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Concerns over the Safety of Waterbirth

© Nicole Deak

When I was pregnant and considering a natural labour and delivery (that is, one without medication, pain killers, gas etc.), I was, like most women, concerned about the pain. After doing a considerable amount of research into the problems associated with epidurals and other drug-related pain relievers, I came across some information on water. I’ve always been drawn to water when I had a headache or cramps, so it seemed obvious to me that water should be included in my plans for an all-natural birth.

Before discussing the many benefits of using water for labour and/or delivery, I’d like to address many of the common concerns. The research speaks loudly and clearly – when used properly, warm water can be a safe method of pain reduction during labour, can speed dilation of the cervix, and reduce the recovery time for women. Babies born in water maintain a steady and strong heartrate, often need no suctioning to clear mucus, do not cry but look around peacefully, and are not exposed to the shock of bright lights and rapid handling often associated with hospital birth.

Still, I had a great number of specific questions. What if the baby breathes underwater? Scientists have discovered that the mechanism that triggers a baby’s first breath is a change in temperature. Thus, the baby does not breath until lifted from the water (and they should be lifted as soon as they are born). This is based on the fact that the temperature of the water is close to that of the amniotic fluid. Cold water would shock the infant, and labouring in extremely warm water would exhaust the mother and baby. Keeping the water to body temperature is ideal.

What about contamination? I learned that if you can drink the water, you could give birth in it. There is no need to purify the water. Keeping your feet clean while getting in and out of the birthing tub or bathtub is a good idea, and a rinse basin can rest by the side of the tub. By the end of the birth, there will be a fair amount of debris floating around in the tub. Again, this is not harmful due to the extent of dilution. A partner can use a small fishnet scoop to remove any larger pieces of debris from the tub during the labour and delivery process.

Assessing blood loss is one real concern when giving birth in water. It is very difficult to estimate the amount of blood in water due to the dilution. Therefore, as I did, a midwife may request that the placenta be birthed outside of the tub. If the water ever became cloudy with blood, I knew that my midwife would ask me to exit the water immediately. But, studies show that under normal circumstances, the amount of blood loss during a waterbirth is less than that during a ‘land birth’.