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  • 21 Things to Consider When Choosing a Water Birth

    Water birthing has become more popular over the years as word of it has made the rounds. Once considered something that “hippies” did, it has gained popularity to the point that many hospitals offer water birth as an option and provide facilities for it.

    The activity of water birth is the exactly as it sounds: having a baby while in the water. It means that you are immersed in a warm tub of water during your labor and all the way through to the actual birth of the baby. Here are some things to think about when considering whether water birth is for you.

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    Relaxing to the Body

    Water birth is considered by many to provide a more relaxed body for the birth experience. Being buoyed by the warm water can help relax muscles, much like having a warm bath to soothe a back ache.

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    Relaxing for the Mind

    A warm bath soothes the senses and helps the mother in labor feel more relaxed mentally and more in control. Dimmed lights, soft music, and lighted candles can add to a relaxed atmosphere.

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    Opposing Viewpoints on Water Birthing

    There hasn’t been very much scientifically based research into the risks or benefits of water birth because the normal research protocol is virtually impossible to follow. Some research was based on prospective studies where women were enrolled after they became pregnant, and were followed after the babies were born. Other research was through case-controlled studies where women were matched up after birth.

    In 2014, the American Academy of Pediatrics (AAP) and the American Congress of Obstetricians and Gynecologists (ACOG) released statements that water birth should only be done for clinical research. The opinion was based on previous findings from an AAP Opinion Statement from 2005.

    In response, the American College of Nurse-Midwives (ACNM), the Royal College of Midwives (RCM), and the American Association of Birth Centers (AABC) each released declarations supporting water birth as an evidence-based, safe option for women. The AABC also released data that included information from birth centers all around the United States on almost 4,000 water births that proved safe for mother and baby. 

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    Babies Rarely Breathe Underwater

    The occurrence of the baby breathing while still underwater is extremely rare, and most feel that it is an unwarranted fear. A baby has an inherent reflex that keeps them from breathing when immersed in water. Also, it has been shown that babies will not cry and breathe until the air hits their face and there is a distinct change in temperature. In addition, the baby receives oxygen from the umbilical cord during the birth and until it is cut, or the baby’s face hits the air, it has no reason to try and breathe.

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    Water Birthing Eases Labor Pain

    Water birth is believed to ease the pain of contractions by providing a more relaxed location that helps avoid the need for pain medication and speed labor along. When a woman gets into the deeper water of a birthing pool (compared to a bathtub), the body releases oxytocin, which helps regulate contractions and increases endorphins that decrease pain reception.

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    Labor Can Be Encouraged

    With a more relaxed body and mind, it is believed that labor moves along more smoothly. A tense body and mind can hinder the rhythm of contractions, thereby slowing down the process. When the body and mind are relaxed, the natural rhythm can take over.

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    Less Chance of Vaginal Damage

    There may be less vaginal tearing during a water birth and the need for an episiotomy is reduced. The skin will be softer, more relaxed, and more pliable while immersed in warm water.

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    Don’t Try It Without a Professional

    Never try a water birth at home without a nurse-midwife or midwife present. The safety of you and your baby should be foremost in consideration. No matter how normal and problem-free your pregnancy has been, life is known for throwing curve balls and you or your baby may experience problems that only a professional can handle.

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    Consult Your Doctor

    If you are considering a water birth, discuss it with your OB-GYN, and find out what their thoughts are and whether it can be an option for you. Find out if the hospital you plan to use offers the service. You may need to find a birthing center or do it at home, where you will need to find a midwife.

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    When Not Try a Water Birth

    You should not try a water birth if the following applies to you:

    • You are over 35 or under 17 years of age.
    • You have diabetes or preeclampsia or other complications
    • Your baby is coming prematurely
    • Your baby is in the breech position
    • You have an infection
    • You need constant monitoring that isn’t possible with you in the water
    • Your baby is especially large
    • You are expecting more than one baby
    • You are overweight
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    Water Close to Body Temperature

    The temperature of the water for the birth needs to be maintained between 95° and 101° F, so it’s not going to be like getting into a steamy hot tub. Keeping the water temperature close to body temperature assures that the mother doesn’t become overheated, which could raise the baby’s heart rate. 

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    Mother-to-be Needs to Stay Hydrated

    Plenty of cool water and cold compresses should be on hand to cool the mother during labor, as it is hard work and liquid and electrolytes are lost through sweat. It is important for the mother to remain hydrated.

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    Go Ahead and Eat

    Water birth or not, many women are told not to eat once labor starts, however, early contractions can be irregular and mild and go on for 12 hours. If you are hungry, eat, and especially drink. You can’t expect to run a marathon on an empty stomach and you will need all the energy you can muster when contractions become strong and regular.

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    Stress Can Inhibit Labor

    Stress-related hormones, such as catecholamines and noradrenaline, cause the blood pressure to rise and actually slow down labor. Many also believe that the hospital environment with bright lights and noise is non-conducive to enjoying the birthing process. Water birthing is most often done in a quiet, private environment that allows the mother to concentrate on the birth and not on what is going on around her.

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    Less Gravity to Fight

    The buoyant effect of the water makes the labor process more comfortable for the mother as she can move around freely in the water without having to fight gravity to change position. If you’ve ever gotten into a tub of warm water to ease tired muscles, then you know the relaxing sensation that becoming virtually weightless can provide.

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    Most Women Would Do It Again

    Mothers who have gone through the experience of water birth found the experience amazing and would use the method again. Most describe how relaxed the entire process was and that it definitely helped ease the pain of labor. Women report that once they entered the water, their pain level dropped almost immediately, allowing them to focus on the process of bringing new life into the world.

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    An Unmatched Bonding Opportunity

    A water birth can provide a fabulous bonding experience for mom, dad and baby. It may be possible for your partner to join you in the pool at a point during your labor, giving the opportunity for hands-on encouragement. They can sit behind the mother during contractions and coach breathing, and provide something extra for the mother to push against or hold on to. You’ll have to check with your birthing facility to see if this is allowed.

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    Reasons to Leave the Tub

    You may need to leave the tub if:

    • Your baby’s heart rate changes dramatically, indicating a problem
    • Your blood pressure goes up
    • You feel drowsy or faint
    • Your labor is not progressing well. (You may be asked to get out and walk around to help the baby move down.)
    • You begin to bleed
    • If baby poo is detected in the water
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    Easier Transition for Baby

    The reason water birth has become popular is that it is felt that since the baby has grown inside the uterus filled with amniotic fluid, being born into a fluid environment will be less stressful. This idea is believed to have first started the movement, but as time has passed, the benefits to the mother have come to light.

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    Not Recommended by Some

    When it comes to actually birthing the baby underwater, the American College of Obstetricians and Gynecologists (ACOG) recommends that once the cervix is fully dilated, the mother comes out of the water for the actual birth and that having the baby born underwater is still experimental. However, tens of thousands of babies have been born using this method. Complications do not occur any more often than with normal deliveries. 

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    The Risk of Infection Is Minimal

    There is a lot of controversy over whether birthing in water is more liable to give the baby an infection, but there is no evidence that this is the case. Approximately 40-50 percent of women will defecate during the pushing phase, or the baby itself sometimes will have their first bowel movement during the birthing process. However, evidence has shown that bath water does not enter the vaginal canal. When proper cleaning and disinfection procedures are followed, the risk of serious complications from water birth is 4.5/1000.

    When you are pregnant, you certainly want everything to go as smoothly as possible. If water labor or water birthing sounds like an option for you, talk with your OB/GYN and learn about what the options are in your area. 

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