BY HEATHER NUGENT, HOMESCHOOLING MOTHER, WRITER, REGISTERED NURSE, DUNKIRK, NY
Everything comes around again. So my grandmother used to say when she noticed the profile of a ladies’ shoe, the hemline of the season’s newest skirts or the latest hairdo walking out of the neighborhood salon. So it is with fashion. So it is with music. And so it is proving to be with maternal-child health. After a couple of decades in which the medicalization of even normal births seemed to be the wave of the future, women are becoming educated about the benefits of a more natural approach to childbirth and are making more informed birth-related choices.
Discovering that the medical technology known as continuous electronic fetal monitoring, once promised to provide improved safety and better outcomes for them and their unborn child, has been shown to offer no benefit when a normal, healthy woman labors and gives birth, women are choosing to no longer be figuratively “tied to the bed” by this apparatus and to birth more freely and naturally, just as their great-grandmothers did. Because of this change in mindset and demands of consumers, hospital administrators are finding it to their benefit to support more natural options in birthing at their facility. For this reason, water birth, which was once a choice only afforded by women who labored at home or in birthing centers, is finding its way into hospitals here in Western NY.
Why give birth in water? For one thing, it’s more comfortable. Women who labor in warm water experience labor pains as less severe and more manageable. They also have more freedom to listen to their bodies and adjust their positions accordingly. Water provides support against their bellies and backs, where labor surges are felt. It also supports the pelvic floor muscles for women who wish to squat during labor and birth. Women who labor in water are less likely to require IV narcotics or epidural anesthesia for pain management, both of which can alter the course of a birth and lead to a series of unplanned medical interventions.
Warm water is also regarded as a gentle transitioning environment for the baby to experience between womb and world. Newborn babies are accustomed to a fluid environment that is body temperature. Because the water mimics the environment inside the mother, the delivery of a baby into water is often a gentler, slower process than birthing directly into the atmosphere of the hospital room. Mother and baby are enveloped in the gentle caress of water, allowing mother to actually lift her own baby to her breast and remain together for those first few moments before the cord is cut. Having done the work, Mom gets to enjoy the spoils by being the very first to touch the fruit of her labor.
I have witnessed water births where the baby’s head emerges and spends a number of minutes hanging as if suspended in time while the laboring mother rests and waits for the next contraction. This is rare in non-water hospital births, where the focus is on speedy delivery of the entire infant once the head has crowned. This sort of space to rest is important. A woman is less likely to have her body tear when she is allowed to listen to her body’s urges and push in her own timing, without coaches and well-meaning staff directing her. This resting period also allows baby to emerge gently and slowly for a more
natural, peaceful transition from one world to the next. I can understand why the idea of the baby’s head being suspended under water for a number of minutes may sound frightening to the average person. We have to remember, though, that as long as the umbilical cord is not cut and the placenta is still attached to the mother’s womb, the baby is getting all of his oxygen from his mother via the placenta. There is no danger that the baby is going to inhale water. This is the result of a number of physiological mechanisms that begin to unfold as the mother enters labor. Some of these mechanisms rely on the mother’s labor being natural as opposed to chemically induced, however. This, and the need for continuous fetal monitoring when inducing agents are given, make water birth unsafe for women who are being artificially induced using Pitocin, a chemical that is manufactured to mimic the body’s natural hormone known as oxytocin.
Water-born babies are sometimes brought out of the water almost immediately, but may linger in the water for a few minutes after they are born. They can then be examined by a midwife or nurse in the loving comfort of the mother’s arms. Both mother and baby are kept warm by the birthing tub water until they are ready to get out for a more thorough checking-over.
Women considering water birth need to understand the utmost importance of having a care provider who is sympathetic to her wishes, who views birth as a natural phenomenon and who is familiar with the research regarding water birth. Women tend to find this sort of practitioner more often in the form of a midwife. Certified Nurse Midwives can legally practice in hospitals in New York state, and are usually the practitioners bringing water birth clients to hospitals. Because the midwifery model of care dictates that high-risk pregnancies be referred for obstetrical care, midwives are accustomed to utilizing a less intrusive form of fetal heart monitoring by way of a Doppler or fetoscope. Individual hospital policies regarding monitoring during water birth differ, but moms should expect to be monitored for a brief period before entering the pool and then intermittently as their labor progresses. Any intervention that increases the risk of complications, such as the use of narcotics or epidural anesthesia, will not be viable options if the mother wishes to continue laboring and delivery in water.
An excellent resource for women and families who are interested in learning more about giving birth in water is Waterbirth International (www.waterbirth.org).
Lisa Jordan is a family child care provider in Warren. She received her early childhood education degree from Clarion University in May 2009.