It was a sticky December Durban evening and the air conditioner hummed noisily in the background. My eldest son gave me sips of water and maintained his firm grip on the torch while my husband, doula and midwife leaned on the edge of the pool chatting about this and that and reassuring my Daschund that I was alright. My younger son wandered in and out of the room as the whim took him and the general feeling was very relaxed and jovial. Were it not for the fact that my third son was about to be born, it could have been any other normal night. Tarquin made his way gently into the water shortly after 8pm and mine were the hands that lifted him onto my chest. He didn’t cry, but having had two other children at home, I knew that this was the norm. Babies who have a gentle birth generally do not scream in protest. Even though he weighed 4.3kg, his birth was easy and beautiful.
Igor Tjarkovsy introduced the concept of water births to the Western world in the sixties, but the idea was by no means new. There are legends of South Pacific islanders who gave birth in shallow sea water, and of Egyptian pharaohs born in water. Women in Mongolia, Hawaii, Samoa, Greece and Guyana have taken to the water to birth their babies. In the 1970’s, Frederick Leboyer encourages parents to bath their babies in warm water as soon as possible after birth to allow them a gentle entry into the world. But it was Michel Odent, a French obstetrician, who began to encourage women to use birth pools to ease the pain of labour at his maternity unit in Pithiviers, France. Odent noticed that many women are attracted to water during their labours, whether it was the use of a shower or a bath. After one of his patients accidentally gave birth while still in water, he began to research the use of water for birthing and not just for labour.
I have heard every objection under the sun to water births, from the idea that if babies were meant too be born in water, they would be born with a snorkel (this from an obstetrician) to the idea that the baby would drown. The truth is that our babies are floating in liquid for nine months, and it is the feeling of air on the skin that stimulates the baby’s reflex to take that first breath. Babies who are born into water can be given the chance to unfurl in the water and slowly adjust to the idea of being out of their watery womb before being brought to the surface. The umbilical cord remains attached and continues to feed the baby oxygen and nutrients, so there is no pressure to get the baby breathing immediately. Although studies have been done, there have been no findings of an increase in risk factors for women or babies who are birthed in water.
Beautiful Benefit of Water
Aside from wanting to give the baby a natural and gentle birth process, the main reason women choose to have a water birth or to use water in their labour is to reduce pain. Water provides an optimal environment for the mother to manage her labour. Water helps the birthing mother to relax – just think of lying in a hot bath after a tiring day at work and you get the idea. As she relaxes, so too does her pelvic floor and her cervix is able to open. The muscles of the uterus contract more effectively, require less oxygen to do so and recover better between contractions. Relaxation allows for the endorphins (happy-hormones) to rise appropriately in response to pain. Endorphins produce a sense of well-being and elation, so that even though the pain is still felt, it is more diffuse and the mother feels more detached from it. There is a corresponding rise in oxytocinThe mother experiences less pain and less fear, and on average, a faster labour. Because of its pain-relieving properties, the use of water during birth reduces the need for analgesics and epidurals. A reduction in the use of pain relieving drugs not only benefits the mother, who is more alert and responsive after the birth, but also the baby. levels (which causes the uterus to contract) and a drop in stress hormones which can slow down labour.
The ability to move around during labour is vital to the progress of the labour. Labour in water becomes more manageable as the mother is able to move around more freely because her body is completely supported by the water. The buoyancy of the water counteracts the effects of gravity and the mother is able to adopt positions that may have been difficult out of the water. By moving naturally and instinctively she is better able to move the baby through the pelvis.
A birth pool creates a kind of privacy that is often lacking in other kinds of births. The pool becomes the mother’s sanctuary, her sacred space, and permission must be asked before anyone can enter. It seems to create an entirely different environment and atmosphere for a woman giving birth, and also for the midwife caring for her. Sensory input and distractions are low, which makes it easier for her to relax deeply. Birth takes place in a quiet room, with personal care from a midwife who is concerned to support the normal physiological process of birth. Women find that they are more able to let go and follow their instinctual nature when they are in this kind of environment.
Another pro of water birth is that it decreases the chance of an episiotomy or perineal tear. The warm water softens and relaxes the perineal tissue, which becomes more elastic and stretches to allow the baby’s head to crown. Counter pressure form the water makes the crowning of the head more controlled and gentle, and allows the mother to push more steadily. Even if the woman labours in water but gets out of the pool to give birth, there will be beneficial effects on the perineum.
There are some safety precautions that should be observed to ensure a water birth that is free of complications. The water should be at body temperature – 37◦C – so that it is neither too hot nor too cold for the baby, and so that the mother does not overheat. Care should be taken during the birth to maintain this temperature and this job should be given to someone specifically. The mother should get into the pool only when she is in active labour (after 4-5cm dilation). At this point, the relaxing effect of the water speeds up the labour, but if she gets in before this point, the labour may slow down. Both mother and baby should be monitored throughout the labour (using a hand-held Doppler for the baby) and if there are any signs of foetal distress, the baby should be born out of the water. Your midwife or obstetrician should be experienced and competent in caring for women giving birth in water.
Water birth is associated with a non-intervention approach to labour and delivery. Instead, water encourages you to find your own strength and your instinctive knowledge of how best to birth your baby, so your birth is much more likely to be a natural one. Births where the mother is conscious and aware put her in control of her birthing process and allow her to bond quicker and more deeply with her baby. Women who experience this kind of conscious birth feel empowered and awed by the amazing strength and wisdom of their bodies and carry this newfound strength into the rest of their lives.