Water Births: A Gentle Experience

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Gone are the days when doctors held newly born infants by their heels and gave them a good smack on the behind.

Today’s births are usually much kinder and gentler, and many couples are gratefully and wholeheartedly embracing this trend. Some, in an effort to experience the pinnacle of peace and serenity at their births, are choosing to have their babies in water.

The Beginning of Water Birth

The first recorded water birth occurred in 1803 in France. A woman who had been laboring for a very long time sought relief from her contractions in a warm tub of water. Before she had time to get out, so the story goes, she unintentionally birthed her baby in the tub.

From this occurrence in the early nineteenth century until the 1960s, doctors and historians recorded only a few water birth events. Then, in the early 1960s, Igor Charkovsky (a self-educated Russian scientist) began to observe the effects of water during the labors and births of various animals, including humans.

Around the same time as Charkovsky, Dr. Frederick Leboyer in Les Lilas, France installed a large laboring tub in the maternity ward of his hospital. Many of his clients simply did not want to leave the warm and comfortable water when it was time to give birth, so babies began to be born quite regularly in the “birth tub.”

A contemporary of Charkovsky and Leboyer, Dr. Michel Odent began practicing in a hospital in rural Pithiviers, France in the early 1960s. He was the first obstetrician who openly recognized the value that water held for a laboring woman, and his ideas greatly influenced other professionals.

Here in America during the early 1980s, many lay-midwives became aware of the increasing popularity of water birth in other parts of the world. Through community support and education, these midwives encouraged women and their health care providers to explore the water birth option. By 1985, Dr. Michael Rosenthal, practicing in California, had opened the first birth center in America where women were free to have water births.

Today there are thousands of midwives and obstetricians all over the world who attend women every day as they give birth in the water.

Risks Associated with Water Births

People have many pertinent questions about water birth: Isn’t it dangerous? Can’t the baby drown? Isn’t infection risky with water birth? Do you have to use a special kind of tub or a special kind of water? Do you have to have the water at a special temperature? When can a woman get into the tub during labor? What about the placenta — can it come out in the tub, too?

All these can be answered very easily. Barbara Harper, RN, discusses some of the procedures and protocols for water birth in her book, Gentle Birth Choices, which some call the water birth textbook. Though details may differ from professional to professional and from woman to woman, most would agree on the following water birth methodologies:

Before Water Birth

  • Any tub that suits the woman can be used for birth: a bathtub, an outdoor hot tub, an inflatable portable tub or baby pool, or a birth tub.
  • The tub must be cleaned before being filled with water. A 50 percent bleach and water solution or hospital-grade cleanser can be used.
  • A new and clean hose must be used to fill the tub with water. If a regular bathtub is used, then the faucet must be cleaned first.
  • Preferably, the tub should be filled with filtered water. If it is clean enough for drinking, then it is clean enough for giving birth.
  • Water temperature can be anywhere between 90 – 101 degrees Farenheit, and the woman can control the temperature within this range for comfort. Monitoring the temperature helps insure that the baby does not prematurely breathe due to any drastic temperature change from the womb to the tub water.

During Water Birth

  • The mother must take a shower before entering the tub.
  • The woman can enter the tub at any point she wishes during her labor and can stay as long as she likes.
  • Any debris that collects in the water while the woman is in the tub should be scooped out.
  • The mother may push her baby out in any position comfortable for her (hands and knees, squatting, kneeling, etc.).

After Water Birth

  • After the baby is born, her face should be lifted out of the water as soon as possible. Care should be taken to insure that her face does not go into the water again.
  • The mother and newborn may remain in the tub until the umbilical cord has stopped pulsating and can be cut. The cord should not be cut until after the baby’s face has emerged from the water.
  • The placenta can be birthed into the tub and then the woman can be assisted out of the tub.

Why Bother?

Women and health professionals may still ask, “Why birth in the water? After all, doesn’t water birth carry additional risks for mother and baby?” The best answers come from the women who have experienced water birth and the health care providers who have attended and studied those water births.

Mary Ann Richardson, certified professional midwife and president of the Tennessee Midwives Association, attends women who give birth at home. Many of her clients choose to give birth in the water. In fact, Richardson believes so strongly in the benefits she has witnessed with water births that she provides a birth tub as an option for her clients.

“Sometimes it is frustrating as a midwife to realize you can’t take away the intensity of labor for a woman; but when I help a woman down into the water and I watch her melt, it is a supreme relief for everyone — especially the mother. Water during labor is like a really cheap epidural,” she says.

Richardson also feels that the process of water birth is much gentler for both mother and baby than a regular birth. She believes the buoyancy of the water helps ease the pressure from the baby’s head on the mother’s perineum as it is birthing. “It just seems that I see less tearing and a faster recovery with my water birth clients,” she adds, “and I am also awed by how water seems to facilitate the bonding between mom and baby. Babies born in the water seem so much more calm, trusting and alert.”

Bronwen Pope of Leiper’s Fork birthed her second baby in her hot tub at home. “I got in the water to better manage the intensity of my labor,” she says. “I wasn’t necessarily trying to have my baby in the water; but when the time came, it just seemed like the most natural thing to give birth there. I don’t think I would ever give birth somewhere where water wasn’t an option.”

Ronelle Hall of Columbia gave birth to her second baby in a birth tub. “I really wanted to have my baby in the water if all went well. I just felt that it would be a less shocking entrance into the world for the baby. I also felt like the water would help labor and birth be gentler on my body,” she says.

Water birth studies show scientifically what these women know intuitively: water birth enhances the birth experience and poses no increased risks for mother or baby. “Waterbirths: A Comparative Study,” published in Fetal Diagnosis and Therapy, looked at more than 2,000 waterbirths. Authors V. Geissbuhler and J. Eberard reported that “the experience of birth itself is more satisfying after a birth in the water.”

The study demonstrated lower rates of episiotomies, tears, maternal blood loss and pain medication use with water birth moms. Additionally, APGAR scores and umbilical pH levels were higher in babies born in the water. The professionals in this study witnessed no incidents of drowning or any other water-related complications. They concluded that, “waterbirths and other alternative forms of birthing … do not demonstrate higher risks for the mother or the child than bed births.”

The Draw of Water

The power of water seems to beckon women who are birthing. Water calls to them with its warmth, relaxation and peacefully surreal environment.

“If you’re looking for a self-esteem boost, natural childbirth (in particular, water birth) is superior to the task,” says Hall. “It can make a world of difference in how you see yourself and what you’re capable of doing.” Clearly, water birth is a gentle and positive experience for most moms and babies.

From the 1800s and before to the 21st century and beyond, water birth has been and will continue to be a safe and enjoyable birthing alternative.

Jessica Harrison Carlyon is the mother of two children, ages 3 and 1, and is currenly expecting her third. She supplies birth tubs to women and is completing certifications as a doula, a childbirth educator and a lactation educator.

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