You've heard the nightmare stories about the pain of childbirth, and it scares you to death. Women expecting everywhere seek to find ways to ease the birthing experience. One way is laboring in water ... maybe even a water birth.
According to Amandine Bossy, certified doula at Mama Moon Birth Concierge in Nashville, full water birth experiences — not to be confused with hospital laboring tubs — are only available for home births and births at Baby+Co. in Nashville. They're not for everyone.
"Any mother with an uncomplicated pregnancy and labor can be a candidate for water birth," says Margaret Buxton, CNM, DNP, regional director of clinical operations at Baby+Co. "We ensure that Baby is healthy, Mom is without fever or other labor complications, and the family is comfortable and knowledgeable about water births."
Baby+Co. provides parents information to review prior to birth; it gives details about the risks and benefits of water birth.
"If you're being induced for any reason, have gestational diabetes not controlled by diet, or you have preeclampsia you will not be allowed to have a water birth," adds Bossy.
If floating in water during pregnancy has benefits, surely a water birth will too, right?
According to Buxton, warm water immersion causes major muscles to relax. "In labor this muscle relaxation allows more blood to flow to the uterus, making labor contractions more efficient and effective," says Buxton. The feeling of weightlessness helps to relax you and allows you to rest more deeply between contractions.
Warm water also helps the perineum stretch and avoid tears Bossy says. She adds that it reduces stress and anxiety, which regulates blood pressure, reduces pain level and the need for pain medication, speeds up labor and increases energy. In contrast, being in the tub might not offer the optimal pushing position.
"If you don’t make progress while pushing, then it might be best to try a different position outside of the tub," says Bossy.
And, while laboring in water improves your ability to relax, Buxton says there's no "benefit" to the newborn, and the risks of harm are very minimal.
There are two common concerns people have about water births that can be dispelled, according to Buxton: 1) Being born in water can affect Baby's breathing, and 2) The water itself can create the potential for an infection.
The duration of time that Baby remains in the water is minimal.
"When you give birth in the water, the provider brings the baby directly up and out of the water and onto your chest," says Buxton.
Bossy agrees and says that babies only take their first breath when they're in contact with air. Until then, the placenta continues to provide oxygen through the umbilical cord. "It can take a full minute before a newborn takes his first breath," adds Bossy.
When it comes to the water itself, the providers attending to you also keep the water clean and warm. They remove debris from the water during labor as well as drain and refresh the water as needed — especially during longer labors. This helps keep the water at an ideal temperature, which, according to Buxton, should be about mom's body temperature (97º - 99º F). An important thing to remember is the water should be fresh (regular tap) with nothing added to it.
A common complication for a water birth at home is exhaustion due to long labor, adds Bossy. In which case, she says you may need to transfer to a hospital to receive an epidural (if you want one) and to get some rest.
PREPPING FOR WATER BIRTH
When it's time to pack your bag that goes with you to delivery (if you're not having Baby at home), don't forget these few extra items for laboring in the water or a water birth: bathing suit top or sports bra, hair ties and a robe.
What tub is best? Buxton says any type of tub is OK to use. The most important thing is your comfort.
Baby+Co. has standard tubs and some area hospitals have side door tubs. However, the hospitals only offer laboring in the tub and then delivering on the hospital bed.
If you're planning a home water birth, refer to the "New Parent Services" section on page 20 of this magazine to locate a birthing doula or midwife. Next, consider the tub in your bathroom versus a blow up rental tub. You can situate a rental tub anywhere. Bossy says to use a tub that allows the water to come up to your armpits. And, you must plan ahead for where to put it, how to fill it up and how to drain it.
Bossy says home birth midwives provide a list of supplies they need to have for themselves during and after the birth, for the tub and for the baby. Items include a tub (home tub or rental inflatable), a sterile liner for the tub, a brand-new garden hose, two pumps (one to air up the tub, one to pump out the water), an electric kettle and lots of towels.
The tub should be close to a water faucet as well as on the same floor where you plan to recover postpartum. Bossy says this is best in case an emergency arises or if the pushing phase does not progress well and you need to move to the bed. Buxton says it's important to discuss the plan for complications with your provider prior to labor.
WHEN TO GET IN
While getting in the warm water may feel nice and soothing for labor pains, it can actually slow down contractions if you get in too early. Labor tubs are used mostly when active labor starts. Buxton says this could be when you dilate to five to six centimeters and have strong, regular contractions. As for how long you labor in the tub, that's up to you.
"It's all about Mom's preference for how long she stays in," says Buxton. "Some women may want to get out and stretch their legs, or sometimes moms feel a bit overheated after time goes by." So, don't worry if you feel the need to get in and out repeatedly — it's very common during the labor.
If you do want to have a calm and more relaxed labor or birth experience, using water is a great option.
"Laboring in the tub is wonderful," says Bossy. "It's soothing for both Mom and Baby."