pregnancy

Everything you need to know about water birth, and its potential benefits.

Water births are becoming more and more popular in Australia.

But for many women, there are still a lot of unanswered questions when it comes to choosing whether to labour and/or deliver in water.

To find out everything there is to know about water birth, we spoke to an obstetrician, a doula and a midwife to find out the benefits, the potential risks and how to prepare for a water birth.

Here’s what they had to say.

What is a water birth?

A water birth is a birth which involves the mother spending part of the labour in a tub or birthing pool filled with warm water.

Some women choose to labour in the water but not actually deliver in the water while others choose to stay in the birthing pool for both the labour and delivery.

While the majority of water births are done at home, some Australian hospitals do currently offer the use of a birthing pool.

According to a recent Australian study on midwives’ views on water immersion during labour, almost 90 per cent of the midwives surveyed stated that they believe the practice should be offered to all pregnant women.

A water birth involves spending part of the labour in a tub or birthing pool. Image: Getty.

What are the benefits of a water birth? Is water birth painful?

It’s clear why support for water birth is growing among midwives – immersion in water while labouring and delivering does carry benefits.

Much like a warm bath or a hot shower can provide comfort when you're dealing with pain, a water birth can provide similar benefits.

“For some people, they have less perception of pain [in the water],” obstetrician and gynaecologist Dr Gino Pecoraro told Mamamia.

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And according to research, birthing in water can potentially make it easier for the mother to cope with the pain of contractions.

"The research tells us that water immersion in a bath or pool during labour decreases the need for pain relieving drugs, shortens the first stage of labour by an average of 32 minutes, and increases women's reported satisfaction with pushing, making the experience more enjoyable, with no adverse effect on the length of labour, caesarean rate or baby's wellbeing," midwife and founder of Wholehearted Family Health Andrea Fallon told Mamamia.

"The women I have cared for have said that they feel more relaxed, calm and comfortable in the water and have felt more in control, being able to bring their baby out of the water and straight onto their chest," she added.

According to Renee Adair, founder of the Australian Doula College, other benefits may include greater comfort for mum, buoyancy which brings rest and weightlessness and reduction of pressure on the abdomen.

Are there any risks associated with having a water birth?

A recent Cochrane systematic review found that there was no evidence of increased risks to the mother or baby from labour and/or birth in water.

"Water births are considered to have minimal risks for women who are healthy with no pregnancy complications," Andrea told Mamamia.

But just like any other birth plan, there are a few minimal risks associated with water birth.

A question many women ask is ‘how will my baby breathe if he or she is born underwater?’ However babies born in water normally do not inhale until their face, mouth and nose are exposed to the air.

“Because the baby is still attached to the cord, most babies would not breathe underwater,” Dr Pecoraro explained.

Despite this, Andrea added that there are still some precautions to take to prevent water inhalation.

"It's important in a water birth for a baby to remain fully submerged and not exposed to excessive stimulation until they are able to be lifted out," she explained.

If the water temperature of the birthing pool is too cold, the baby may be triggered to breathe while still submerged.

To avoid this, midwife Andrea says the birthing pool's water temperature should ideally sit at 36-37°C and no more than 37.5°C.

"If it is too hot, mum’s temperature can rise causing baby’s heart rate to increase," she explained.

Infection control is also a concern during water birth.

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"It is important to keep the water clean during labour and to ensure that the bath or pool has been properly cleaned to minimise the possibility of infection," Andrea said.

What situations are not ideal for a water birth?

While water births can be suitable for women with a low-risk pregnancy, water births aren’t suitable in all cases.

If a baby is premature for instance, water birth may be ruled out.

Water birth may not be suitable in all cases. Image: Getty.

Another case where water birth may not be recommended is when the woman is carrying multiple babies. A woman may be discouraged from having a water birth with multiples in the interests of ensuring all babies can be monitored safely.

“I think it would be a brave person who would monitor both babies if you had multiple pregnancies and you wanted to labour or deliver in the pool,” Dr Pecoraro said.

But as Renee explained, there are still many positive documented water births of twins.

"There are mixed schools of thought on who may or may not be suitable for a water birth," she told Mamamia.

Besides multiple birth, breech birth and premature birth, there are a number of situations where water birth may not be ideal.

“If you’ve got increased risks, like the baby’s too big or too small, if you need to monitor the baby and its progress through labour, if mum’s got preeclampsia, if mum’s got any medical conditions or if mum wants more pain relief, then it just makes it harder to monitor both mum and baby [in the water],” Dr Pecoraro explained.

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But while there are some situations where water birth is not ideal from the get-go, sometimes complications during the labour and delivery can mean that a planned water birth has to be abandoned.

Complications may include bleeding, the baby being in the breech position, foetal distress, high blood pressure, the labour progressing very slowly, a problem with the baby’s heartbeat or if the mother feels drowsy.

"Consultation with an obstetrician is advised to determine individual risks, and consider all factors if a women has a complication but would like to use water during her labour and/or birth," Andrea said.

Monique Bowley and Rebecca Judd take a look at the final month of pregnancy, including what to pack in your hospital bag, getting to the hospital, and what to expect from your midwives.

Want to hear to more?  Subscribe to Hello Bump.

How do I prepare for a water birth?

If you're hoping to labour or deliver in water, the first step is to contact your midwife or doctor for more information, to ensure water birth is right for your circumstances.

"I would always suggest women learn as much as possible through childbirth education classes before making a list of birth preferences, and then discuss those preferences with their support person," Andrea said.

If you’re planning to give birth at a hospital, it's important to make sure the hospital provides water birth facilities, such as a birthing pool, or find out if any equipment needs to be purchased or hired.

When it comes to getting in the tub, some evidence suggests that women should wait until they’re at least five centimetres dilated before getting in the water.

"It is generally recommended that a woman waits until she is in established labour before entering the water," Andrea said.

"In other words, she is having regular, painful contractions and her cervix is progressively dilating from about 4cm."

It is also recommended to be submerged at least to your chest, to provide optimal buoyancy and comfort.

"I always like to keep women out of the bath until we run out of all other natural pain management options," Renee explained.

"Keeping the bath up your sleeve like a trump card is a good option but there is no reason why you can't get in and out and back in if you are getting good relief," she added.

"Being in the bath in early labour can slow labour down for some, so that's another good reason to wait it out if you can and try the shower and exhaust all your other options first."

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