Ahhh! I love the water!

Waterbirth is a way of gentle birthing using a warm tub of water to help ease the pains of labor and the baby’s transition. Many women say it takes away about half of their birthing pains.  That’s a pretty great accomplishment for a tub of warm water!  It is safe, highly effective as pain relief, and easy to set up.

Safety of waterbirth

Waterbirth is safe because it helps support the body’s natural birthing instincts and does not impose any drugs or interference onto the birthing process.  It helps the mother relax and breathe deeply, thus helping the baby move down the birth canal effectively with a maximum supply of oxygen.  Because a woman has no epidural or drugs on board, she has full movement of her body both in the water and the capacity to get out and move to the bed or a different location.  This means that if her position in the water makes it hard to hear the baby or she’s uncomfortable, she can easily move to a better position.

We use a waterproof, hand-held doppler to monitor the baby’s heart rate while mom is in the tub.

Improving Birth, A US consumer group, has published a letter criticizing the recent ACOG/AAP opinion on water birth as completely non-evidence based. Not only was only the lowest level of evidence cited, but at least one article discussed in the opinion was completely misrepresented. Hopefully your doctor isn’t citing the ACOG/AAP opinion as the reason why you can’t waterbirth in your hospital.

But why does the baby not breathe underwater?

There are several adaptations in the baby that inhibit their first breathing response. First, the baby’s muscles for breathing are inhibited by prostaglandin E2 (from the placenta).  Second, babies are born experiencing mild hypoxia, or lack of oxygen. Hypoxia does not cause breathing or gasping, actions that would draw water into the lungs, but rather swallowing.  Third, the amniotic fluid already present in the baby’s lungs is denser than water and does not allow water into the lungs.  Finally, babies have what is called the “dive reflex”, a reaction in the larynx that causes the glottis to automatically close when a bad tasting substance touches it.  The water solution would be swallowed, not inhaled.  Interestingly, breastmilk does not cause the same reaction because it tastes good!

For a more complete description, please read Barbara Harper’s Waterbirth Basics and check out Waterbirth International.

Pain relief of water

Remember what it’s like to have had a hard day working or skiing and your muscles are all tired and sore?  And then you slip into a hot tub or a deep, warm bath?  Ahhhhh…..  Labor and birth are not so different, really.  Muscles can relax and stretch more easily in the warm water, it’s easier to work out the knots, and your whole body can sink down, supported by the water.

A laboring mom really appreciates the buoyancy the water provides, allowing her to achieve a squatting or hands and knees position that would have been too difficult otherwise.  She can sway her hips, change positions when one isn’t working anymore, and be rocked by the water.

The ability to change positions is key to helping relieve pain.  This is because the baby presses on the pelvis and the muscles differently as it moves down into and through the pelvis.  The mother feels these changes and can relieve the pressure by moving her body.  Much of the pain of labor, as we generally know it, comes from being immobile, on our backs, with the weight of the baby pressing through our sacrum toward the bed.  (That, and the fear that comes from not having a calm, reassuring presence with us the whole time.)

Of course the stories we have heard from our mothers, grandmothers, and friends who have been forced into bed on their backs, some even tied to the bed, are full of pain and misery!  If these are the stories we “know”, there is no room for the ease and beauty of waterbirth and natural childbirth.

Ease of set up

Setting up for a waterbirth is pretty easy, it just requires a little bit of planning.  Most of the supplies needed can be found in your house already, at a local hardware store, or are provided by the midwife.

When the tub is delivered, we assess your house for the best location for the tub, how to hook up the hose, and where to drain the tub.  Usually this is in the master bedroom so that you are close to your bed and bathroom.

Dads or partners are really important to getting the tub set up!!  It’s really your job to get everything in working order.  When labor hits and she wants the tub, she really wanted it yesterday, for goodness’ sake!!!