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 helping women to feel lighter
  • Facilitating position changes
  • Helping to 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
  • Encouraging relaxation of the pelvic floor
  • Reducing inhibition and anxiety by creating a feeling of privacy allowing a mother to follow her natural birthing instincts and work with her body
  • Encouraging a gentler arrival and transition for baby
  • By facilitating movement, privacy, and emotional and physical relaxation it can reduce the length of labour by encouraging the release of labour hormones
  • Reducing the risk of medical interventions

 

How will my baby breathe during a water birth?

When we see a birth out of the water, we often notice baby is quickly breathing and crying. However, simply exiting the womb doesn’t trigger breathing. Babies are triggered to breath when they feel the change in temperature. When a birthing pool is kept at a safe temperature, (between 36 and 38 degrees celsius ~ body temperature) and a baby will continue to receive oxygen via the umbilical cord. Once brought swiftly out of the tub, the change in temperature will trigger baby to take her first breath.

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

 

Is there a risk of infection?

The birth tub is properly 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), therefore 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 an antiseptic and also to make the water more like body fluid so the baby is birthed from fluid into a saline like fluid. It is important to ensure that both the mother and the baby are healthy if they wish to have a waterbirth. French obstetrician and a world renowned pioneer in waterbirth, Dr Michel Odent, reported no infections, regardless of intact or ruptured membranes (waters) during a study on water birth. [2] 

 

When should a woman get in the water?

Experience has shown that it is best to think of using water in mid labour, when you are about 5 to 6cms dilated. Labour is usually very intense at this stage and you may well feel that you need some help, this is the ideal time to enter the birth pool. After about half an hour or so of being in the warm water you are likely to enter a very relaxed state where you can go to a deeper level inside yourself and let go to the power of the more active phase of labour. This is the time to let your body take over, to trust in nature and to surrender to the involuntary forces that are opening your body and bringing your baby to birth.

The warm sensations of the water on your skin will help to modify the pain and the buoyancy of the water relieves you of your body’s weight. This helps enormously to make you more comfortable in upright positions and to conserve your strength and energy. Its 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, you are unlikely to notice the world outside the rim of the pool or how much time has passed. It helps you to stop thinking and to be in your body. There is an increase in oxytocin secretion when you enter the water which peaks after about 2 hours, oxytocin, an important labour hormone, flows best when a woman feels safe, comfortable and loved. Along with the release of oxytocin, which stimulates labour contractions, the body also releases beta-endorphins which is a hormone that aids in coping with pain, it can even create feelings of euphoria. The environment of a water birth is therefore aiding a woman's body to use its natural pain relief.

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 sure what things will best help you cope with contractions. However, many women do plan for a waterbirth, and make sure to take steps to keep it a viable option should they find it helpful. If you’re wanting a water birth, your maternity care provider choice is important. Genesis Clinic midwives are supportive and experienced with water births.

 

What benefits does water birth have for babies?

Midwives who attend water births report that babies tend to be calm, and transition to life outside the womb easily. Women who labour in water respond by feeling more relaxed, which facilitates a 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 looked at 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 assess 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 aren’t likely to require any assistance and are considered to be in excellent condition. This concurs with another study from Australia, which looks at birth outcomes over 12 years in a large Sydney birth centre. The researchers found babies who were 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.