Water birth
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Water birth is a method of giving birth in a bathtub or pool full of warm water. Proponents believe this method has many benefits for both mother and infant, and is a safe alternative to standard types of delivery.
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[edit] History
The use of warm-water pools for labor and childbirth is a relatively recent phenomenon in Western culture. During the 1960s, Russian researcher Igor Charkovsky undertook considerable research into the safety and benefits of waterbirth in the Soviet Union. In the late 1960s, French obstetrician Frederick Leboyer developed the practice of immersing newly-born infants in warm water to help ease the transition from the womb to the outside world, and to mitigate the effects of any possible birth trauma.
Another French obstetrician, Michel Odent, took Leboyer's work further and used the warm-water birth pool for pain relief for the mother, and as a way to normalize the birth process. When some women refused to get out of the water to give birth, Odent started researching the benefits for the baby of being born under water -- and the potential problems in such births. By the late 1990s, thousands of women had given birth at Odent's birth centre at Pithiviers, and the notion of water birth had spread to many other western countries.
Water birth first came to the United States through couples giving birth at home, but soon was introduced into the medical environment of hospitals and free-standing birth centers by obstetricians and certified nurse midwives. In 1991, the first hospital to create a protocol for giving birth in water was Monadnock Community Hospital in Peterborough, New Hampshire. By 2005, there were over 300 hospitals in the US that had adopted such protocols. More than three-quarters of all National Health Service hospitals in the UK provide this option for laboring women.
[edit] Research
Considerable research has been undertaken into the safety of water birth. Two of the most prolific researchers have been Michel Odent and the American obstetrician Michael Rosenthal. Dianne Garland, a midwife in the UK, has focused on gathering research through the National Health Service system, and has published a book called, Waterbirth: An Attitude to Care. In the US, Barbara Harper, a nurse and childbirth educator, has explored waterbirth throughout the world, and chronicled the history and current use of waterbirth in dozens of countries in her book, Gentle Birth Choices. Harper has compiled an extensive bibliography of research on the subject, which can be seen at the website for Waterbirth International. [1]
[edit] Advantages
[edit] To the mother
The warm water is relaxing and eases labour by reducing the excretion of adrenaline caused by pain and fear.[citation needed] The water also stimulates the release of endorphins.[citation needed] The elasticity of the perineum is increased. These all help to result in an easier birth with fewer lacerations and tears.
With increased buoyancy in the water the pregnant woman can change her position easily. In most cases, water births are shorter and less painful and few women need analgesics. The buoyancy also causes a hormonal change in the mother's body, giving her more oxytocin (the hormone responsible for labour contractions), making her labour more efficient.[citation needed]
Specially designed birth pools are large enough to accommodate a labor support person such as the father, or a midwife, and some are equipped with waterbed style heaters to maintain optimum water temperature. However, a roomy standard tub is also sufficient for those planning a home birth on a tight budget.
The great majority of women who have experienced water birth say that they would never want to have a baby any other way.[citation needed]
[edit] To the baby
Birth can be a strenuous experience for the baby as well. Water eases the transition from the birth canal to the outside world, because the warm liquid resembles the familiar intra-uterine environment, and softens light, colors and noises.
[edit] Disadvantages
There are some concerns with regard to water births, though most objections are because the idea is unusual.[citation needed] There is a minute risk that the baby can aspirate water if it is raised to the surface after the birth and then re-immersed. However, midwives and obstetricians are well aware of this risk and once the baby is brought to the surface the baby is placed straight on the woman's breast to feed and not re-immersed in the water. The baby's first breath is triggered by the absence of the water over the face which triggered the mammalian diving reflex along with contact with air pressure on the trigeminal nerve area of the face. For the first breath to take place the baby switches over from fetal circulation to newborn circulation, closing the shunts in the heart, creating pulmonary circulation, changing the pressures in the lungs, pushing out fluids that are already present in lung spaces and allowing for the exchange of oxygen and carbon dioxide. This process takes a few minutes to completely initiate, during which time the newborn typically is still receiving oxygen from the umbilical cord. There is no threat that the newborn will inhale water during the birth process since its trigger to breathe oxygen is not present until it makes contact with the air.
Another objection raised is that the water may increase the chance of infection for the baby, but to date there has been no evidence to support this contention. However the Cochrane Database of Systematic Reviews states in their conclusions that The safety regarding infection and neonatal outcomes are not addressed and large collaborative trials are needed to answer these critical issues. The Cochrane Database of Systematic Reviews found that although there are limitations in the validity and reliability of the Randomised Control Trial evidence to date due to trial design, the statistically significant reduction in maternal perception of pain and in the rate of epidural analgesia suggest that water immersion during the first stage of labour is beneficial for some women. No evidence was found that this benefit was associated with poorer outcomes for babies or longer labours. There is insufficient evidence about the use of water immersion during second stage of labour and therefore clear implications cannot be stated.
[edit] Acceptance
Water birth is accepted and practiced in many parts of the United States, Canada, Australia, and New Zealand, as well as many European countries, including the United Kingdom and Germany, where many maternity clinics have birthing tubs; some offer water birth and others offer only water labour. Also, many independent birthing centers and many home birth midwives offer water birth services. At present, water birth is practiced mostly by those who choose to have a home birth, because the majority of hospitals have not yet installed proper birth pools in their maternity wards.
[edit] References
- Flade, Ines: Rundbrief Nummer 2. Einiges über die Wassergeburt.
- Geburtsberichte, Geburtshaus und mehr e. V. Jena, Jena 1999.
- Schroeter, Ken, "Water Births: A Naked Emperor" Pediatrics, Vol. 114 No. 3 September 2004, pp. 855-858 (critical commentary in a mainstream medical journal)
- Waterbirth: An Attitude to Care, Dianne Garland, Books for Midwives PR, UK, 2000 1 5947 7067 0
[edit] Resources
Books
- New Active Birth — A Concise Guide to Natural Childbirth,' Janet Balaskas, HarperCollins, UK, 1995 ISBN 0-7225-2566-4
- Gentle Birth Choices, Barbara Harper, Inner Traditions, USA, 2005 ISBN 1-59477-067-0
- Having a Great Birth in Australia, David Vernon, Australian College of Midwives, Canberra, 2005 ISBN 0-9751674-3-X
Films
- Water Baby: Experiences of Waterbirth an award-winning documentary by filmmaker Karil Daniels
