When thinking about your birth story, how do you envision it?! Are you birthing your baby in a hospital? At home? With your partner? A doula? Are you pushing baby out on a bed? How about in a tub or birthing pool? These are all things you should think about during pregnancy and start to envision for your birth!
A water birth can be a beautiful and often described as “magical” experience for the birthing person and for the baby too! It allows a slower transition from the womb to the world.
What is a water-birth?
A water birth is just as it sounds: when the delivery of your baby takes place in a body of water, generally a bath tub or birthing tub/pool. It can take place in a hospital (although many don’t “allow” it), a birthing center, or at home. With a doctor, nurse-midwife, or midwife.
Evidence Based Birth has a fantastic article going over the details of these studies and outcomes! Definitely take the time to check it out. Here is a recap of the benefits and risks of water birth, from that article…
Benefits of water births
- Less pain and higher satisfaction with the birth experience
- Less medication use for pain relief—this may be important for people who want or need to avoid epidurals or narcotic medications during labor
- Less use of artificial oxytocin and possibly shorter labors
- Higher rates of normal vaginal birth
- Lower rates of episiotomy
- Higher rates of intact perineum, especially in high-episiotomy settings
- Possibly lower rates of severe tears (3rd or 4th degree), especially in high-episiotomy settings
- Possibly lower rates of postpartum hemorrhage
Potential risks of water birth
More research on waterbirth needs to be made to make a truly informed choice. But here are some things that were observed from the studies done.
- There may be a higher rate of mild labial tears from waterbirth in low-episiotomy environments such as homes and birth centers
- Umbilical cord snap is a rare but possible occurrence. Care providers need to take care not to place too much traction on the cord when guiding the infant out of the water and identify the source of any bleeding immediately.
- There have been several case reports of water aspiration. These cases have not been observed in prospective research since 1999, and almost all of the infants in the case reports made a complete recovery.
- Although large research studies have not shown any increase in the risk of infection, there have been several case reports of infections after waterbirths. This risk can be lowered by using pools that are easy to disinfect, filling tubs closer to the time of the birth, and regularly testing hospital water supply, hoses, and birthing pools.
When do you go into the water?
It’s often encouraged to use the water whenever most wanted. Some mothers find that a bath in early labor can be useful for its calming effect and to determine if labor has actually started. Once contractions are strong and regular, no matter how dilated the cervix is, a bath can help you relax enough to help with progression.
What temperature should the water be?
The water should be at a temperature that is comfortable for the mother. This is typically between 92-100 degrees Fahrenheit. The temperature should never exceed 101 degrees Fahrenheit as it may lead to an increase to the body’s core temperature, which in turn may cause the baby’s heart rate to increase. It is important to drink plenty of water to prevent dehydration. Cold cloths can be helpful for the face and neck, or having a small fan near by to cool off the body. If the birther is exhibiting signs of overheating, such as facial sweating or flushing, they should get out of the tub for a short period of time and the water should be cooled down.
How does the baby not drown in the water?
There are four main factors that prevent the baby from inhaling water at the time of birth:
- The fetus moves the muscles of the chest wall during pregnancy about 40% of the time. Close to the time of labor, the Prostaglandin E2 levels from the placenta rise, which cause a slowing down or stopping of those fetal breathing movements. As the baby is born, the Prostaglandin levels remain high, disabling the baby’s muscles for breathing. The muscles simply don’t work, thus engaging the first inhibitory response.
- All babies are born experiencing mild hypoxia or low oxygen levels. Hypoxia causes apnea (absence of breathing) and swallowing, not breathing or gasping. The first reflex after a baby is born is to swallow, not breath. The swallowing will allow the fluids that are in the mouth to enter to stomach.
- Fetal lungs are already filled with fluid. That fluid is there to protect the lungs, and keep the spaces open that will eventually exchange carbon dioxide and oxygen. It is very difficult, if not improbable, for fluids from the birth tub to pass into those spaces that are already filled with fluid. One physiologist states that “the viscosity of the fluid naturally occurring in the lungs is so thick that it would be nearly impossible for any other fluids to enter.” The blood supply to the lungs is also very low during pregnancy and birth. This causes a high pressure within the lungs, thus keeping everything out.
- The mammalian diving reflex is an inhibitory factor that is present at birth in all humans as well as all mammals. It lasts in humans up to six to eight months. When the face comes into contact with water, the glottis at the back of the throat automatically closes and prevents water from entering the lungs. Any solution that enters the throat is swallowed, not inhaled. This allows babies to also breastfeed without aspiring the fluid into the lungs.
For a more complete description, please read Barbara Harper’s “Birth, Bath and Beyond: The Science and Safety of Birth in Water.”
When does the baby take it’s first birth?
The initiation of breathing is a complex system which allows the newborn to switch from fetal life in the womb (where the placenta supplies all the oxygen needs) to a newborn that activates its respiratory system for breathing.
All babies continue to receive oxygen from the placenta via the umbilical cord, if it is left unclamped and not cut. The timing of the clamping of the umbilical cord affects the quality and ease of newborn respirations. The stimulation to breathe and switch from being an aquatic mammal in the womb to an air breathing mammal in the room, is also a combination of factors which begin with room air and gravity on the baby’s face.
Water babies sometimes show a short delay taking their first breath only because they have not had the stimulation from gravity and room air while their head is being born, as opposed to babies born on land. Only after baby’s face greets the warm room air for the first time do they begin the miraculous switch from fetus to newborn.
Water babies are gently lifted out of the water and placed on their mother’s chest where they immediately receive signals from their mother’s presence. Her skin keeps them warm while the baby’s heart begins pumping a large volume of blood into the lungs for the first time. It is only after the blood volume increases that the lungs become cleared of fetal fluid and the respiratory centers in the brain are stimulated. This process may take a full minute, so be patient. The baby’s color will gradually change and sometimes the baby will cry.
Water babies are often very still and quiet, although extremely alert, eyes open and arms and legs moving. Those are all signs of a healthy normal newborn. A trained waterbirth provider will know to give the baby plenty of time to gently transition into newborn life.
Water births are recommended for low-risk pregnancies
Water births are generally only recommended for women with low-risk pregnancies who have reached term. This is mainly because any complication during labor or delivery can be further complicated by the need to get the mother safely out of the water.
Regardless of where you plan to birth your baby, a water birth should be planned in advance and written into your birth plan.
If you’re thinking about a water birth, talk to your health care professional early in your pregnancy to find out if it’s a service the hospital provides. If so, who will manage your labor and delivery? If it’s not something offered in your hospitals, start researching birth centers that do offer it, and/or interview with home birth midwives who offer the support during a water birth.
It’s a good idea to come up with a “Plan B” just in case something changes or you decide that it’s not something you want to do. Keep in mind that laboring and delivering in water is not only about the kind of experience you want, but also how you can manage pain during it. It’s also important to take some time to learn about the other pain management options that may be available to you, so you know which options you’d be comfortable with if needed.
Did you have a water birth?! Share your experience below!
Information gathered from Evidence Based Birth & Waterbirth.org – find more information there as well!