbirth topics and the less traditional means of managing discomfort in labor and birth.
