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Water Birth? Why Not?

Dec 7, 2005 at 10:55 AM Chime in now

Bath tub


Are you considering a water birth? If you are, and you've mentioned it to others, you may have been asked why any woman would choose such a thing. Your friends probably fear the baby might drown or you might suffer some dread complication that can only be managed on land.

Those fears are unwarranted: water is essential to human life, and our bodies and our Earth are composed primarily of water. Our babies float in warm water for the first nine months of their lives. Across the world, women have delivered in water throughout recorded history.

Why Choose Water Birth?
Movement is easy when you labor in water. Often, women who labor in water ‑- even for long periods in the hospital ‑- are taken to bed as the moment of birth approaches. Now, you may have the option to deliver in water.

Although water birth is still undergoing scrutiny by care providers and researchers, much of the evidence has demonstrated great benefits. A review of eight trials that included 2,939 women found a statistically significant reduction in the use of epidural anesthesia among women who were immersed in water during the first stage of labor compared with those who were not. Other findings included:

-- No significant difference in the use of a vacuum, forceps or cesarean birth.
-- Significantly less pain among women who used water immersion during the first stage of labor than among those not laboring in water.
-- No significant differences in Apgar scores, neonatal unit admissions or neonatal infection rates.
-- A lower incidence of perineal trauma.
-- A shorter labor.
-- A sense of control.
-- Greater satisfaction with the birth experience.

Some women, when interviewed, commented:
"I was weightless and I could turn so easily. I felt that I actually delivered my own baby."

"No one shouted at me to 'push.' I pushed when I needed to push. Because no one could really see 'down there,' I felt like I avoided a lot of needless exams."

"When the baby came out, the midwife brought him to the surface and he just breathed. He didn't cry ‑- he just took in this deep breath and wrinkled his nose. I think he was telling us he disapproved of this 'air stuff.'"

In general, I've noticed that babies born in water seem more content, cry less and don't startle as much as those born in bed. They have a longer time to make the transition to the world. They can focus on their breathing without expending the calories needed to stabilize their temperatures and glucose levels. They are born into a familiar environment of muffled sounds and warmth. As they are put to their mother's breast, there's no contact with cold hands and no need for rough blankets. They seem to say, "That wasn't too bad!"

So Why Don't Babies Drown?
In most water births (and all those that take place in U.S. hospitals and birthing centers), babies are brought to the surface immediately after birth. Once released from the pressure on their chests within the birth canal, they are met with the natural resistance of the water pressure and it discourages gasping. Water babies don't encounter the dry air and significant temperature change that greatly stimulates the breathing reflex. But as their heads gently emerge from the water, the air does offer sufficient stimulation to breathe.

Who Should Try It?
Some women are not good candidates for water birth, either because of complications in their medical or obstetrical history, or because of complications encountered in labor. Ask your midwife or doctor if you meet the criteria. If you have any of the following conditions, you may not be an appropriate candidate:

-- Temperature of 100.4 degrees F or higher.
-- Non-reassuring fetal heart rate.
-- Unexpected or unusual vaginal bleeding.
-- Epidural analgesia or intrathecal narcotic for pain control.
-- Any condition requiring continuous electronic fetal monitoring (e.g. oxytocin induction or augmentation of labor).
-- Presence of any infection transmitted through blood or body fluids.
-- An active herpes outbreak.
-- A baby who is not presenting head down.
-- Previous cesarean birth.
-- Presence of meconium in the amniotic fluid.
-- Premature birth prior to 37 completed weeks of gestation.
-- Any condition that will require the presence of a neonatal team at delivery.

Before you choose water birth, you'll be asked to meet the following conditions:
-- You agree to allow the nursing staff to listen to the baby's heart beat as needed while you're in the tub.
-- Your temperature and blood pressure and baby's heart rate must be within the normal range.
-- You agree to follow instructions from the CNM, MD or nurse, including getting out of the tub if asked to do so.
-- Your cervix must be dilated to 5 cm or more.
-- You must have a support person with you at all times.
-- Your fetal heart rate must be normal on a fetal monitor.
-- You have tested negative for HIV, hepatitis B and hepatitis C during the course of your pregnancy and these results are documented on your prenatal records at the time of delivery.
-- You will stand or leave the tub to deliver the placenta. Repair of any tears will be done in the bed.
-- Support people who enter the tub must wear a bathing suit.

Now that you know something about water birth, you might be tempted to consider this gentle delivery method for your baby. If you'd like to learn more, check out http://www.waterbirth.org and  http://www.waterbirthinfo.com.

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