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Water and its use in labor and birth

 

By Natalie Burgess

 

Water is a wonderful medium for the laboring, and birthing, woman.  A bath, deep enough to cover the belly and big enough to accommodate movement provides the laboring woman with a sense of safety and security.  The water provides a barrier between her and her caregivers, therefore avoiding any unnecessary poking and prodding and disturbing of the labor process and the woman’s internal focus.  The buoyancy of water reduces strain on the body and promotes comfort, almost giving the impression of a warm and nurturing embrace.  The warmth and support of the water encourages relaxation, allowing the normal and uninterrupted progression of labor, encouraging oxytocin and endorphin release.  A relaxed mother breathes more effectively, increasing the ability to oxygenate her uterus and her baby, and reduces blood pressure.

 

Research has indicated that there are no adverse effects for mother or baby with the use of water in labor.  Women who labor (and birth) in water are less anxious, more relaxed and have an increased positive perception of their labor and birth experience, Women who labor in water have reduced medical intervention rates (Cluett et al 2004).

 

There are plenty of positives with the use of a bath in labor, and it is every laboring woman’s right to have access to a wonderful warm pool of water, where she can labor undisturbed, and quietly observed by her caregiver. 

 

Using a pool of water, means just that.  Sitting in a tiny tub, with a trickle of water that is regularly temperature tested, with an anxious care giver waiting is not going to promote the benefits of the water.  The pool needs to be deep to allow all the benefits of the water to be felt.

 

Women who labor in water are less likely to require medical pain relief (such as pethidine, epidural and nitrous oxide), though if it is required nitrous oxide can be safely used while still in the bath to provide additional pain relief at the peak of the active stage of labor.

 

Due to the supportive nature of water, women who birth in water are more likely to retain an intact perineum, than those who do not.

 

The freedom to adopt positions of comfort and be able to labor without disruption also results in decreased medical intervention, such as instrumental delivery.

 

An increasing amount of research based evidence consistently shows that water in labor and birth is a safe a viable option, providing no increase in neonatal or maternal morbidity directly attributable to water.

 

To address the main fear of water birth, that the baby will inhale water and drown, let us first look at what happens prior to birth.

The baby is oxygenated via the placenta, and the baby grows in a fluid environment.  The baby does not inhale large amounts of amniotic fluid.  At birth your new baby senses a change in their environment, from a warm, dark closed space (your uterus), to a bright, cooler, bigger space, and a number of factors stimulate their first breath. 

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Light

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Touch

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Sound

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Change in temperature

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Reduced oxygen via the placenta as the umbilical cord stops pulsating or is clamped

All of these factors contribute to your new baby taking his or her first independent breath.  When your baby is birthed in a water environment they are less likely to be touched (perhaps only by the mother), the temperature of the water is similar to the uterine environment (water temperature is according to maternal comfort), sounds are muffled, and immediately after birth while the placenta is still inside the mothers uterus the baby is still receiving oxygen rich blood via the placenta.  A baby birthed in a water environment is then immediately birthed into the air environment, triggering the first breath and first beautiful cry.

 

28th May 2006: My labor and birth in water

 

Cluett, E.R.  Pickering, R.M.  Getliffe, K.  St George Saunders, N.J.   (2004).  Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour.  BMJ, 328:314.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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