A
Guide to Water Birth
If
you're getting ready to have a kid, you're probably considering all of your
options before settling on a birth strategy. More and more women are giving
birth outside of a traditional hospital setting; in fact, the popularity of
home births and birthing centres increased by 20% between 2019 and 2020.
A
water birth is one of the birth plan alternatives. A water birth may be chosen
by some women to reduce discomfort during labour or to have a more
"natural" birth, but is it safe, and what safety measures should you
take to make sure your baby is healthy? To learn more about giving delivery in
water, keep reading.
What
is Water Birth?
According
to Michelle Owens, M.D., a board-certified OB-GYN and clinical director of Mae,
which offers pregnancy and postpartum support to Black people through doula
services, a water birth occurs when the birthing person is submerged
specifically during delivery. While some people may choose to be immersed in
water during the labour process, water births only occur when the birthing
person is submerged during delivery.
The
goal of using water during labour or delivery is to incorporate hydrotherapy:
According to Karen Jefferson, a certified midwife and the director of Midwifery
Practice at the American College of Nurse-Midwives, water immersion during
labour could relieve pain, leading to a reduction in the need for epidurals and
shorter labours. As being in water may prevent vaginal tearing, Jefferson
continues, "those who remain in the water to have a water birth are more
likely to have a shorter second stage of labour (i.e. time spent pushing) and
have fewer or less severe perineal lacerations.
It
is significant to highlight that patient who have received an epidural are not
permitted to give birth in the water.
The
ideal time to enter the birthing pool while submerged from the waist down is
when the expectant mother is in active labour. Periodically, the person may
exit the tub to go potty and get some fresh air before returning to the pool to
perform. In order to maintain the pool's sterility and safety, a midwife
remains outside the tub to support the person giving birth and ensure that they
have a secure way to enter and exit in case of an emergency or to use the
bathroom.
Benefits
of Water Birth
A
few small studies have suggested that people who have given birth using water
rather than more traditional methods have often had happier delivery
experiences. Of note, Jefferson notes that waterbirthers in one study
"expressed a better sense of autonomy and control."
Dr.
Owens believes that having a water delivery is more likely to make the birthing
parent more comfortable than the infant. Dr. Owens states that labour may be
shortened and the need for regional (spinal or epidural) anaesthesia may be
lessened if the mother is submerged in water during the initial stage of labour
(up until the cervix is fully dilated).
Risks
of Water Birth
According
to Nicole Rankins, M.D., a board-certified OB-GYN and host of the All About
Pregnancy & Birth podcast, there aren't many research on water birth,
therefore there isn't much hard evidence of risks to the person giving birth.
Aspiration
(difficulty breathing underwater due to water in the lungs) and infection due
to insufficient tub disinfection are infrequent risk risks for infants after
water deliveries. According to Dr. Rankins, there have also been incidents of
umbilical cord avulsion, or tearing of the umbilical cord, which makes it
challenging to deliver the placenta.
It's
vital to remember that water deliveries cannot be monitored continuously for
the foetus, and they are riskier because of issues like dystocia, in which the
baby becomes lodged in the delivery canal and is unable to exit. Only perfectly
normal labours should be considered candidates for water births.
Due
to a paucity of data on the overall dangers and advantages of water birth, the
American College of Obstetricians and Gynecologists (ACOG) advises against it.
Although you have the right to give birth in the water, Dr. Rankins advises
that you should consider any prospective, extremely unlikely but serious
consequences for the child. If a doctor believes, based on facts, that a water
delivery might be hazardous to the mother or the baby, they are not required to
conduct the procedure.
Who
is an Ideal Candidate for a Water Birth?
According
to Dr. Rankins, only pregnant women who are full-term and free of
pregnancy-related issues could be candidates for water birth. It ought to be
secure if there are no existing difficulties.
According
to Dr. Owens, some of these pregnancy issues may include preterm (delivering
before 37 weeks of pregnancy), preeclampsia, or diabetes. You might not be able
to choose to give birth in the water due to pregnancy issues that affect the
baby. If you are expecting multiples (twins or more), the baby may be in a
breech position, which is feet facing forward in the uterus rather than the
typical posture of head facing forward.
This
might be a viable choice for you if you're healthy and having a straightforward
pregnancy, according to Dr. Owens. If you do have a higher-risk pregnancy and
would not be a suitable candidate for a water delivery, labouring in water can
be a good option.
How
Can I Give Birth in the Water Safely?
Some
OB-GYNs do not perform water births since ACOG does not advise them. But
according to Jefferson, certified midwives and certified nurse-midwives are
well-suited for water births because they have received training in supporting
labour and delivery.
Despite
this, several parts of the nation have quite high rates of OB-GYNs performing
water births. Just make careful to verify that your nurse midwife has the
necessary training for water births as each state has various standards for
qualifying midwives.
In
addition to the healthcare provider, there are rules that a water birth must
follow, including controlling the water's temperature (which should be between
95- and 99-degrees Fahrenheit, per The American College of Nurse Midwives, and
adhering to sanitation rules for the tub to ensure that it is sterile and has a
reduced risk of spreading infection, according to Jefferson. Everyone involved
in the water birth should have personal protection equipment, according to Dr.
Owens.
To
keep the baby safe, certified midwives and certified nurse-midwives also adhere
to a set of rules. In order to maintain thermoregulation, Jefferson says,
"These include bringing the infant's face to the surface as soon as
possible following a water birth and maintaining the infant's body submerged
with their face above water."
Finally,
according to Dr. Rankins, it's crucial to have protocols in place for
monitoring maternal and foetal vital signs to make sure everyone is healthy and
for having a clear departure strategy from the bathtub or pool in the event of
any birth issues.
What
Am I Going to Need for a Smooth Water Birth?
You
must first decide where the birth will take place. "Some hospitals,
birthing facilities, and/or home births may offer the option of water immersion
during labour," explains Dr. Owens. If you're not going to give birth at
home, she advises visiting a hospital or birthing centre beforehand so it feels
comfortable.
You
may type "water birth near me" into your search engine to find a
birthing facility in your neighbourhood. Jefferson advises enrolling in
birthing classes like Lamaze and Mindful Birthing during this period of
preparation to ensure that you are prepared for labour.
Additional
materials are required: According to Jefferson, an inflatable birth tub can be
ordered or rented online for a home birth. She adds that a hospital or birthing
facility may employ an inflatable or built-in tub for a water delivery, and if
you decide to give birth in a tub alone, you may subsequently transition to a
bed for a "land birth," as the term is known.