The Benefits of Water Birth
by Andrea Eastman, MA, CCE, IBCLC From Gentle Birth Alternatives

1. Greater comfort and mobility.
The mother has greater ease and freedom to move spontaneously and to change position to assist the descent of the baby.

2. Reduction of pressure on the abdomen.
Buoyancy promotes more efficient uterine contractions and better blood circulation resulting in better oxygenation to the uterine muscles, less pain for the mother, and more oxygen for the baby.

3. Helps mother to conserve her energy.
Immersion reduces opposition to gravity; supports the mother's weight so that her energy can be used to cope with the contractions.

4. Promotes deeper relaxation.
As a woman relaxes deeply, her hormones will kick in and she will start progressing faster and with more rhythm; labor becomes more efficient.

5. Water relaxes the pelvic floor muscles.
Minimizes pain to the levels at which relief by other methods are no longer needed.
water stimulates the touch and temperature nerve fibers in the skin and so blocks impulses from the pain fibers, known as the Gate Theory of Pain.
Immersion is often more effective and safer than an epidural.

6. Facilitates a dysfunctional labor.

Can be a way to stimulate dilation of the cervix when the mother has difficulty progressing into the active stage of labor.
Can reduce need for drugs to artificially stimulate labor often, getting into the pool may result in dramatic and rapid progress to full dilation within an hour or two.

7. Lowering of blood pressure.
when anxiety is causing high blood pressure, immersion in water may help lower it.

8. Change of consciousness.
Immersion helps relieve anxiety and promotes relaxation.
Allows a woman to let go and to focus inward as labor strengthens.

9. Easier breathing.
The moist air makes it easier to breathe and can be helpful to women with asthma.
10. Facilitates the second stage of labor.
Mothers are less inhibited in the water.
The warm water softens the vagina, vulva, and perineum, leading to fewer injuries to these tissues.

Many women experience rapid second stages, with the baby emerging minutes after the body starts pushing, also known as the fetus ejection reflex (see Odent, The Nature of Birth and Breastfeeding).

Waterbirth Frequently Asked Questions
Waterbirth is considered by professional providers and mothers alike to be the most gentle method of natural childbirth. Below are some frequently asked questions about waterbirth. If you are interested in a home waterbirth please visit our Midwifery Services for more information.

Why waterbirth?
It is essential that we adjust the way we bring our children into this world. By providing a safe and comfortable environment with plenty of privacy and a feeling of love and security for the mother, she is better able to release her baby with an experience of joy, an experience shared by her baby. The use of water for labor and birth is one way of providing this opportunity for women and their babies.

What is the temperature of the water?
For a waterbirth, the water in the pool is maintained at a temperature which is comfortable for the mother, usually between 95-100 degrees Fahrenheit. The water temperature should not exceed 101 degrees because it could lead to over heating which can cause the heart rate to accelerate and it increases the babies oxygenation needs. It is important that the mother continues to drink plenty of fluids. Cold compresses and a cool facial mist make many hot mamas cooler.

When can I get into the water?
A woman in labor should be encouraged to use the labor pool whenever she wants. If a mother chooses to get into the water during early labor, before her surges are strong and close together, the water may relax her enough to slow or stop the labor altogether. That is why some practitioners limit the use of the pool until labor patterns are established and the dilation of the cervix is at least 5 centimeters. The first hour of relaxation in the labor pool is usually the best and can often help a woman achieve complete dilation even in short amounts of time.

What prevents a baby from taking a breath under the water?
There are several factors that inhibit the baby from beginning to breathe during the period when its head emerges into the water and just after the full body has been born. First of all, the water temperature is basically the same as the amniotic fluid in the womb, so there is no shock of a temperature change. Second, the baby is receiving oxygen from the umbilical cord just the way it has for the previous nine months. And third, the baby has an autonomic reflex, called the dive reflex, which prevents it from inhaling any substance that is in its throat and causes it instead, to swallow. This reflex is present for approximately six months after birth and than it disappears. Air breathing begins only after the baby is out of the water and exposed to a change in temperature and air pressure and experiences a complex metabolic chain reaction of hormones and chemicals that cause the process to begin. Know that it is physiologically impossible for a newborn to breathe until its body is out of the water and in the air.

How long is the baby left in the water?
Here in the U.S., all practitioners bring the baby out of the water within the first ten seconds following birth. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth DVDs that depict leaving the baby under the water and the babies are just fine. But physiologically, the placenta is supporting the baby with oxygen during this time and it can not be predicted when the placenta begins to separate and stops the flow of oxygen to the baby. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him into his mother’s arms.

Is waterbirth safe?
The safety of water birth needs to be judged in looking back at the number of cases that have been reported world wide and the number of problems that have occurred as a result of birth in water. To date, over 100,000 documented cases of water births gives us a good look at the statistics. The opinion of practitioners is that water birth poses no threat to mother or baby if all the normal parameters are met during labor and birth. If complications arise they are evaluated and sometimes the mother is asked to leave the water before the birth takes place. Everyone’s goal is to keep mother and baby safe and to facilitate a satisfying birth experience. The British government stated in a published health report that any woman who wants a waterbirth should be able to have one and that it is up to the practitioner to become familiar with the technique if they are not already educated.

How is the baby monitored during a waterbirth?
The manufacturers of monitoring equipment and hand held dopplers have developed water proof varieties of monitoring equipment. In typical waterbirths the baby’s heart tones are listened to every 30 minutes during first stage and after every pushing contraction during second stage.

For more information about local midwifery services available to you, including homebirth and waterbirth, please call AquaNatal Birth Center: 909-591-2924


References:
Water Birth: The Concise Guide to Using Water During Pregnancy, Birth, & Infancy
-- by Balaskas, Janet and Yehudi Gordon
(London: Thorsons and HarperCollins Publishers, 1990)

The Waterbirth Handbook: A Guide to the Gentle Art of Waterbirthing
-- by Lichy, Dr. Roger and Eileen Herzberg
(Bath, United Kingdom: Gateway Books, 1993)

Water Birth: A Midwife's Perspective
-- by Napierala, Susanna
(Westport, CT: Bergin & Garvey, 1994)

The Nature of Birth and Breastfeeding
-- by Odent, Michel
(Westport, CT: Bergen & Garvey, 1992)
Copyright © 2002 by Andrea Eastman, MA, CCE, IBCLC