Let’s Have A Water Birth
Water immersion therapy, also known as hydrotherapy, involves the use of water for therapeutic purposes. This practice has been present in human cultures for centuries and has been utilised by various civilisations.
The Chinese, Egyptians, Japanese, Assyrians, Greeks, and Romans all recognised the healing properties of water immersion and incorporated it into their medical practices. They believed that water could promote physical and psychological well-being by providing relaxation and pain relief.
Water birth became increasingly recognised as offering various advantages for both the mother and baby during childbirth, having gained some traction from the likes of Russian boat builder, Igor Tjakovsky, who promoted the benefits of immersion in water for physiological health. This was later endorsed and gained further momentum by french Obstetrician Michel Odent (huge supporter and advocate for ‘natural’ birth), whose contribution to popularising water immersion during labor and birth extended beyond his influence in the United Kingdom. His work also had a significant impact in many other European countries (Odent, 1983).
While some individuals may view water immersion as a temporary craze, it has gained traction and support among women and their healthcare providers who are looking for a birthing experience that prioritises the woman, minimises interventions, and aligns with a "natural" childbirth process. The increasing interest in water birth prompted the organisation of the first international water birth conference in London in 1995. Since then, numerous international seminars, study-day events and conferences dedicated to water birth have been held, reflecting the growing attention on this approach.
In recent years, the use of warm water immersion during labor and birth is now widely accepted in many countries, particularly in midwifery-led care settings.
Why use water for labouring or birth?
1. Pain relief: Immersion in water during labour can provide natural pain relief by reducing the intensity of contractions/surges. The buoyancy of the water supports the mother's body, easing the pressure on her back and abdomen. The warm water also relaxes the muscles and promotes a sense of calm and relaxation, which can help manage the pain.
2. Freedom of movement: The buoyancy of the water allows for easier movement and positioning during labour. Women can change positions, lean on the sides of the pool, and find a comfortable posture that suits them. This freedom of movement can aid in progressing labour and finding positions that promote optimal fetal positioning.
3. Relaxation and comfort: The warm water can have a soothing effect on the body, helping the mother to relax. It can also provide a sense of privacy and personal space, creating a calm and supportive environment for labour. This relaxation and comfort can enhance the release of oxytocin, the hormone responsible for initiating and progressing labour. This can lead to shorter labours.
4. Decreased risk of perineal trauma:
5. Privacy and control: For some women, giving birth in water offers a greater sense of privacy and control. The pool provides a barrier between the mother and the outside world, allowing her to focus on her own sensations and instincts. This privacy can contribute to a more positive and empowering birth experience.
This Cochrane review of a selection of small studies (Immersion in water during labour and birth – PMC) indicates that women who use water in labour were potentially less likely to need Epidurals; a possible reduction in birth by Caesarean Section in labourers who use water; no significant evidence for adverse outcomes for mothers and babies and no significant evidence for risk of infection or the need for resuscitation for new-borns.
What are the potential risks of a water birth?
1. Safety concerns: While water birth is generally considered safe, it is important to have trained professionals, such as midwives or doctors, present to monitor the mother and baby during labour. They will ensure that the water temperature is suitable, monitor the progress of labour, and respond quickly to any complications or emergencies that may arise.
2. Limited pain relief options: While water can provide natural pain relief, it may not be sufficient for everyone. Some women may find that additional pain relief measures, such as medication or epidurals, are necessary. Therefore, it is important to have alternative pain relief options available if needed.
3. Risk of infection: There is a small risk of infection associated with water birth, particularly if the pool is not properly maintained and cleaned. It is essential to follow strict hygiene protocols and ensure that the water is regularly tested and cleaned to minimise the risk of infection.
4. Availability and accessibility: Water birth may not be available or accessible in all birth settings. Some hospitals may not have the facilities or resources for water birth, and home birth may require renting or purchasing a birth pool. It is important to discuss and plan for water birth with your healthcare provider well in advance.
5. New-born hypothermia: due to babies’ ability to lose their heat and become cold rapidly; particularly if the water temperature is not monitored.
The overall safety and usefulness of water immersion during labour and birth is yet to be determined as there are limited studies that have been done, however the studies conducted have found that water immersion offers great outcomes for both mother and baby and can lead to an overall satisfactory birthing experience.
In conclusion, water birth can offer many benefits for women during labour, including pain relief, freedom of movement, relaxation, and a sense of privacy and control. However, it is essential to consider the potential downsides and ensure that safety measures are in place. Further research is needed to establish the true benefits and potential harms associated with water immersion. Midwives and associated health professionals must be educated about the risks and benefits of this intervention to provide high-quality evidence-based care to birthing women and families.
How to have a water birth?
Some tips:
Ensure you have had a discussion with your midwife or doctor, as it is important to consider your overall clinical picture and circumstances when labouring and/or birthing in water.
Find a birth environment that you consider comfortable. Ensure the room can be kept warm, maybe spacious enough for a couch, cushions, or mattress where you can rest during or after birth, and most importantly that there is space for midwives/doulas to attend or assist where needed.
Find a pool. Use a new inflatable birth pool (if at home) with a single use liner to eliminate potential risks of infection. Ensure the size of the pool is appropriate for you – allowing the freedom of movement and deep enough which ensures that baby is born submerged under water (cool air may stimulate baby’s breathing too early!)
Make sure the water is warm and comfortable—usually maintaining this at body temperature. Use of elongated hoses, pots, pans, kettles (with hot water), new and clean buckets or basins to carry hot water if all else proves difficult.
Ready the birth room. Have many towels (some you may be happy to part with afterward), warm blankets, and additional dry clothes or grab bag available for any changes in birth plan. For more information book a chat.
