Why Waterbirth?
Posted on June 11, 2016 by Rita Ramkissoon
Published in Birth Issues, Volume XXX Number 1 Winter 2016
The Magazine of the Association for Safe Alternatives in Childbirth
www.birthissues.org
With my eyes closed, I hear the gentle sounds of the ocean, rolling in… rolling out. The moistness of the water caresses and soothes my skin, like a cocoon, secure, comfortable and warm. Oh so peaceful and just where I want to be, where I need to be.
No, I am not really in the ocean, but in the birth pool seeking comfort as each surge1 flows in, and out. Not for one, but for all three of my children, the water was my solace, my sanity and pure solitude. Did I always dream of having a baby in water? No, but following in the footsteps of some beautiful women in my life just seemed like the most natural thing to do when the time came. Thankfully my husband agreed!
Benefits
So why waterbirth? Research tells us there are many benefits that can be achieved for you and baby through the calming, peaceful environment provided by a birth in the water.
When the body relaxes in a warm body of water, with sensory stimulation reduced, the birthing mother is less likely to secrete stress-related hormones. This in turn allows the body to produce the pain inhibitors – endorphins – that complement labour. Water is thus said to have an analgesic effect. When the labour becomes physically easier, the birthing Mother is then able to concentrate, and calmly focus inward on the birthing processes.2
Another benefit of labouring in water is the elasticity that water imparts to the tissues of the perineum, reducing the incidence and severity of tearing and eliminating the need for an episiotimie.3 The first physician to keep waterbirth statistics, Dr. Michael Odent, reported that in one hundred waterbirths he had attended, no episiotomies were performed and there were only twenty-nine cases of tearing, all of which were minor surface tears.4
Emersing yourself in a warm body can also provide you a sense of privacy and control over your birthing process. The sense of buoyancy provided by the water can allow you to move naturally into optimal birthing positions5. The warm, soothing water also provides a gentle, welcoming environment for your baby, while empowering the mother in her ability to accomplish a conscious, natural birth.
Sounds good right! That’s what I thought, and with my first pregnancy my birth plan included a pool. As the unknown and unfamiliar feelings of labour continued throughout the birth day of my daughter, I welcomed the moment I crawled into the warmth of the pool. I spent several hours in the water, and several hours pacing the hallways of our home, waiting… but the moment I held onto my little girl and brought her out of the water was surreal.
Loving the experience, our second birth was planned as a home waterbirth.
Having had three babies born in the water, I can attest to all of these many benefits – plus, it just feels good! My passion for this beautiful birth support tool gave me the motivation to develop a way to share this tool with many birth mothers – along with a gentle nudge from a good friend! In 2009 my husband and I launched a birth pool rental company – Baby Birth Pools – so we could help other expecting moms enjoy the water. Six years and over 400 clients later, it gives me great joy to celebrate in the excitement and satisfaction they have had as well.
“My wife stays out of the water as long as she can, right up until the moment of “O my God, I can’t do this! Get me some drugs!”. And then floating in the warm water makes it all bearable again. She says without the pool she couldn’t have done it drug-free. I love that the pool is big enough for me to get in with her to help, and be there to catch our baby when he comes out.”
“Laboring in the water is amazing. My first child wasn’t born in the pool but I labored in the pool for a long time. The water eased my discomfort and allowed me to manage a very long and tiring first labor without a hospital transfer or medication. With my second baby, he came much more quickly and with a lot of intensity. When I reached transition, getting in to the pool reduced the intensity and allowed me to bring a nice rhythm to labor. He was born in the water. The feeling of a baby coming tumbling out of you into the warm water is really and truly incomparable! My third baby, transition hit when I was laboring at home alone after 30+ hours of trying to bring baby earth side. When I suddenly felt like pushing, and there was no one else here, getting into the water helped me manage those sensations until my husband and midwife arrived. He was also born in the water. Both of my water birth babies were just over ten pounds, and delivered quickly and without any tearing. I thank the pool for that!” 7
“Being in the water during the birthing process took almost all the pain away. The water is amazingly helpful. It helped me control my breathing and helped me to relax during the most intense contractions. I would close my eyes and let the warmth of the water take over. The water let me move around comfortably and it allowed me to try several positions weightlessly. Being calm and relaxed helped me have the natural birth I wanted.
I strongly believe there is a peaceful transition being made from the womb into the water that has a calming effect on the baby. Both births had the same outcome. Our babies did not cry or seem to be in any form of distress after being born. They were both calm and content, starring happily back up at us.” 8
Risks
Every pregnancy is different, and every birth experience is different. You should always consult with your care provider to determine if water birth is a safe option for you.
One of the biggest questions around water birth, is when should the mother enter the water? You are able to get in and out of the water as often as you like, but it is optimal to enter the water when surges are approximately five minutes apart. If the mother enters the water before surges are strong and consistent, it is possible that the relaxing effects of water can slow labour down. But the water can also have the effect of encouraging dilation even in the early stages. Every situation is different and it is best to decide with your care provider.
Another common concern is when and how does the baby take his or her first breath? A baby born without distress into the water usually does not receive the stimulus to breathe until he or she has been brought to the water’s surface. There are four main factors that prevent the baby from inhaling water at the time of birth9:
1. The prostaglandin levels from the placenta increase, which cause a slowing down or stopping of fetal breathing movements.
2. Babies are born experiencing a lack of oxygen or mild hypoxia. This causes apnea and swallowing, not breathing or gasping.
3. Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. Hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence. So even if water were to travel past the larynx, it could not pass into the lungs.
4. Babies are born with a “dive reflex,” which revolves around the larynx. The larynx is covered with five times as many chemoreceptors, known as taste buds, as the whole surface of the tongue. When a solution hits the back of the throat, passing the larynx, the taste buds interpret what the substance is and the glottis automatically closes. The solution is they swallowed, not inhaled.
Keep in mind that some babies may receive the stimulus to breathe before their bodies are born. Physical stimulation, handling, environmental changes, and placenta separation will encourage the baby to take their first breath. This is why giving birth with a professional who is experienced with water birth, will help you relax as they keep a watchful eye on your baby.
What are my options?
If you have decided that a water birth is something you would like to experience, the next step is to make your plan. There are many different options out there, so which one is right for you?
Home Bathtub – We all have a bathtub in our home, and this is definitely an option that can be used. You have direct access to hot water as you need it, and can drain water as it gets cold and when you are done with it. It is already set up in your home, so no extra work is required, and it is available any time you need it. The downside of your conventional bathtub is that it may not be deep enough or wide enough for you to maneuver to the birthing position of your choice. The hard edges and bottom of your tub just might not be comfortable enough for you to relax. It is also important to consider the size of your bathroom – is it large enough to accommodate your birth team? Is there enough room for the midwives’ supplies to be readily available? You will want to ensure you have the space for your birth team to have easy access to you and baby at all times.
Child-Sized Pool – Remember those little pools with fish decorated on the side, perfect for cooling you off on a hot summer day. Well, they can also double as a birthing pool. The main advantage for this option is that it is very affordable. It can also be inflated and filled quickly because it is a little bit smaller than a birthing pool. But because it is not designed for birth, it may not be supportive enough for you or your partner to lean on the edges of the pool. Depending on your size, you may not be able to move into a comfortable position, and the water level may not be deep enough to allow you to fully immerse and relax. Clean up might be a little more work as there are no disposable liners available for this type of pool.
Birth Pool Purchase – There are several inflatable birthing pools available on the market today for you to purchase. Local specialty stores may carry some, or you can shop online. They are designed for the birthing mother and often have an inflatable floor for comfort, several handles to grasp, are deep enough for full immersion, and are strong enough for you and your partner. Some even have seats molded into the design! Most come with a single use disposable liner, which makes clean-up a snap – after you have drained the water. They will cost a little more though because you will need to purchase all the accessories to get the water in and out. However, they are easy to store and if you are planning on more than one baby it can be worth it. And you will have the pool in the end for your little ones to play in – they can make a great ball pit.
Birth Pool Rental – If you are lucky, you may have access to a birthing pool rental option in your community. The rental company will likely provide a professional birthing pool, designed with all the amenities you would find in a personal-use pool. If the company is providing a service as well, they may be willing to drop off the pool for you, pick it up after baby arrives, and even clean it. They may also provide all the accessories you need to fill the pool, such as hoses, air pumps, submersible drainage pumps, a tarp and a disposable liner to ensure your hygiene. You will pay a rental fee that might be similar to buying a pool, but you also get the service, so you can concentrate on more important things like the arrival of your new baby!
It is also worthwhile to check with your midwife or doula if they provide a birthing pool with their services. With all the options available, water birth is definitely a feasible option.
Home birth or Hospital
With midwifery services being covered by most provinces in Canada (Alberta April 2009), families now have greater options in how they choose to give birth, including water birth! Most midwives welcome water births and would be open to discuss if this is a good option for you. They can also help you decide what might be the best birth pool option for you. Midwives are able to assist you with a home water birth, and even have hospital privileges if you rather arrange for birth at the hospital.
If you have a doctor and the hospital is your planned location for birth, you will need to check with your doctor if they are willing to let you labour and birth in the water. Hospitals will have to follow their policies and procedures, and bringing in a birthing pool for labour and birth may or may not match their guidelines. If they do not allow you to give birth in water, consider using a birth pool for labour at the hospital, or even at home. Just know you have options and it is up to you to explore them. You may be pleasantly surprised!
Bibliography:
1. Surge is a HypnoBirthing® term for contractions. The philosophy is to use more positive, gentle, and non-medical words that bring out an emotion of feeling good, rather than full of fear and a lack of understanding. Reference: HypnoBirthing – The Mongan Method, by Marie Mongan, Copyright © 2005, HCI
2. Gentle Birth Choices by Barbara Harper, R.N.; Retrieved from Chapter 6: Waterbirth; Copyright © 1994, 2005 by Barbara Harper, Healing Arts Press
3. Otigbah et al., “A retrospective comparison,” 15 – 20.
4. Odent, “Birth under Water,” 67.
5. Baby Birth Pools Inc. (2009) – Retrieved January 17, 2011 from Water Birth at www.babybirthpools.com
6. Testimonial from Martin Kerr and Tara Rout
7. Testimonial from Chandra Fisher
8. Testimonial from Sonya Spencer
9. Waterbirth International – Retrieved January 18, 2011 from Waterbirth FAQ at http://www.waterbirth.org/mc/page.do?sitePageId=38564&orgId=wi
Rita Ramkissoon works full time, is a mother to her three beautiful water babies and gets to enjoy each moment with her wonderful husband. Her experiences have inspired her to run a home-based business to help mothers give birth in water.