Water birth

Water birth is a method of giving birth in a bathtub or pool full of warm water. Proponents claim this method has many favourable effects for the mother and child and is a safe alternative to other ways of delivery.

History

The use of water for labor and birth in is a reasonably recent phenomenon in Western culture. The Russian researcher Igor Tjarkovsky undertook considerable work during the 1960s into the safety and benefits of waterbirth in the USSR. Frederick Leboyer in the late 1960s undertook work in France on the value of immersing newly born babies in warm water as a way of acclimatizing them from the move from the womb to the outside world and mitigating any possible birth trauma. Another Frenchman, the obstetrician Michel Odent took Leboyer's work further and used the warm water birth pool for pain relief and as a way to normalize the birth process. When women refused to get out of the water to give birth to their baby, Odent started researching the benefits and potential problems about the baby being born under water. By the late 1990s, thousands of women had given birth at Odent's birth centre at Pithiviers and the notion of water birth had spread to many other western countries. Waterbirth first came to the United States through couples giving birth at home, but soon was introduced into the medical environment of hospitals and free standing birth centers by obstetricians and certified nurse midwives. In 1991, the first hospital to create a protocol for giving birth in water was Monadnock Community Hospital in Peterborough, New Hampshire. By 2005, there were over 300 hospitals in the US that had adapted protocols for women to give birth in water. More than three quarters of all National Health Service hospitals in the UK provide this option for birthing women.

Water birth is still widely practiced by those who have home births simply because many hospitals do not have proper birth pools in their labour wards.

Research

Considerable research has been undertaken into the safety of water birth. Two of the most prolific researchers have been Michel Odent and the American obstetrician Michael Rosenthal. Dianne Garland, a midwife in the UK, has focused on gathering research through the NHS system and has published a book, "Waterbirth: An Attitude to Care." In the US, Barbara Harper, a nurse and childbirth educator, has explored waterbirth throughout the world and chronicaled the history and current use of waterbirth in dozens of countries in her book, "Gentle Birth Choices." An extensive bibliography of this research can be seen at Waterbirth International' ^*

Advantages

To the mother

The warm water is relaxing and eases labour by reducing the excretion of adrenaline caused by pain and fear. The water also stimulates the release of endorphins. The elasticity of the perineum is increased. These all help to result in an easier birth with fewer lacerations and tears.

With increased buoyancy in the water the pregnant woman can change her position easily. In most cases, water births are shorter and less painful and few women need analgesics. The buoyancy also causes a hormonal change in the mother's body, giving her more oxytocin (the hormone responsible for labour contractions), making her labour more efficient.

Specially designed birth pools are large enough to accommodate a labor support person such as the father, or a midwife, and some are equipped with waterbed style heaters to maintain optimum water temperature. However, a roomy standard tub is also sufficient for those planning a home birth on a tight budget.

The great majority of women who have experienced water birth say that they would never want to have a baby any other way.

To the baby

Birth is also a strenuous effort for the baby and water eases this exertion. The warm liquid is still familiar to the child and softens light, colors and noises.

Disadvantages

There are some concerns with regard to water births, though most objections are because the idea is unusual. There is a minute risk that the baby can aspirate water if it is raised to the surface after the birth and then re-immersed. However, midwives and obstetricians are well aware of this risk and once the baby is brought to the surface the baby is placed straight on the woman's breast to feed and not re-immersed in the water. The baby's first breath is triggered by the absence of the water over the face which triggered the mammalian diving reflex along with contact with air pressure on the trigeminal nerve area of the face. For the first breath to take place the baby switches over from fetal circulation to newborn circulation, closing the shunts in the heart, creating pulmonary circulation, changing the pressures in the lungs, pushing out fluids that are already present in lung spaces and allowing for the exchange of oxygen and carbon dioxide. This process takes a few minutes to completely initiate, during which time the newborn typically is still receiving oxygen from the umbilical cord. There is no threat that the newborn will inhale water during the birth process since his trigger to breathe oxygen is not present until he makes contact with the air.

Another objection raised is that the water may increase the chance of infection for the baby, but to date there has been no research to support this contention. Midwives and doctors experienced with water births have not noted an increase in infection rates for either mother or baby.

Acceptance

Water birth is accepted and practiced in many parts of the United States, Australia, New Zealand, and in many European countries, including England and Germany where many maternity clinics have a birthing tub. Some offer water birth and others only permit water labour. Also, many independent birth centres and many home birth midwives offer water birth services.

References

Flade, Ines: Rundbrief Nummer 2. Einiges über die Wassergeburt.
Geburtsberichte, Geburtshaus und mehr e. V. Jena, Jena 1999.
"Gentle Birth Choices" Barbara Harper, Inner Traditions, USA, 2005 ISBN 1 5947 7067 0
The Waterbirth Website: All About Waterbirth and WaterBabies & Karil Daniels
New Active Birth — A Concise Guide to Natural Childbirth, Janet Balaskas, HarperCollins, UK, 1995 ISBN 0 7225 2566 4
Having a Great Birth in Australia, David Vernon, Australian College of Midwives, Canberra, 2005 ISBN 0-9751674-3-X
" Waterbirth: An Attitude to Care," Dianne Garland, Books for Midwives PR, UK, 2000 1 5947 7067 0

External links

Childbirth | Midwifery | Obstetrics

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