midwife04What is a Water Birth?

Water birth is when a woman labours and gives birth while in a tub filled with warm water. Some women choose to labour in water, but not actually birth in the water.

Many mothers choose to labour in water because they find it soothing and are able to relax more and so experience their contractions as less intense.

If you laboured in water, you’re likely still relaxed and benefiting from the flow of all the beneficial hormones. Being in water provides birthing women with privacy and autonomy, while helping them to cope with contractions.

If we think about a time where we’ve felt discomfort or pain, when we’ve been really tired, or when we felt physically fatigued, a warm bath or shower tends to help relax us, and relieve our discomforts. Genesis Clinic has birth tubs, if you choose to have a waterbirth.

 

 “There is a secret in our culture, and it’s not that birth is painful. It’s that women are strong.” ~ Laura Stavoe Harm

 

The Benefits of Water Birth: 

Current research and reported experiences tell us water birth has many benefits: [1 & 3]

  • Pain relief
  • Relaxation
  • Buoyancy to helping women feel lighter
  • Facilitating position changes
  • Helping reduce stress hormones that increase pain
  • Immersion in water can help reduce anxiety
  • Reduced risk of episiotomy and tearing
  • Can facilitate the fetal ejection reflex rather than interfere with it
  • Encourages relaxation of the pelvic floor
  • Reduces inhibition and anxiety by creating a feeling of privacy to allow a mother to follow her natural birthing instincts and work with her body
  • Encourages a gentler arrival and transition for baby
  • By facilitating movement, privacy, and both emotional and physical relaxation water birthing can reduce the length of labour by encouraging the release of labour hormones
  • Reduces the risk of medical interventions

 

How will my baby breathe during a water birth?

When we observe a birth out of the water, we often notice baby quickly breathes and cries. However, simply exiting the womb does not trigger breathing. Babies are triggered to breathe when they feel the change in temperature. When the birthing pool is kept at a safe temperature, (between 36 and 38 degrees Celsius ~ body temperature) the baby will continue to receive oxygen through the umbilical cord. Once brought swiftly out of the tub, the change in temperature will trigger baby to take the first breath.

The method most commonly used term for baby to be birthed is, "through" the water as opposed to "into" the water. By this method, the baby is birthed and brought to the surface within one minute of birth. Once a mother has birthed her baby, she will want her baby in her arms immediately!

 

Is there a risk of infection?

The birth tub is thoroughly cleaned before and after the birth and the water is clean (if it is clean enough to drink then it is clean enough to birth in) and there is no significant increased risk of infection to either the mother or the baby. Salt is also added to the water to act as a natural antiseptic and to make the water more like body fluid so the baby is birthed from fluid in the uterus into a similar saline fluid. 

It is important to ensure that both the mother and the baby are healthy before choosing a water birth. During a study on water birth, French obstetrician and a world-renowned water birth Dr Michel Oden, reported no infections, regardless of whether membranes (waters) were intact or ruptured. [2] 

 

When should a woman get in the water?

Experience has shown that it is best to use water in mid labour - when the mother is about 5 to 6cms dilated. Labour is usually very intense at this stage and the mother may feel she needs help and this is the ideal time to enter the birth pool. After about half an hour of being in the warm water the mother is likely to enter a very relaxed state where she can enter a deeper level inside herself and surrender to the power of the more active phase of labour. This is the time to allow the body to take over, to trust in nature and to surrender to the involuntary forces that are opening your body and bringing your baby into the world. 

The warm sensations of water on skin will help to modify the pain and the buoyancy of the water will relieve the body’s weight. This helps enormously to make the mother more comfortable in upright positions and to conserve strength and energy. It’s much easier, for example to move or to squat in water.

Your partner can sit right beside the birth tub or even get in with you to massage and hold you. Once in the water, the mother is unlikely to notice the world outside the rim of the pool or how much time has passed. It helps her stop thinking and to be “in” her body. The increased secretion of oxytocin when the mother enters the water peaks after about two hours. Oxytocin, an important labour hormone is more easily secreted when the mother feels safe, comfortable and loved.  This aids the secretion of birth hormones which stimulate contractions and aid the body’s natural pain relief mechanisms.

When you feel you are ready to push and give birth to your baby you may decide to leave the pool and have your feet firmly planted on the ground or you may decide to remain in the water for the second stage.  Provided there is good progress and no sign of any complication, birth in water can be easier for the mother and gentler for the baby.  [3]

 

Is a water birth right for me?

Until you’re in labour it can be hard to know for certain what will best to help you cope with contractions. However, many women do plan for a water birth, and take steps to keep it as a viable option should they find it helpful. 

If you want or are interested in a water birth, your maternity care provider choice is important. Genesis Clinic midwives are supportive and experienced with water births and are available to advise you.

 

What benefits does water birth have for babies?

Midwives who attend water births report that babies tend to be calm and the transition to life outside the womb more easily. Women who labour in water respond by feeling more relaxed, which in turn facilitates more effective labour and less stress on their babies. 

Babies who have been surrounding by warm water for nine months are eased into a warm, watery environment, reducing the sudden temperature changes and bright lights. The transition to breathing is gentle, as the baby is brought to the air and the umbilical cord is left intact.

 

New research shows benefits of water births.

A study published in the Journal of Midwifery & Women’s Health looked at midwife attended water births in the United States over a five year period. [4] The researchers analysed data collected by the Midwives Alliance of North America Statistics Project (known as MANA Stats).  More than 6,500 women in the database gave birth in water, either at home or in a freestanding birthing centre; the study didn’t include women birthing in hospitals. 

The outcomes in these water births were compared with the outcomes for births not in water. The results speak for themselves. Babies born in water are no more likely to require transfer to hospital after birth, or require admission to a neonatal intensive care unit (NICU) in the first six weeks following birth, than babies who aren’t born in water.

Water birth babies are also no more likely to have a low Apgar score after birth than babies born out of water. The Apgar score assesses your baby’s wellbeing at 1 and 5 minutes after birth, to determine if any treatment or assistance is needed. Factors that are assessed in the Apgar score are skin colour, heart rate, reflex response, muscle tone and breathing. Babies with an Apgar score of 7 or higher are not likely to require any assistance and are considered to be in excellent condition. 

This concurs with another study from Australia, which analysed birth outcomes over 12 years in a large Sydney birth centre. The researchers found babies born in a semi-reclined position were more likely to have lower Apgar scores than babies born in water. 

Water birth is increasingly popular as a method of pain relief and relaxation during labour. You might be undecided about whether you will just labour in water, or choose to birth there as well. If access to a water birth during labour is important to you, make sure you choose a birth setting with care providers who are supportive and experienced in water birth.


Evidence based Research for Water Birth:

1.The Evidence on Water Birth, The Journal of Perinatal Education, 2014 Summer; 23(3): 124–134.

2. Water Labour & Water Birth, International Childbirth Education Association Paper, 2015.

3. Water Births: A Comparative Study, Fetal Diagnosis Therapy ,2000.

4. Journal of Midwifery & Women’s Health, Maternal and Newborn Outcomes Following Waterbirth: The Midwives Alliance of North America Statistics Project, 2004 to 2009.