Waterbirth - the advantages and safety concerns
Waterbirth tends to create a special atmosphere, and can be a very
different experience from having your baby in the main labour suite of
a hospital. The theory behind waterbirth is that the baby has been in
the amniotic sac for 9 months and birthing into a similar environment
is gentler for the baby and less stressful for the mother.
The advantages
- Immersion in warm water is an excellent form of pain relief. Some
women feel the relief as soon as they lower themselves into the pool,
for others it takes 10-15 minutes to get the full benefit
- Most women find being immersed in water intensely private, giving
feelings of security and control.
- The depth of the water gives support and makes it easier to try different
positions as well as providing extra buoyancy which means you do not
have to use energy to support your own body
- The warm water is a natural aid to relaxation, releasing tension and
anxieties, and leaving you free to go with the flow of the contractions
- Waterbirth is often accompanied by dimmed lights and aromatherapy
oils, which can also aid relaxation
- With less anxiety, the body produces less of the stress hormones adrenaline
and noradrenaline. This in turn allows more endorphins to be produced,
which are the body's own painkillers, and which also promote a feeling
of wellbeing
- Studies have shown that the mother's blood pressure can drop between
10 and 15 minutes after entering the water.
- You can still use entonox (gas and oxygen breathed in through a mask
or mouthpiece) while you are in the pool, and some women turn to this
during the intense contractions at the end of the first stage of labour
- The atmosphere of a waterbirth is less rushed. The second stage of
labour can take longer, which may be due to less pressure on the mother
to push
- Despite the lack of time pressure, some studies have shown that the
first stage of a waterbirth labour is shorter than average
- It is a low-tech way of conducting labour and leads to fewer interventions.
However, the baby can still be monitored, using a pinard stethoscope
or a hand-held Doppler with a waterproof cover
- Waterbirth can be a gentler entry into the world for baby
Michael Odent says "Many women do not want to leave the pool because
it is so comfortable. As a result sometimes the baby comes while the mother
is still in the pool."
And Janet Balaskas says, "Most women feel ecstatic after a physiological
waterbirth. Babies tend to be calmer and often seem to smile fleetingly.
"Many mothers feel that this is the kindest, gentlest and most loving
way to have a baby and that nothing could be more natural.
"For you and your partner it can be wonderful way to celebrate the birth
of your child."
Safety concerns
Since waterbirth was introduced in the 1970s it has been welcomed by
many mothers and midwives, but there is still concern that not enough
research has been done to identify possible disadvantages or even dangers
for the mother and baby. However, most birth units have developed their
own guidelines and protocols and over the years practices have been standardised
to make it safer.
- Water temperature - this should be monitored and adjusted to the mother's
comfort as women vary in what temperature is beneficial for them. During
labour the water should be between 32º C and 36º C. For delivery the
water should be between 36º C and 37º C.
- Water depth - this is best measured by asking the mother to kneel
resting on her heels. The water should then cover her belly, resting
just below the breasts.
- Mother's temperature - this should be monitored regularly and the
mother should be encouraged to drink plenty to prevent over heating.
- Baby's heart rate - this should be monitored with a waterproof foetal
heart monitor to ensure baby's safety throughout labour and detect any
signs of foetal distress. General recommendations are every 30 minutes
during first stage labour and then after every contraction where possible
during second stage labour.
- Water embolism - in the early days of waterbirth, some obstetricians
were concerned that water could enter the uterus and then the mother's
bloodstream through the placenta. However, the Royal College of Obstetricians
and Gynaecologists have acknowledged that this has never happened in
the thousands of waterbirths that have taken place.
- Baby's first breath - Janet Balaskas says "It is now commonly understood
that babies born in water have inbuilt physiological reflexes that prevent
inhalation of the water during a waterbirth. However, it is important
to maintain the right conditions to support this reflex." This includes
slowly bringing baby to the surface, over 7 - 10 seconds, maintaining
pool temperature at 37º C and minimal touching of baby's head and face.
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