Waterbirth:
A Story and Information

by Midwife Marina

I am so pleased by the waterbirths that are happening in hospitals now. Water has gone a long way and my hope is that it continues to melt away restrictions and provide women with its gentle and empowering benefits. For those of you who are interested in learning more about waterbirth here is one of my early waterbirth stories and a review of some of the recommendations from the literature on waterbirth.

Jane decided to walk down the small hall separating the bathroom from her bedroom and lay on the bed for the birth. One more contraction and the pushing urge returned. She realized that she was not able to tolerate labor in bed. She got up and began to walk towards the toilet. The baby was almost between her vaginal lips. Everyone followed the crowning mother, her husband Ben and myself, birthing tray in hand, all of us in line, marching towards the bathroom. I pictured her sitting back on the toilet.

She went straight past the toilet and into the tub. Ben followed her in. The water was about a foot deep and at a pleasing temperature. It supported her abdomen and Ben her back. She had been laboring on and off in the water during the early morning hours. She only gave a few pushes while kneeling in the tub and the baby was born right into the water. Her husband and I helped to bring the baby up to her chest. She sat back in the water and looked with tears and smiles at his perfect body. He was born with lots of long black curls. With a puzzled look about her, Jane said: "My gosh, I had a waterbirth."

Water Birth Common Sense:

Be flexible, don't hang on to plans if they are not working.

The tub should be cleaned with an antiseptic solution, air dried and filled with clean tap water.

Keep water clear, find a way to empty and replace water when it becomes cold, dark or cloudy.

The temperature must be comfortable for mom, and the water level should cover her abdomen.

Take the baby gently out of water soon after the birth.

Keep baby warm, using warm wet blankets.

Keep room temperature warm, and have plenty of dry towels available.

Even though the literature on the use of water during the maternity cycle and early infancy is limited to only several articles and books, the information provides a basis for safety and general benefits of the waterbirth method. Themes from a review of the literature are as follows:

Water can be used for prenatal exercises.

Water serves to relax the laboring woman.

Water immersion provides comfort and a lowering of stress hormones that facilitates labor.

Water serves to increase the elasticity of tissue and promote tissue integrity.

Episiotomies can be performed in water but are not generally recommended.

It is recommended to help the woman out of the water during complicated deliveries in order to use the force of gravity.

The breathing mechanism of the newborn is stimulated by a change in temperature and by the contact of the skin with air. Therefore water inhalation is avoided.

It is recommended that the newborn is brought out of the water gently but right after the delivery.

The birth of the placenta in water is not recommended by all authors. It seems that the earlier literature supports delivering the placenta outside the water while later reports of placenta deliveries under water have not been associated with complications.

Breech, VBAC, and twins have been safely delivered in water.

One author comments on the possibility of contamination of practitioners from HIV contaminated water. HIV testing is recommended. The use of long plastic gloves is also recommended to avoid practitioner contamination.

Breastfeeding underwater has been done, but is not commonly recommended.