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Water birth

“Pure water is the world’s first and foremost medicine” – Slovakian Proverb

Water birth is not a new phenomenon or trendy fad. There are tales of South Pacific Islanders giving birth in rock pools and Egyptian Pharaohs being born in lakes.

Some obstetricians in the mid-1980s, most notably French, believed birth had become unnecessarily medicalised to the benefit of the doctors and detriment of the women and their babies.  They thought the transition from the womb through a quick and mechanically forced labour into a cold, noisy, bright environment traumatised infants for life.

The peaceful transition from the warm water of their mother’s womb to the warm water of the birthing pool seemed less traumatic and women benefited as they were calmer, more relaxed and less reliant on strong forms of pain relief. Water birth babies were noted to be calmer, more settled and because of the lack of pain relief, less likely to display feeding problems.

Little research had been done on the subject of water birth and the medical fraternity was distrustful that something so natural and simple could be used as an alternative to drugs and instruments. Midwives too struggled to champion this method but over time water births have proved very popular.

Safety

In your uterus baby does not breathe. His lungs are filled with fluid and your placenta provides him with oxygen and removes waste products. Babies gasp when they are born due to a negative pressure in their chest sucking air into the lungs. This air will displace fluid water in his lungs and after a few breaths his lungs are clear. A number of stimuli cause a baby to gasp at birth; exposure to cold is usually the first reason, and when the umbilical cord is cut the build-up of carbon dioxide and low oxygen will also trigger a gasp.

Fears that the ‘dive reflex’- the reflex used by all mammals in order to submerge and dive in water – will kick in are unfounded. This reflex is triggered by water no warmer than 21 degrees Celsius. The diving reflex will not be triggered in a birthing pool which is just below normal body temperature. It is the lack of the usual stimuli to take a breath that will prevent the initiation of breathing.

Benefits

The benefits of using water for labour and birth are numerous. The warm water helps to relax your muscles and the buoyancy of the water helps lessen the work for your muscles.  Your body can then divert that unused energy, in the form of glucose, to the muscles of your uterus, where they are at their greatest need.

In water you can change position more easily and frequently and the relaxation encourages the production of oxytocin and endorphins, helping labour to progress with natural pain relief.

A study found women who opted for water birth were half as likely to use pain relief compared to those who did not although you are still free to use gas and air and your partner can still rub your back in water.

Also, there is no extra risk of tears to your perineum during a water birth and it is thought the pressure of the water against your perineum gives it support. If you do suffer a tear which needs repairing then your water-logged tissue will have to return to normal before this can be done, usually after around an hour following your water birth.

One drawback of a water birth is the lack of closeness with your partner, but providing the hospital allows it, there is no reason why he shouldn’t be able to join you in the pool.

In relation to clothing, some women prefer to be naked while others will wear bikinis, underwear or a nightdress in the water.

A word of warning though, should you open your bowels in the water and depending on your hospitals policies, he may be expected to scoop it out. The faeces itself is not a danger to your baby as its diluted but you should avoid letting it get into your eyes or open wounds.

There are few ways to give birth as beneficial as immersion in water. Each labour ward or birthing centre will have set criteria for water birth and most will accept women with otherwise straightforward labours who require a heart rate trace as an underwater monitoring unit can be used for this.

Do bear in mind that the birthing pool may be in use so when you arrive in labour inform your midwife of your wishes immediately.  Additionally, although water is an effective form of pain relief, it can slow the birthing process if used in the latent or early phase of labour.  In active labour, providing your cervix has opened to around five centimetres, this should not be a factor.

There may be occasions when your midwife will advise you to leave the pool and they may include:

  • If your baby’s head is exposed to the air, no matter how small a part of it.
  • If your contractions have slowed down.
  • If your pulse has increased.
  • If your baby’s heart rate has changed.
  • If your baby has passed meconium.
  • If you begin to bleed.
  • If your temperature begins to rise.
  • If you need to pass urine and your midwife wishes to measure it.
  • For vaginal examinations

In a normal healthy pregnancy with no risk factors the use water for labour and birth should be the first thing you use for pain relief. Even if the thought of giving birth in the water frightens or even repulses you please try it, you will be amazed at its effect.