Water Birth

Rod Stewart’s pregnant fiancée Penny Lancaster is planning to give birth underwater following other celebrities such as Kate Winslet and Pamela Anderson. Gwyneth Paltrow was also rumoured to have originally chosen a home water birth before deciding to give birth near her home in England at a hospital that was equipped for water births.

Last year it is estimated than more than 5 000 woman in UK, used a birthing pool to reduce stress, ease labour pain and lessen the need for drugs.

Over the last 10 years researches have consistently proven that submersion in warm water can shorten labour and make it less painful. While labouring in water, women are less likely to require the use of drugs such as pethidine or epidural, which cross the placenta making baby sleepier and breastfeeding more difficult.

Why Water?

Woman Giving Water Birth In PoolWater soothes, relaxes, and rejuvenates, providing an easy way to unwind and let go of the tensions built up during the day. During pregnancy, water becomes even more desirable.

As the pregnancy progresses and your body grows heavier and more unwieldy, total immersion may be the only time you feel relief from the constant pressure of the growing foetus on your lower back and pelvic region. Soaking in the tub at this time can feel so good; you may never wish to get out. Getting into a soothing tub of water relaxes you and allows your body’s natural endorphins and oxytocin to kick in. Immediately, your contractions are less painful and more effective, which may account for why water births are proving to be consistently shorter than traditional births. It allows tight and tired muscles to relax fully, to release their tension and to be rejuvenated for the next contraction. The water also acts topically to soften the tissues of the perineum, making episiotomies much less necessary and causing fewer and less severe, tears. (Extract from Choosing Waterbirth by L. Bertram)

What Happens?

Women who have had a water birth like the feeling of being in their own space where nobody is going to push a hypodermic syringe or intravenous drip into them. And they enjoy moving freely in water. Birth is a dance. It is not a matter of getting into different positions and then being stuck in them, but of moving – gliding from one position to another, circling, locking and tilting the pelvis, kneeling forward and backward, and making rippling movements with the whole spine. Studies show that water birth is just as safe as more conventional methods. Women use far fewer pain-killing drugs, are far less likely to need an episiotomy (cut) or to bleed heavily, and birth is equally safe for the baby. (Extract from Sheila Kitzinger of babyworld.co.uk)

The Water Birth Experience

“As soon as I got into the water I felt safe, secure and free. The water cradled me. I wasn’t heavy any longer – and I could move”. The water needs to be deep enough to cover the top of the uterus if you are to get adequate pain relief from it and be able to float. Woman Giving Birth In Pool“I resented being asked to get out of the water to be examined”. There is no need for this. There are under-water sonic aids to listen to the baby. Or you can pop a condom in your birth kit, which can be slipped over an ordinary sonic aid. “I’d choose water birth again because it reduces the pain and increases mobility”. She’s right. Pain turns into suffering if you feel trapped. Being free to move helps you handle contractions your way. “As my baby was born I wouldn’t have dreamed of getting out. It would have interrupted the whole process. It would have been like saying ‘Oh, you can walk around as much as you like, but as soon as you start labour you must lie down on your back”. Or perhaps it’s like someone saying, just as you are about to have an orgasm, “Hang on a moment! You can’t do that here. We are going to move you now..”. (Extract from Sheila Kitzinger of babyworld.co.uk)

The first birthing pool

The first hospital birthing pool happened in the 1970s in a French state hospital. We took into account that, when in labour, many women seemed to be attracted by water. Some wanted to have a shower, others a bath. That is why I eventually bought a blue inflatable garden paddling pool. As soon as the birthing pool was installed new strategies became possible. When a woman in hard labour was expressing an imperative demand for painkillers, we had something else to offer… From that time on the question was not, “When will you give me a painkiller?” It was more often than not, “How long does it take to fill the pool?” One of the most typical scenarios (with many possible variations) was the case of a woman entering the pool in hard labour at around 5 centimetres, spending an hour or two in the water and then feeling the need to get out of the pool at a stage when the contractions were less and less effective; going back to dry land was often a way to induce a short series of irresistible and powerful contractions so that the baby was born within some minutes. From the time when such a scenario became common, the pharmacy bill of the maternity unit started to drop dramatically. In other words, we learned that the birthing pool can replace drugs…” (Extract from Michel Odent, Midwifery Today Issue 54)

Birthing pools: which one?

First consult your doctor or midwife and determine if a water birth delivery will be suitable for you. If your delivery is not foreseen as a simple or natural one, you may be advised against a water birth. If planning a hospital birth you will need to check with the hospital in which you are booked, if they have a birthing pool. If they don’t, you should still be able to hire or buy one and take into the hospital. If planning a home birth, you will need to buy or hire a birthing pool for use at home.

The more midwives help with water births, the more they like them. They often develop an understanding of birth that is denied other midwives who work in hospitals where it is the practice to hurry birth and tell the woman when and how to push. When a midwife attends a water birth she watches and waits. She does not intrude. She respects the spontaneous rhythms of labour. And she learns about the normal physiology of birth in a way it is impossible to do in any hospital where “active management” is practised and everything is made to happen in a set period of time by using drugs to stimulate the uterus. “I had never seen a birth like this before. The mother knew exactly what to do without being prompted”. When a woman can focus on the power of contractions, and work with them, she responds in a smoothly co-ordinated way. Instead of fighting her body, she ‘listens’ to what it is telling her. “Water births are peaceful. There’s no need for commanded pushing, the mothers seem much more confident that what they are doing is right”. An unforced second stage, without deliberate breath-holding and straining, enables more oxygen to reach the baby. “The perineum is usually protected by the water. As a result an episiotomy is rarely needed”. A woman with an intact perineum avoids the pain of stitches and the feeling that she is sitting on thorns for weeks after. (Extract from Sheila Kitzinger of babyworld.co.uk)

Safety Concerns

The UK Central Council for Nurses, Midwives and Health Visitors (UKCC) has recognised “that water birth is preferred by some women as their chosen method for delivery of their babies. Water birth should, therefore, be viewed as an alternative method of care and management in labour and as one which must, therefore, fall within the duty of care and normal sphere of the practice of a midwife”. The use of water for labour and delivery has largely not yet been evaluated or researched, although a recent study looked at the safety of giving birth in water. This concluded that water births were as safe as conventional low-risk births. To ensure the safety of using water for labour and birth, in the absence of research evidence it has been suggested that:

The temperature of the water should be restricted to body temperature, or lower, to prevent problems to the baby caused by overheating.
The baby should be brought gently to the surface as soon as she is born and that the baby is face-up as she emerges from the water.
The baby is monitored using an appropriate method, and the woman should give birth out of the water if there is indication of foetal distress.
The woman is attended by a midwife who is confident and competent in caring for women giving birth in water.