Depending on our preference, our health and the health of the baby, some women may choose to give birth in the hospital, in a birthing center or at home. More and more women are choosing water birth as the way their babies come into the world.
During a water birth, the mother is submerged in water, usually in an inflatable bathtub, and will deliver the baby in the water. You can also choose to spend the contractions in the water and give birth outside. This can be a good option if we want the benefits of hydrotherapy , along with the benefits of giving birth in a hospital.
What is water birth?
Some women report that the water relieves contraction pains and the pain of childbirth itself. Unfortunately, if they get an epidural, it’s not possible to give birth in water. This is due to the need to monitor the epidural site and keep it sterile and safe. Gas and air can be put in while we are in the water, but we will have to get out if we have an analgesic injection such as pethidine, which can make us sleepy. It can be re-entered after a couple of hours, once the effects of the injection have worn off.
You may or may not be a good candidate for a water birth if you are pregnant with twins or higher order multiples. These pregnancies have a higher risk of preterm labor and other problems that may need closer monitoring during labor and delivery.
Water birth in hospital
If we want to have a water birth in the hospital, there are some positives and some drawbacks. Hospitals have fully equipped delivery rooms and some women feel safer in a hospital setting as there is quick access to intervention should they need it.
If you are giving birth in a midwife-led unit or hospital, there will be dedicated rooms with a large specialized bathroom where you can give birth or go in to help ease labor pains. These calving pools have a special plumbing system. They often have ambient lighting in and around calving pools.
However, there may be situations in the hospital where there are not enough staff or pools available. Therefore, further restrictions may be placed on the woman to ensure that she does not enter the pool too soon before labor sets in. This is to prevent a woman who is not fully established in labor from blocking a pool.
water birth at home
At home, a birthing pool is usually inflatable and it is the responsibility of the birthing partner to fill it, empty it and clean it afterwards. It is still possible to have a water birth at home by renting an inflatable pool. The midwife will take the temperature from time to time to make sure the mother is not too hot. You don’t have to be in the water all the time. You can come and go as you see fit. The couple can even get into the pool if they want.
Labor often slows down or stops when a woman feels nervous or insecure. This is something that can happen when a woman leaves her home to go to the hospital. While work at home is usually less subject to this effect since women are in their family environment. Couples and other family members can move freely and there is easier access to food and drinks. This will be the right decision for some women. Others may feel safer being in a hospital or birthing center.
Benefits
Water births have become more popular in recent decades. Expert gynecologists acknowledge certain benefits, but do not recommend being in the water beyond the first stage of labor, when the cervix is fully dilated. They also do not recommend giving birth in water.
Immersion in water in the first stage of labor can help shorten the length of labor . Water labor can also decrease the need for epidurals or other spinal pain relief.
A small study found that women who give birth in water may also have a lower cesarean section rate (13.2 percent vs. 32.9 percent). Not only that, but women who gave birth in the water reported less stress incontinence 42 days after delivery than those who gave birth on land. Larger-scale studies are needed to confirm these findings.
Women who give birth in water also report greater satisfaction with childbirth . The warmth of the water and weightlessness usually give space to give birth without disconnection.
Contraindications
In general, it is recommended that water labor be offered to women who are between 37 weeks and 41 weeks, 6 days gestation. There are other guidelines, including having a low-risk pregnancy, clear amniotic fluid, and the baby on its stomach. Water births may not be recommended for women who are in preterm labor or who have had two or more prior cesarean deliveries.
risk of infection
Water birth means sitting, pushing, and giving birth in a bathtub, which often includes feces . A baby born in such an environment could possibly swallow the contaminated water, increasing their risk of infection. Depending on who we ask, the probability of an infection differs because the data is limited. However, there is no way to make the water free of contaminants. This is because the bathtub becomes contaminated with vaginal and rectal flora the moment the mother sits in the bathtub, even if the water is sterile.
A baby who swallows bathwater is at risk of infection. Babies are genetically and physiologically programmed to take their first breaths of air, not water, within seconds of their heads being delivered. They have a “diving reflex” that instinctively closes their airways and prevents them from breathing water, but some scenarios can still cause them to inhale water:
However, it is important to know that even when infectious bacteria are expelled during delivery, nothing moves up or in. Therefore, the risk of infection occurs only if the baby breathes too soon (midwives and obstetricians are trained to minimize that risk) or if the equipment is not properly sterilized.
Risk of meconium aspiration
This medical term means that a baby has had its first bowel movement before birth and inhales contaminated amniotic fluid, causing breathing problems.
Doctors and midwives can tell if this has happened when your water breaks because the meconium is usually green, sticky, thick and thick. Extra precautions should be taken when the first bowel movement occurs before delivery. A doctor or midwife needs immediate access to the baby in order to clear its airway, which often means giving birth on its back.
risk of pneumonia
Although significant studies have yet to show the exact percentage of pneumonia cases in water birth, it is one of the risks. To prevent pneumonia, the water should stay warm and the baby should come to the surface immediately after delivery.
Pneumonia usually develops within the first 24 to 48 hours after birth and is caused by meconium aspiration, fecal contamination, and bacteria from bath water. There are also case reports of babies dying of pneumonia after water birth that was the direct result of ingesting fecal-contaminated water. As most water births take place at home or in an independent birthing centre, there is little ‘research’ done.
risk of drowning
Where there is water, there is a risk of drowning. One study lists drowning and suffocation as fetal risks of water birth. Due to complications, the baby may stay underwater too long and his lungs may fill with water.
Medical professionals do their best to prevent this by placing the baby with its head above water so that it can get enough oxygen to breathe as soon as it is born.
Risk of umbilical cord rupture
Short umbilical cords can bind the fetus underwater or tear, leading to fetal blood loss. Maternal tears can be difficult to assess underwater, and mothers may bleed excessively. The good news is that a cable short enough to cause such an incident is rare.
During a water birth, the baby usually comes to the surface quickly, head first. This quick movement will allow them to start breathing as soon as possible, but there is a risk that the umbilical cord will break. A ruptured umbilical cord can be life-threatening, as the fetus can bleed freely until it stops. It is usually easily treated by clamping the cord. It normally leads to neonatal anemia than anything else.
How much?
A water birth in a hospital can cost the same as a natural vaginal birth. In many cases, most or part of a hospital delivery is covered by health insurance or Social Security in Spain. Without insurance, a vaginal birth can cost anywhere from $5,000 to $10,000, though costs vary by location and facility.
Delivery prices at each can vary by location, but are generally lower than hospital costs (if not covered by public health). In the case of private insurance, most of the time home births are not covered. When choosing the team that will assist with the water birth, it is recommended to ask for a full breakdown of expected prices.
Some experts offer birthing tubs as part of their services. Otherwise, the price of renting or buying a birthing tub also varies depending on the location and options we choose. A basic one with a lining can cost less than 300 euros, for example. Rental prices are around the same price. Other supplies will also be needed, so plan accordingly.
