Despite the fact that waterbirth has been around for quite some time now, and numerous studies have shown that it can be a safe option with an experienced birth attendant, ABC news this week spoke out against water birth.
The news report was triggered by the announcement that Giselle Bundsen had given birth at home in a bathtub. While ABC admitted that studies have shown warm water relieves labor pain, they stated that “to learn more about this method of birth” they would turn to their resident expert, Dr. Tim Johnson, who in turn interviewed an obstetrician, Dr. Laura Riley, medical director of the labor and delivery unit at Massachusetts General Hospital. ABC did not interview any expert who was experienced in water birth.
After listening to the interview (you can watch it here), I was left wondering if Dr. Riley has ever actually seen a water birth, and where she got her ideas about women giving birth in water. Having personally been the midwife at dozens of water births, without a single complication, I question the following statements by Dr. Riley (my comments are in parentheses):
- A few studies “suggest” that women who labor in water are more comfortable, but there are also studies suggesting that it doesn’t really work (Really? The Cochrane Review states, “Evidence suggests that water immersion during the first stage of labour reduces the use of epidural/spinal analgesia.”¹)
- The baby is submerged in water and this may prevent the baby from “taking a good vigorous cry” when it’s first born. There have been case reports of stillbirth, and babies who needed positive pressure ventilation because they never had the chance to take that good first breath. (As a midwife who’s attended many water births, I have seen numerous babies born who never had “a good vigorous cry”, but simply, peacefully, began breathing and turned pink without ever crying. For a fascinating theory on why babies start breathing after birth, read Dr. George Morley’s article entitled Why Do Babies Cry?
- Babies can breathe in amniotic fluid but they can’t breathe underwater once the cord is cut. ( Obviously, we are mammals, and mammals are air-breathing. What this statement is not recognizing is that babies don’t “breathe” in amniotic fluid. They make breathing motions, but no air is taken into their lungs. At a water birth, the cord is not cut while the baby is underwater. Every responsible care provider I know of brings the baby’s face out of the water immediately after birth so that the baby can breathe AIR. The cord may be cut shortly after birth, or may be cut when it stops pulsating, but would never be cut and the baby left underwater).
- There are some reports of babies who’ve had serious infections because, obviously, it’s difficult to sterilize the water. (How sterile is a birth on a bed? Many women have a bowel movement while giving birth, and this can be difficult to keep out of the birth canal and off of the baby. The provider’s hands may have sterile gloves, but once they touch the vagina, they are no longer sterile. Most provider’s hands are maneuvering, checking, and repeatedly touching the birth canal and the perineum. . .not sterile at all.)
- I suspect that getting into the water at 9 months pregnant is a little bit tricky. (Is this the biggest concern you can come up with, Dr. Riley? Should this even be mentioned as a reason to avoid water birth? I suspect that Dr. Riley is used to seeing women with epidurals who are unable to move their own bodies from one side to another on the bed. I have never seen a 9-month pregnant woman with a healthy attitude toward pregnancy who had any problem moving in and out of a birthing tub. Especially when she knows it will help ease her discomfort.)
The water births I have attended have been overall the most peaceful, calm, and gentle births for both mother and baby. I believe water birth can be a safe option if common sense is used–baby is brought to the surface immediately so there is no chance of aspirating water. Once again, we see physicians in authority speaking out against something they have never personally witnessed and know little about.
For more research on water birth and the pros/cons surrounding this topic, see Barbara Harper’s list of research articles.
1. Immersion in water in labor and birth. Cochrane Review. Retrieved 2.2.10 from : http://www.cochrane.org/reviews/en/topics/87.html