Water birth is becoming a more and more popular way to give birth.

Water has been used from as early as 1806 for pain relief and to aid relaxation during labour and birth.

It soothes the tension away and in doing so relaxes those oh so tight muscles – including the cervix. Water has been proven to speed up the birth process and reduce the incidence of intervention. It is a safe and positive option for those interested in using water for labour or birth. There are often many concerns and questions which should rightly be asked and answered.

Candidates for a water birth include:

  • a low risk pregnancy
  • a health mother and baby
  • a mother who is well informed has made a decision to birth in the water
  • the birth should be conducted by a caregiver that is experienced in water birth
  • the baby should be born into water that is body temperature : 36.5 – 37.5 degrees

Common concerns and questions:

Does the water get very dirty?

When the baby is born into the water we find that the majority of the time the water is clean. This is largely due to the fact that there is little to no intervention – i.e. no cutting of episiotomies, fiddling, manipulating, stretching the cervix and frequent internal examination, which cause the tissue to be traumatised and bleed at times. If the woman in labour does tear a little as the baby is being born there may be a little blood in the water at the time of birth.

Usually blood is only noticed in the water once the placenta separates and there is a ‘release’ bleed.

Will my baby drown?

No! Evidence has shown that if the birth is done by an experienced caregiver and the water is body temperature, the baby will not take it’s first breath until stimulated. The baby comes out of the warm womb into the warm water and doesn’t register any different. The baby is then gently lifted out into the mothers waiting arms. Strict guidelines are adhered to as to who is a suitable candidate for a water birth and who should rather just use the water for pain relief and rather get out for the birth.

*See Article written by Barbara Harper in the water birth page for more information about mechanisms preventing baby from breathing.

Does my partner also get into the water?

This is a personal decision, which you need to take together. Most midwives doing water births are completely open to partner participation including being in the bath at the time of birth, but we never put pressure on the father-to-be to submerge.

How do you monitor the baby’s heart and see everything is ok if I am in the water?

An aqua fetal dopler is used to monitors baby’s heart rate. During labour we listen to the baby’s heart every 30 minutes. We will listen during and directly after a contraction, as that is when we will be best able to assess how baby is doing.

During the pushing stage we listen either after every contraction or every 10 minutes.

Does the midwife get into the water?

Definitely not! We work from the side of the bath and wear gloves.

Is the baby going to get cold?

This is a very good question as a newborn baby loses its core temperature very quickly after the birth. When a newborn baby gets cold it struggles to breathe effectively and it also takes a long time to regain its temperature. Once baby is born we encourage the mom to try and submerge its body in the water (head out obviously).

Skin-to-skin care at all times. If the baby isn’t submerged we cover baby’s body with a warm towel to keep him/her warm. In all the research done this was one area that came back negatively about water birth…. “the risk of the baby getting cold and developing respiratory distress”. This can be managed effectively and prevented.

What sort of bath is used?

If you are giving birth in an Active Birth Unit there will be a bath installed in the Unit. Ideally the bath should be large, spacious and deep enough for you to be fully submerged up to you chest.

If you are giving birth at home or in a labour ward without a birthing bath you can hire a bath.

There are many different birthing baths available to hire. Soft, inflatable baths can be bought or hired. Fibre glass birthing baths are also readily available.

Geyser capacity is important as you will need to keep a constant warm temperature. Your midwife will assist you with this if you are birthing at home. If you are birthing in an active birth unit the geysers will be specifically installed with this in mind.

 

An inflatable kiddies pool – minimum 65 cm depth

A cylindrical fibre glass pool with 4 panels and a blue vinyl lining (single use) – www.birthworks.co.za

Active Birth Unit – A large spacious, deep bath

What do I wear in the bath?

Anything you like. Most women tend to wear a bikini top, bra, or tank top style sports bra. T-shirts don’t work too well as they get wet and cold, and sag. Bring more than one top for submerging in the water with as you may be in and out and no one likes putting on a wet top.

Naked is also fine. It al really boils down to what you are comfortable with.

Note: Dads-to-be who want to get into the tub, please wear a costume (for your midwife’s sake).

 

In conclusion:

Water birth should be an option made available for those who prefer to birth naturally and use water. It should be undertaken by a caregiver who is experienced in doing water births and the necessary criteria for a safe water birth should be adhered to.