Water Birth

Let me make one thing clear: I have eight children. In the course of eight pregnancies, eight births, and raising these children, I have learned a few things. I also love to read and one of the subjects I happen to be passionate about is birth. When I was pregnant with my fifth child, I had read much about laboring and delivering in the water. I love water; I love the weightless feeling of being in water. I wanted to attempt a water birth. It didn’t happen. We had a hard time finding a midwife and when we did, she was new to the area and hadn’t had time to set up everything when it came time to deliver. When I was pregnant with my sixth child, we had the same midwife and this time water birth was the plan. However, this baby was in a hurry and was born in the van on the side of the road as we drove to the midwife. Foiled again. Pregnant with my seventh child, in a new state with another midwife, water birth somehow never came up and probably wouldn’t have worked anyway because this baby was also in a hurry and was born before the midwife arrived. Pregnant once again, with a new midwife because the first one we had in this state was going to be in Africa for a year, we finally had the chance for water birth. This is our successful water birth story:

Our water birth baby: Joseph.

“Joseph Eoghan was born Tuesday August 22, at 2:14 am. Alisha said her clock said 2:11 and she’s most likely right because it always takes a minute or two to get things recorded.

“Joseph was 9# 3oz and 20 ½” long. He has dark hair currently and is very cute. Today when he got weighed he was 8# 12 oz.

“Last Monday I went in for a prenatal visit as usual even though we were a week late and I said I might call the next morning about castor oil if nothing had happened by then. When I got there and they checked baby’s heartbeat, it was really fast. Barb had me drink a big glass of cold water and just sit and relax. I was quite warm when I got there and sometimes that causes fetal heart rates to be high. When she listened again, they were lower but she said she’d come over and check the next day if nothing happened before then.

“I sat down on the bed in the afternoon/evening to finish reading a few chapters of Proverbs. It was very uncomfortable and I said so and moved around and suddenly there was a pop and a gush—my water had finally broken.

“I don’t know what order anything happened in but we called the Scotts, started getting things ready, ate dinner, etc., etc. Laura and Joanna helped quite a bit getting everything ready to go over to the Scotts and getting things ready here. My mom and Becky had gone out to dinner so they didn’t know anything was going on until they got back and there was a sheet in the window instead of the usual curtain.

“[The pool was taken] over to Les Schwab to fill it with air because the bicycle pump was taking too long. Then. . . we started filling it. We had to give the hot water heater a break part-way through but it worked out okay.

“Barb and Kendra got there sometime between 9:30 and 10 and got stuff out and situated. I was having some decent contractions but nothing seemed all that promising. When I got in the water at first, everything slowed down. After a while, Kendra gave me a cohosh tincture and . . . I went for a walk up and down the street. That was productive so I came back in and got in the pool. Things still seemed slow so I went for another walk, this time with my mom, and got back in the pool. Kendra gave me another dose of the tincture at some point and while I was out walking [again], Barb went to lay down in her car (she’d managed to get a cold or something, as I recall).

“I don’t know when things began feeling serious but I’d been visualizing for a while when I finally felt that things were really picking up. At one point, I had one and had to push. Kendra asked if I was ready but there’s no way I could have answered at that point. She later said that had she been a novice midwife, she’d never have believed that I was even in labor until then. When I didn’t answer, she figured it was time to don some gloves and . . . get Barb.

“I was fully dilated and it took by their calculations a whole four minutes to get Baby pushed out. He was a bit harder than the rest—it seemed like I’d never get his head out which was my goal because I knew the rest would be fairly easy. After weighting and measuring, it is no surprise he was harder to push out because he was so much bigger than his older siblings.”

Our water birth baby 9+ years later learning in the kitchen.

 Fairly recently, a friend gave birth to her first baby. This being the digital, social networking age it is, Facebook friends got live updates. At one point, dad posted, “And ... we continue to wait in the hospital.” To which I commented, ““Go for a walk. Really. Or take a bath.” Then, “Well, mama, anyway.”

The next comment was, “Once her water breaks, she can't take a bath. Showers, yes.” I have to admit that I allowed that to make me angry. Livid, even. Ask Laura. I was ranting. I had to shut my computer and walk away and remember that this woman had been brainwashed by the medical system. And, no, this is not an assumption as the rest of her comment was, “I know I ran the hospital's water bill up 900% when I had mine.”

The abounding ignorance amazes me. It really does. I currently live in an overmedicalized state and it drives me absolutely crazy. Still, there are two hospitals I know of with polar opposite views on water birth and they are only 39 miles apart. Hospital G allows (and this word is a bone of contention with me when it comes to birth) women to give birth in the water (“The Birthplace...”). Hospital H allows women to labor in the water but not deliver in the water (Blake). What is the difference? I don’t know. If a woman is allowed to give birth in the tub, it stands to reason that her membranes have ruptured, although I have a friend whose baby was born in the caul in the tub, so that isn’t a factor of concern. Or maybe it is, I haven’t seen Hospital G’s policy for water birth. Hospital H’s policy as of July 20, 2012, states, “Membranes should be intact or if ruptured, fluid should be clear or may be light meconium (Blake).” I am not sure all staff members are aware of these because I have heard women be told that they won’t be allowed in the tub once membranes have ruptured.

