Water Birth: Risks, Cost, Benefits of Water Birth & Preparation



In the current world of technological advances and increasing medical advancements, you have a variety of birthing options at hand. It depends on your preference as to how you wish to deliver your baby. You could choose a hospital, a birthing center or birth at home. Nowadays, more and more women are opting for water births as their choice of delivering their babies.

What is a Water Birth?

Waterbirth is a birthing procedure in warm water (range of 97F to 100 F) that uses a deep bath or a birthing pool. During a water birth, the mother will be submerged in warm water (in a tub) and will deliver the baby in the water. A Doctor, Nurse or Midwife will help you if you are at home or hospital. You can opt for a water birth option at home or hospitals too. Because many reputed hospitals start water birth options now.  There is an option of laboring in the water and delivering out of the water. There are several benefits associated with water birth like it eases the pain, is relaxing, soothing, etc. Keep reading to gain more knowledge about water birth.

 

Benefits of water birth

Benefits for Mother:

 

  • The warm water will be soothing, relaxing and comfortable.
  • The water has been shown to increase the mother’s energy in the later stages of labor.
  • Buoyancy lessens the mother’s body weight, thus allowing free movement and better positioning.
  • Buoyancy can also promote better uterine contractions and better blood circulation. This results in better oxygenation of the uterine muscles, less pain for the mother and more oxygen supply to the baby.
  • Immersing in water also helps lower high blood pressure caused as a result of anxiety.
  • The water reduces stress-related hormones, thus, allowing the mother’s body to produce endorphins which in turn serve as pain-inhibitors.
  • Water makes the perineum much more elastic and relaxed, thus, reducing the incidence and severity of tearing. The need for an episiotomy and stitches is reduced.
  • Water helps the mother relax and as she relaxes physically, she can relax mentally with a better ability to focus on the birthing process.
  • The water provides a better sense of privacy and can lessen inhibitions, anxiety, and fears.

 

Benefits for the baby:

  • Water provides an environment similar to the amniotic sac to the baby.
  • It takes away the stress of birth, thus increasing the reassurance and sense of security.

Water Birth risks and Downsides

  • Babies do not breathe in the uterus, so in theory, the baby should not start breathing when he comes into the water. He should start breathing only when he is outside of water and into the air. ACOG says that if the baby somehow happens to inhale when submerged in the water, it could potentially cause serious complications like drowning and meconium aspiration. There are a few situations that could cause the baby to inhale underwater:
    • The baby is startled during birth
    • The head comes to the surface before the rest of the body. This can override the dive reflex (A reflex that can instinctively close the airway and keep the baby from breathing in water)
    • The oxygen supply from the placenta is affected somehow.
  • CDC says that babies born underwater could get Legionnaires’ disease which is an extremely serious type of bacterial pneumonia. This was the case with two newborn infants who were delivered in-home bathtubs in 2016.
  • There are considerable risks to the baby during the final labor stages and delivery. ACOG comments that it is all right to labor in water but mothers should deliver on dry space.
  • When water births take place at home, they become all the more dangerous. That is because you can avail of no immediate medical help in such a case.
  • There might be tearing of the umbilical cord underwater if they happen to be short and this could lead to fetal blood loss.

Some other risks the baby might face include:

  • Difficulty in regulation of the child’s body temperature
  • Damage of the umbilical cord
  • Respiratory distress for the baby
  • Asphyxia and seizures in the baby’s body

Water birthing is not recommended if the mother has any of the following conditions:

  • Maternal blood or skin infection
  • Fever of 100.4 °F (38°C) or even higher
  • Excessive vaginal bleeding
  • Difficulty tracing heartbeat of the fetus or the need for continuous tracing
  • History of shoulder dystocia
  • Sedation
  • If you carry multiples  

Restrictions

Regardless of the place you decide to have your water birth at, you need to look out for a certain number of things:

  • You should have an experienced and licensed health care professional along with doctor backup. These people will help you through labor and delivery.
  • High measures need to be taken to ensure that the tub is kept clean and maintained well.
  • Infection control measures need to be taken.
  • The mother and baby should be properly monitored while in the tub.
  • The water temperature should be well-regulated and usually kept in the range of 97 to 100 F.
  • You need to drink enough water during the birth to avoid getting dehydrated.
  • There should be a plan to get you out of the tub as soon as the doctor, nurse or midwife says that it is time.

