Water birth was the hot discussion topic during Club BUMP, following a Zumba4BUMP class in Witney recently. On hand to answer the group of mums-to-be questions was Ethel Burns, a midwife for over 30 years and lecturer at Oxford Brookes University. Ethel introduced the first custom made birthing pool in an NHS maternity unit in the UK, in Oxford in 1990.
Club BUMP offers women an enjoyable half hour chat after a fun dance-based hour long work-out. It covers a wide range of pregnancy-related topics: from soothing massage techniques and helpful birth tips, to pain relief options and breastfeeding advice. Uniquely, the classes also encourage Mums to return with their babies, and to dance with them, safely supported of course!
Here’s a selection of the water birth discussion questions and answers.
Does water help with pain of labour?
Birthing in water helps you zone out and creates a relaxing environment to optimise the release of the body’s natural pain-killers. The buoyancy of being in a birthing pool helps you to move into different positions. Women who choose to labour in water are less likely to have an epidural or sedation, or require labour to be augmented with an infusion of synthetic oxytocin, and are more likely to give birth spontaneously compared with women who labour on land1, 2.
Does the pool stay warm?
Babies don’t like water that’s too hot or cold. Your midwife will ensure that the pool is kept around body temperature using a thermometer, whether at hospital, in a midwifery led unit, or at home.
What happens with all the ‘stuff’ that’s released during birth in a pool!?
It’s true that some women open their bowels during labour, but this is a great sign your baby’s nearly ready to be born! Your midwife is very used to this and can help you out of the pool to the toilet, or they will discretely keep the pool tidy for you. Blood is heavier than water and so usually sinks to the bottom of the pool. Your midwife will be monitoring your blood loss during a waterbirth the same as during land birth.
When will I be advised to get in the pool?
In hospital you might be advised you can only use the pool once you’re in ‘established’ labour (midwives class this as 2-3 strong, regular contractions in 10 minutes, and when your cervix is around 4 cm dilatation). However, immersion in water can be very beneficial at any point during labour. There is sometimes a concern that getting in the pool ‘too early’ will slow down labour, and it is true that sometimes contractions can slow down for a short period after you have been in the pool for around 30-40 minutes. However, the frequency and strength of the contractions usually then return and labour proceeds normally3. If labour does slow in the pool, your midwife can support you to stand up out of the water, or have a walk around to get things going again. It is important to remember that the duration of labour is always at best an educated guess!
Is it true that babies are calmer when born into water?
Yes water birth babies are often calmer. Your midwife will keep a close eye on you both.
Does water birth help prevent tears down below?
Most women have some perineal tearing during childbirth, and this can range from minor grazes to your labia and shallow tear to your vagina to deeper tears into muscles. Evidence shows that women giving birth in water are less likely to have an episiotomy (a small cut) and more likely to not tear at all1, 4, 5. All pregnant women planning a vaginal birth can help reduce these chances further by doing perineal massage in pregnancy – this is gentle massage of the perineum, or skin between the vagina and anus 6.
- Burns EE, Boulton MG, Cluett E, Cornelius VR, Smith LA. Characteristics, Interventions, and Outcomes of Women Who Used a Birthing Pool: A Prospective Observational Study Birth. 2012; 39(3,): 192-202.
- Cluett E, Burns E. Immersion in water in labour and birth. Cochrane Database Syst Rev 2009 22nd October 2009 [cited 2016 14th January ]; CD000111.pub3.]. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000111.pub3/pdf
- Benfield RD, Hortobagyi T, Tanner CJ, Swanson M, Heitkemper MM, Newton ER. The effects of hydrotherapy on anxiety, pain, neuroendocrine responses, and contraction dynamics during labor. Biol Res Nurs. 2010; 12(1): 28-36.
- Geissbuehler V, Stein S, Eberhard J. Waterbirths compared with landbirths: an observational study of nine years. Journal of Perinatal Medicine. 2004; 32(4): 308-14.
- Henderson J, Burns EE, Regalia AL, Casarico G, Boulton MG, Smith LA. Labouring women who used a birthing pool in obsteric units in Italy: prospective observational study. BMC Pregnancy Childbirth. 2014; 14(1): 17.
- Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic reviews. 2013 [cited 2016 4th February]; Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005123.pub3/epdf
Authors: midwifery student Emma Thompson and midwife Ethel Burns.