Use Water to Manage Your Labor Pain
Labor is uncomfortable. Women in general are very frightened of the pain associated with labor. This fear keeps many women from even considering natural childbirth. Women who often refrain from taking any medication at all their entire pregnancy will allow very strong medications to be put into their epidural space for their delivery. Even when they know that the epidural has many potential negative effects, they will still choose it because they are terrified of experiencing childbirth without it.
If a woman is provided concrete alternatives to epidural anesthesia to cope with labor pain, she is more likely to consider an unmedicated birth. Water immersion is the single best way to tolerate the pain of labor. Midwives and doulas use water to their clients’ advantage in many ways.
Water is helpful in a tub, in a glass, when frozen and on a washcloth. Most hospitals don’t offer water therapy at all. Using water is labor intensive for already overburdened labor and delivery staffs so they choose to not offer it. Taking a bath in labor (water immersion) is actually considered riskier than epidurals and cesarean birth by most Obstetricians. In a standard labor and delivery unit, there is no time for the staff to monitor a woman in a tub and auscultate the fetal heart intermittently instead of continuously. Because of that and, of course, the large number of concerns held by the majority of OB’s and hospital administrations regarding bathing in labor, water immersion and birth is offered in very few hospitals. Water therapies like ice packs, immersion, hot packs and cool cloths are often not offered because they require constant human contact. That is All most women need in labor.
Water labor and birth has come under attack by the American College of Obstetricians and Gynecologists (ACOG) calling for more studies proving its safety but the American College of Nurse-Midwives (ACNM) has substantial proof of waterbirth safety and they are working hard to publish more data proving the same. The Midwives of New Jersey are convinced that water immersion and birth are safe after attending over 1200 waterbirths since the year 2000 with no poor outcomes associated with the water.
Ways to Use Water in Labor and Birth.
1. Water Immersion
Most people recognize the relaxation that accompanies entering a pool of water. This is the reason we like swimming pools, hot tubs and bath tubs. In labor, entering a pool of water gives a laboring woman pain relief, freedom of movement, less stress on joints, a feeling of safety, decreased stress hormones, increased endorphins and increased oxytocin. These things reduce the need for pharmacologic pain management. A woman in the tub tends to be more independent and in control, assuming the positions that are most comfortable. Women generally experience less labor pain and less pelvic pressure as their baby moves through the pelvis. They report less burning as the baby stretches the perineum and are rarely out of control for the birth itself. With water immersion, women often enter the tub and experience the “ahh” effect. This is when they completely relax in the water and their cervix opens quickly-going from even 5cm to delivered in less than an hour.
I have seen it even be quicker, one woman literally entered the tub at 5cm and started pushing in 3 contractions. Women themselves can’t believe the baby could possibly be coming but it can and does happen.
Delivering the baby into the tub of water has several benefits:
- Eliminates the need for the birthing mother to move out of the water. Women often become “fixed” in one spot once the baby is coming out. They find it very difficult to move at all. A woman may need assistance to even turn from one side to another. Waterbirth allows the mother to stay where she has become comfortable.
- Allows a more independent delivery. The buoyancy of water makes the mother and the baby float! Immersed women are more mobile and more comfortable which makes catching their baby by themselves possible. Delivering the baby by herself is one of the most gratifying birth experiences a woman can have.
- Promotes physiologic birth. The woman is more able to access her hindbrain and behave more intuitively when immersed in water-the deeper the better! her discomfort is reduced by the water’s buoyancy and by the increase in Endorphins and her fear is mitigated by the comfort of being held by the water’s hydrostatic pressure and by the decrease in Adrenaline. The more a woman can turn inward and allow her body to do the work that needs to be done, the less often intervention is needed in her labor and the less likely she is to have complications leading to cesarean birth.
- Helps the mother control the delivery resulting in less perineal trauma. When women are not in the water, they sometimes feel such pain and pressure that they cannot control the delivery of the baby’s head. The water blunts the sensations of the delivery and help the mother stay in control. This makes it much less likely to have a laceration. The positions women generally choose in the tub like a supported semi-squat or kneeling are optimal positions for reducing lacerations.
- Gentle birth for the baby. Water babies are handed immediately to their mothers. Cord clamping is generally delayed so cord blood can return to the baby. Baby is greeted by a hormonally instinctive and calm mother which makes the transition more gentle.
The Midwives of New Jersey are waterbirth experts. Our expertise started in the year 2000. Roxie and Cindy were approached by Stacy and her husband who were asking to have a waterbirth in Hackettstown Hospital. The Birth Center where she had previously had a waterbirth was closed. Roxie and Cindy were already using the hospital’s tubs for water immersion. They read everything written about waterbirth and got protocols from another hospital. The manager of the unit gave them the go ahead to deliver Stacy’s baby in the tub.
As typical with 2nd births, Stacy arrived at the hospital in very active labor. In fact, when sitting on the toilet to empty her bladder prior to entering the tub, she started pushing. Roxie and Cindy saw their first waterbirth slipping away so they each took a side and LIFTED Stacy right into the birth pool. Her 2nd water baby was born moments later and waterbirth was off and running in little Hackettstown New Jersey. Since then our practice has caught ~1200 of our clients’ water babies. Even more clients have effectively used water immersion to manage their pain in labor!
Many hospitals have showers instead of tubs. The steady spray of water can help the laboring woman to focus inward, to let the contractions “flow”, keep hospital personnel from interrupting your progress-they generally like to avoid getting wet! Hospitals usually have unlimited hot water, so the shower time can be longer than in a woman’s home. The sound of running water is soothing to everyone-the laboring woman, her family and her care providers. Keeping everyone calm is optimal to the promotion of normal birth.
Applying ice packs to body parts can numb sensation and decrease inflammation. Some women like a cold pack applied to their pubic bone during labor
5. Hot Water Bottle or Heating Pad
Heat packs placed on a woman’s lower abdomen or back can reduce pain
6. Drinking Water/Fluids
Labor is a time of incredible fluid and calorie needs. A woman will need to sip continuous throughout her labor. Avoiding dehydration will keep her body functioning optimally throughout labor. Drinking a cup of milk every hour can reduce labor pain. Try the laborade recipe below to stay hydrated and reduce pain.
1/4 cup fresh lemon juice
1/4 cup raw honey
1/4 tsp good sea salt
1 tablet magnesium-500mg
1 tablet calcium-500mg
4 cups of water or coconut water
Mix in a blender to make sure mineral tablets completely dissolve
Water makes up 60% of our bodies and 70% of the Earth’s surface. Turns out people have a strong affinity to water and all of its benefits. Women should use water in all of its forms to make their birth more pleasurable.