ACOG reports that it is difficult to accurately evaluate or measure complications because there is no uniform way of reporting on them. Still, the most common concerns include an increased risk of infections with both mother and baby, especially with ruptured membranes, difficulties with thermoregulation in the baby, umbilical cord avulsion or umbilical cord rupture, aspiration of the water, and seizures (Committee...). These are reiterated on the WebMed website (Todd). I am aware of one woman who tore extensively because she helped lift her baby up and out before the baby was completely born (Price).

If risk of infection is truly a concern, then a thinking person might wonder why women are subjected to internal exams so often or why they are so often required to have their bottoms resting on a chux pad that isn’t always fresh and clean. Thermoregulation problems in the baby can be easily combatted by monitoring the temperature of the water in the tub. This is suggested, anyway, by hospital policy (Blake) and other sources (Todd). Common sense would seem to tell us that potential umbilical cord problems can be avoided by allowing the baby to be born without tugging on the cord. Lastly, since the baby has been living in a watery environment, it does not seem likely that the baby would attempt to breath under water. As long as once the baby is brought out of the water the head remains out, aspiration and the attendant problems associated with it ought not to be an issue. This is actually discussed by Michel Odent (Johnson).

There are some advantages to laboring in the water. ACOG and WebMD (which seems to mainly reiterate ACOGs position using less medical terminology) agree that while immersion during the first stage of labor does not improve medical outcome for either the mother or baby, it can help ease pain, keep the mother from needing various types of anesthesia, and speed up labor (Committee..., Todd). It appears that, while there may be other factors contributing to the outcome, labor may be shortened by as much as an average of approximately 30 minutes (Committee...) as well.

Some of the other potential benefits of water birth for the mother and baby include the following:

·        Warm water is calming and relaxing.

·        Later in labor, water can increase a woman’s energy.

·        The buoyancy allows more freedom of movement and ease of changing position.

·        Buoyancy also promotes more efficient uterine contractions and improved blood circulation which in turn results in more oxygen for uterine muscles and baby.

·        Immersion can help lower blood pressure.

·        Water can help reduce stress-related hormones and possibly help the woman’s body produce more endorphins (“Water...).

·        Water seems to help maintain more elasticity in the perineum (Kitzinger p 31, “Water...).

·        Water provides a more similar environment to the womb (“Water...).

ACOG reports that the only difference between women who delivered in the water with those delivering out of the water is satisfaction. They do not acknowledge any benefit to the baby from being in the water either during labor or birth (Committee...). It stands to reason, though, that if the mother is more relaxed, the whole process should be less stressful for the baby as well.

Aside from the medical reasons to or not to labor and/or birth in the water, it appears that women have been for millennia. Native Americans and traditional Hawaiians as well as other cultures the world over have used water for labor and sometimes birth (Frye p 629). If there was no benefit, it is not likely these cultures would have included the use of water in this very fundamental and universal human action.

If even ACOG recognizes that laboring in the water can be a good thing, why then do doctors, nurses, and hospitals not allow it to the extent that women preach to one another that it should not, ever, under any circumstances be done? Habit? The way these doctors, nurses, and administrators were taught? The fact that doctors and nurses have less control when a woman is in the water? There are likely myriad reasons for the attitudes women encounter. And while it is quite possible that ACOG will change its mind (because it seems to be quite good at that), there really seems to be no good reason why there should be a blanket restriction against women at least laboring in the water.

So, forgive me for going ballistic when I hear someone say, “Oh, no! If her water is broken, she can’t take a bath!” My own experience tells me that it is okay and Michel Odent agrees with me (Johnson).

Blake, J., MD (approved by), and Karen Beaton, RNC (reviewed by). Heywood Hospital Policy and Procedure Manual Obstetrical Unit. 10 May 2011. Policy and Procedure Manual: Hydrotherapy for Labor. Heywood Hospital, Gardner.

Committee on Obstetric Practice. "Immersion in Water During Labor and Delivery." ACOG. The American College of Obstetricians and Gynecologists, Apr. 2014. Web. 29 Oct. 2015.

Frye, Anne. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice. Portland, Or. (7528 NE Oregon St., Portland 97213): Labrys, 1995. Print.

Johnson, Jessica, and Michel Odent. We Are All Water Babies. Limpsfield: Dragon's World, 1994. Print.

Kitzinger, Sheila, and Marcia May. Homebirth: The Essential Guide to Giving Birth outside of the Hospital. New York: Dorling Kindersley, 1991. Print.

Price, Bethany. "Water Birth." Personal interview. 14 Oct. 2015.

“The Birthplace at Baystate Franklin Medical Center." Birthplace at BFMC. N.p., n.d. Web. 29 Oct. 2015.

Todd, Nivin, MD (reviewed by). "Water Birth Information: Benefits and Risks of Water Birth." WebMD. WebMD, 24 Sept. 2014. Web. 29 Oct. 2015.

“Water Birth: Benefits and Potential Risks." American Pregnancy Association. American Pregnancy Association, 25 Apr. 2012. Web. 29 Oct. 2015.