Monday, October 29, 2012

Understanding Waterbirth

What Is Waterbirth?                  

The term waterbirth is used to describe childbirth that takes place while the mother is partially or mostly submerged in warm water.  While she may or may not have used hydrotherapy (using water for pain relief) during a portion of her labor process, she actually births the baby in water.

Why Labor or Give Birth in Water?

Hydrotherapy can be very effective pain relief. Submersion in warm water both surrounds the body with comforting warmth and supports the weight of the body and uterus. Softening this pressure for the laboring woman is very satisfying. The water allows for more unrestricted movements of the pelvis and back and can allow the pelvis and backbone to sway and stretch to accommodate the widening birth canal and descending baby. Even without being submerged in water, a woman can receive very satisfying pain relief, and needed distraction and refreshment from a shower. If a shower sprayer is available, her birth partner or doula can use it to spray on her lower back, pelvis, or other areas she is experiencing intense pain or pressure. Showers can have a massaging, therapeutic effect temporarily or long term. Allowing warm water to run over the breasts and nipples can also increase oxytocin production, aiding in labor progression.

Women and couples who experience waterbirth often describe it as peaceful, relaxing, soothing and natural. I gave birth to my second baby in the water, and I agree; it was an amazing experience!

The birth of my second son, Alec Michael Sanders.

Is Water Birth Safe?
Babies can be safely born under water. They do not take their first breath until they emerge out of the water. Water birth is a safe, gentle and beautiful way for women to birth their babies. Since the warm water mimics the environment of the womb, the baby experiences less shock of cold air and bright lights, and instead gently transitions out of the womb, through the warm water and straight to his mother’s warm breast. For more information about the evidence to support water birth, read Evidence Based Birth's Evidence on the Safety of Water Birth

Water Birth Options and Considerations:

If you are birthing at home, you can easily labor in your own bathtub or whirlpool. Many people like to rent or purchase birthing pools because they offer more space so a partner can be in the water with you. Also, the pool can be placed within a larger room, leaving the space surrounding the  birth pool available for your doula, midwife, family or other support people to surround the laboring mother. 

If you are birthing at a birth center, chances are they have a labor tub or portable birthing pool available on site.

Your hospital may or may not have a bathtub available. Usually, there is at least a shower available. You will need to inquire about your options. If there is a bathtub available at your hospital or birth center, you will need to inquire about whether you will be allowed to both labor and birth in the tub. Some caregivers will allow their patients to labor in the water, but require they move to the delivery table for birth.

If your practitioner requires continuous EFM (Electronic Fetal Monitoring), he or she may not allow you in water. There are waterproof monitoring strips available, as well as telemetry (battery operated, mobile monitoring units), which would allow you to move away from the monitoring machine located next to the hospital bed. Ask if these mobile units are available at your birthing location. If no telemetry is available, ask if intermittent fetal monitoring is a possibility. If so, you may be able to unhook the fetal monitors and spend time in bath or shower before you’re required to go back and plug them back into the machine for monitoring.

If you have an IV or heparin lock, immersion in water shouldn’t be a problem. A plastic bag can be placed over your IV to protect it from water, and be sure to keep your arm out of the water. If you are receiving Pitocin, it shouldn’t be a problem to roll the rack, which holds the bag of medicine and fluids into the restroom while you are in the bath or shower. Of course, you will need to check with your caregiver to see if this is an option for you.

Though there is little risk of infection, your caregiver may not allow you in the water once your water is broken. Ask your caregiver about his/her protocol concerning hydrotherapy if your membranes have ruptured.

At Honeybee Mama, I'm committed to getting you the tools and resources you need to make informed decisions about your birth. If you're interested in knowing more about your birth options, check out my childbirth training manual or schedule a consultation today!

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Erin said...

I labored in the tub for a couple hours with Luke, but in hindsight, I think it slowed my labor because I couldn't move around. I had trouble finding more than 1 comfortable position. I'd wanted to give birth in the tub as well, but when my water broke, there was meconium in the fluid and the midwives said that I wouldn't be able to because they would need to suction is airways before his body was delivered.

So that's another consideration too - can you move around in the tub and alternate between at least 2 comfortable(-ish) positions and if there is meconium, they will likely require you to move out of the tub.

Missy Rose said...

Thanks for sharing, Erin! Yes, since there was meconium in your fluids, I can see why they would want you to be out to suction Luke's airways. As far as positioning goes, it can depend on the size of the tub. I was in a standard sized bathtub and pretty much could only recline. I was happy with that, and could move and shift my hips; it was all the relief I needed. In a larger birthing pool, you can get on your side, hands and knees, or even squat. So, birthing pools or larger whirlpools offer a lot more freedom!

As far as slowing down your labor goes - if you get into the water too early in labor, it can slow things down. But if you have a long latent first stage labor, you might need that relief. Further in labor, past 5-6cm dilation usually, being in water will help a woman fully relax and allow her body to do what it needs to do and labor will likely progress at a steady pace or even speed up.


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