Opposing Views on Waterbirth
When the concept of waterbirth is posed, people tend to have polar opposite reactions. They may imagine it to be disgusting, swimming in a pool of body secretions or they believe it is relaxing like being in a spa. They may envision it to be completely natural (because of course, the baby has been in a pool of water, not breathing for 9 months) or totally unnatural (after all we aren’t dolphins!). Perhaps they view it as a great innovation over our grandmothers’ very medical, sterile births or they may think it’s antiquated like boiling water and calling a Midwife.
But I find that when a woman is in labor, a pool of water is her best solution to fatigue, anxiety and pain. Most women get in and never want to come out regardless of whether they initially liked the idea or not. Previous concerns about what is in the water completely disappear. She can get back into her “groove” and feel her labor progress again. Women say that they feel more able to follow their bodies’ cues when they have less discomfort. Water immersion makes labor tolerable, if not enjoyable. The Midwives of New Jersey know that water immersion decreases adrenaline, increases oxytocin and endorphins, adds the comforting pressure of hydrostatic pressure on the mother’s body and improves mobility.
Waterbirth for Relaxation and Pain Relief
Our practice sees a lot of natural childbirth. We give water immersion and waterbirth much of the credit. Many clients have specifically chosen us for the encouragement from the Midwives during prenatal care and the support we provide in labor. They are highly motivated to give birth without medication or epidural. Our clients have the advantage of a strong provider/patient relationship and the continuous presence of their Midwife during active labor. Women are active participants in their birth plan, deciding whether to give birth in a hospital, in a birthing center or at home. They are well-prepared for labor during their pregnancy through childbirth classes, birth center and homebirth preparation classes and the Nurse Midwives teach some classes throughout pregnancy too.
We bring a labor doula to the birth site. She is there to support everyone-the mother, her partner, the Midwife and even the nurses. We welcome our client’s doula if she wishes to have labor support at home in early labor. Doulas keep busy during labor pressing on backs or hips and offering drinks, honey and encouragement. We are patient with labor, never quick to induce or augment labor. We like to see labor progress with walking and swaying and ball-sitting. But nothing makes labor more doable and beautiful than waterbirth.
If women have a birth plan that includes water immersion or water birth, they may need to switch doctors or change their place of birth. Every person deserves the opportunity to have the birth experience they desire within the confines of safety. Most birth facilities have a model of care that is more focused on the medical aspects of labor and birth but do not take advantage of the positive effects that maternal comfort and control have on the normal, safe progress of labor and delivery.
Safety remains the main concern of many people and of groups like the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP). Their committee opinion issued in November 2016 stated that the evidence supports water immersion but the evidence for the safety of waterbirth is lacking and so they do not recommend delivering the baby in the water until there is more evidence proving waterbirth safety. The American College of Nurse-Midwives (ACNM) has a much more positive position on waterbirth.
I expect that the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics will have to change their opinion about birth in the tub based on newly published research. The Vanderlaan et al. (2018) meta-analysis has now provided more than enough evidence to prove water birth safety. That group combined the data from many smaller studies to make a sample size large enough to draw reliable conclusions about waterbirth.
It really doesn’t matter how “natural” the birth is if the mother and baby are not ok. We all agree with that sentiment. My practice alone has caught over 1200 waterbabies safely without even one adverse effect related to the birth under water. I know for a fact that babies do not breathe under the water because of my own experience with waterbirth in the past 18 years. Our stats at Morristown Medical Center are very positive and we continue to have the support of the hospital for water immersion and birth.
Additional Benefits of Waterbirth
Benefits of waterbirth beyond pain relief and relaxation include reduced perineal trauma, quicker labor, reduced blood pressure and pulse in mother, fewer infections (as Barbara Harper of Waterbirth International says “the solution to pollution is dilution!”) and reduced need for cesarean section (Source). Our experience at the Midwives of New Jersey is that waterbirth is loved by mother and baby alike. The baby is greeted by a mother who is calm and hormonally primed to begin mothering. We just stand back quietly and observe the beginning of the single most significant relationship the baby will ever have in its life without interfering with God’s/Nature’s perfect plan for bonding at birth.
It is not the water that makes the birth natural, rather the water makes a natural birth much more probable. No matter your initial reaction to the concept of waterbirth, I believe it is worth your consideration.