Water birth

Water birth is a practice in which a mother gives birth in a tub filled with warm water. Water births are different from immersion labor, which involves the mother taking warm showers or baths during labor to ease pain but giving birth out of the water. Most water births occur at birthing centers or at home. Few occur in a typical hospital setting. They are most popular with mothers who wish to have a natural birth, meaning that they do not receive medication or an epidural during labor. While water births are growing in popularity, experts caution that a water birth must be planned carefully and should be overseen by a trained professional, such as a midwife or medical professional at a birthing center.

Background

The first documented instance of a water birth was in France in 1805. The first known water birth in the United States occurred in 1980 in California. The practice became extremely popular in the United Kingdom in the 1990s, where maternal facilities began providing options for women who wanted to have a water birth.

The popularity of water birth in the United States has increased as the desire for natural birth also increased in the late 2000s and into the 2010s. In America, water births often take place at independent birthing centers or at home. Some hospitals allow women to labor and deliver in water, but this is not as common in the United States.

Proponents of water birth argue that it can help reduce the pain associated with labor. Some evidence also suggests that laboring in water can help shorten labor, according to the American College of Obstetricians and Gynecologists (ACOG). However, it is important to note that the ACOG does not recommend that women deliver in water. Small studies have also suggested that laboring in water may reduce the need for a C-section. Some women have also indicated that their birth experience was much more satisfactory by laboring and/or delivering in water. Many of these women said that the water helped ease their pain and provided a calming environment during the birthing process.

Water births may take place in a stationary or movable tub. Some are even inflatable, allowing them to be used in the home and then discarded after birth. Warm water is added to the birthing tub in the early stages of labor. This water is often between 95 and 100 degrees Fahrenheit, but the temperature should be adjusted if the mother shows signs of overheating or dehydration. In addition, the mother should have access to drinking water while soaking to prevent dehydration.

Experts recommend that experienced medical professionals, such as midwives, oversee all water births. These professionals will be able to determine if there is any need to remove the mother from the water at any point and have her deliver elsewhere.

In some cases, a water birth is not recommended. Women who have had complications during pregnancy or are pregnant with multiples are discouraged from water births. In addition, women who are fewer than thirty-seven weeks pregnant (preterm) should not give birth in water. It is important that women who are interested in water birth discuss this delivery option with their doctor well in advance. A physician can best determine the potential benefits and risks for each individual patient.

Overview

Some controversy exists over the safety of water births. Most of this has to do with the fact that there is little research into the benefits and risks of this practice. Proponents argue that water birth has been practiced safely for decades with very little risk.

However, doctors in the United States do not recommend water births for some specific reasons. One risk is that the baby could swallow some of the water in the birthing tub, which is unsafe for a few reasons. First, the water in the birthing tub may be contaminated by feces at some point. This could be from the mother or meconium, which is the newborn baby’s first feces. In either instance, inhaling or swallowing contaminated water could lead to respiratory problems. It could also result in an infection, though a 2005 study of water births published in the Journal of Maternal-Fetal and Neonatal Medicine found that there was not an increased risk of infection for the baby.

The other major concern is the risk of drowning. Whenever water is present, there is a risk of drowning. Because the baby is born underwater, there is a chance that he or she will aspirate water into the lungs while attempting to breathe. Proponents argue that the risk is small because a trained midwife or medical professional will be present to lift the baby out of the water immediately. Still, reports of near drownings during water births exist.

As previously mentioned, the ACOG does not recommend that women give birth in water. In 2014, the ACOG and the American Academy of Pediatrics (AAP) voiced objections to water birth in an ACOG bulletin. The ACOG restated this objection in 2016, posting on its website that there is not enough evidence on the benefits and risks of water birth for the organization to recommend that women deliver in water. This is because there have been few large scientific studies on the safety of water birth.

The organization did note, however, that there have been some benefits to laboring in water, such as a decrease in the use of pain-relieving medications and shortened labor times. The ACOG did make some recommendations for facilities that permit water births. The main recommendation being that these facilities carefully disinfect all tubs and pools to prevent infection. In addition, the ACOG recommends that facilities carefully screen women who wish to give birth in water to make sure that they are good candidates for this type of delivery. For instance, facilities and providers must ensure that the mother does not have a pre-existing condition that would disqualify her from having a safe water birth. The organization also stresses that women should be moved out of the tub if complications arise at any point during the delivery.

Bibliography

“The Basics of Water Birth.” WebMD, 7 Sept. 2018, www.webmd.com/baby/water-birth#1. Accessed 19 Sept. 2018.

Besich, Bekka. “What Are the Dangers of Water Birth?” Parents, 2013, www.parents.com/pregnancy/giving-birth/vaginal/what-are-the-dangers-of-water-birth/. Accessed 19 Sept. 2018.

Besich, Bekka. “What Is Water Birth?” Parents, 2013, www.parents.com/pregnancy/giving-birth/vaginal/what-is-water-birth/. Accessed 19 Sept. 2018.

“Committee Opinion.” American College of Obstetricians and Gynecologists, no. 679, Nov. 2016, www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Immersion-in-Water-During-Labor-and-Delivery. Accessed 19 Sept. 2018.

Davidson, Tish. “Water Birth.” The Gale Encyclopedia of Children's Health: Infancy through Adolescence, edited by Jacqueline L. Longe, 2nd ed., vol. 4, Gale, 2011, pp. 2320–23.

Marcin, Ashley. “Water Birth Pros and Cons: Is It Right for You?” Healthline, 2018, www.healthline.com/health/pregnancy/water-birth. Accessed 19 Sept. 2018.

Shute, Nancy. “Doctors Say Don’t Give Birth to Baby in a Tub, but Midwives Disagree.” NPR, 23 Mar. 2014, www.npr.org/sections/health-shots/2014/03/21/292381478/dont-birth-that-baby-in-a-tub-doctors-say-but-midwives-disagree. Accessed 19 Sept. 2018.

Weaver, Melanie H. “Water Birth in the Hospital Setting.” Association of Women’s Health, Obstetric and Neonatal Nurses, Oct.-Nov. 2014, onlinelibrary.wiley.com/doi/pdf/10.1111/1751-486X.12144. Accessed 19 Sept. 2018.