Where to have a water birth

The mother can choose to deliver her baby through a water birth in any of the following places:

  • At home
  • At any birthing center
  • At a hospital

You can find certain birthing centers that are equipped with birthing pools or Jacuzzis. On the other hand, hospitals are far less likely to be equipped to take care of water birth, though some might.  You might face discouragement due to a lack of resources: Advocacy groups such as Waterbirth International might be able to negotiate permission from your hospital to arrange a purchased or rented birthing pool.

You should not wait until your last trimester to arrange a waterbirth else you would not be able to have one. If you wish to have a home birth, then you can make use of your bathtub during the early stages of labor or bring in a birthing tub that is big enough for both you and your coach.

Planning for a water birth

  • After you get approval from the hospital or birthing center for a water birth, make sure if you need to bring equipment on your own. 
  • If you wish to give birth in your own bathtub at home, keep a thermometer at hand to measure the water temperature.
  • Let your insurance provider know about your plans since they might cover the expenses.

Water Birth Videos

How to prepare for water birth?

  • Check with your healthcare provider first and ask if they are equipped for a water birth or might know some other service in your area that has the necessary equipment.
  • If you plan to deliver at a hospital, ensure that their policies do permit water births. More and more hospitals are allowing parents to have water births.
  • Contact a local birthing center and check if they provide a water birth option.
  • If you are delivering at home, then you can rent a birthing tub online for about $350. Check with your insurance company, if they reimburse the cost of the rental.

How Much Does Water Birth Cost?

The cost of a water birth can vary according to where you decide to have it and whether your birthing center or hospital offers it or not. If the hospital or birthing center does have a birthing pool then they may charge you a fee for using it and they wouldn’t if they don’t have the equipment at hand. If your insurance covers the cost, then a water birth would cost the same as a vaginal birth.

If you buy your own pool kit, then you can do that for around $60 to $500. You could rent a tub and that would cost you around $200 to $400. If you get a pool through a midwife, then she might charge you a renting fee.

The midwife could charge $2000 to $6000 as her fee for a water birth at home. If you are having the water birth at some hospital or a birthing center, then the charges could about $2,300 approximately.

What happens during a water birth?

Some hospitals might allow you to labor in the tub up to a certain stage but then have you deliver on a hospital bed. Others could allow you to go through all the stages of labor in the water tub. There could be a few additional rules as well.

When in the tub, you might see a range of colors or textures as you get closer to delivery. Remember that these are normal, such as mucus, bloody show and feces as well. Your midwife or helper will help to clean them out with a net. 

After the baby has been delivered, your midwife will take care of you, but your baby comes first. While you recover, your midwife or helper will empty the tub into the toilet using a pump. The liner will be thrown away and the tub will need to be wiped with bleach before return.

Is water birth safe with multiples/twins?

If you are carrying twins or higher order of pregnancies, then you might or might not be a good candidate for giving a water birth. Such pregnancies have a higher risk of premature birth and other issues that might need better monitoring during labor and delivery. Discuss thoroughly with your healthcare provider about the risks involved.

What situations are not ideal for water birth?

  • If the mother has herpes, then it can get easily transferred through water. You should discuss this risk with your doctor.
  • If the baby is breech: Water birth is done with bottom or feet first presentations. However, you should discuss the risks involved with your doctor.
  • If the mother is diagnosed with excessive bleeding or maternal infection.
  • If the mother is having multiples: Water births are usually successful with twin births but you should discuss the risk thoroughly with the doctor.
  • If the mother is expected to have preterm labor: If the birth is taking place pre-term, i.e. 2 weeks or more before the due date, then water birth is not recommended.
  • If there is severe meconium: It is normal to have mild to moderate meconium. As meconium floats to the surface of the water, your health care provider will keep a watch and remove it immediately. If the water gets stained and the birth is imminent, then the woman can lift her pelvis out of the water to give birth.
  • If the mother has toxemia or preeclampsia: You need to discuss this risk with your healthcare provider.

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