WATER BIRTH

Ms. Sonia R.B. D’Souza

Asst. Professor
Manipal College of Nursing
Manipal University, Manipal
 What is water birth ?
Water birth is the process of giving birth in a tub or pool
of warm water. Some women labour in water but choose
to get out for delivery, while others decide to stay in the
water for the actual birth of their baby.
 History - water birth
 The first water birth took place in 1803 in France.
 In the 1970’s, some midwives and doctors in Russia
and France including French obstetrician Frederick
Leboyer became interested in ways of helping the
baby make the transition from life in womb to life
outside as easy as possible.
 During the 1980’s and 1990’s interest in water birth
grew in UK, Europe and Canada.
Is it safe to labour and give birth in
water ?
 A study carried out in Liverpool and published in
1997 compared 100 women who used a birthing
pool at some point during their labour with 100
women who laboured and gave birth on land.
 The results showed that the babies born to the
women who used the pool were just as healthy as
the babies born to the women who laboured on
land.
Benefits of water for labour and/or
birth
 Greater comfort and mobility.
 Reduction of pressure on the abdomen.
 Buoyancy promotes more efficient uterine
contractions and better blood circulation resulting
in better oxygenation of the uterine muscles ,less
pain for the mother and more oxygen for the baby.
 Helps mother to conserve her energy.
 Contd..
 Promotes deeper relaxation and thus labour
becomes more efficient.
 Facilitates a functional labour.
 Water can reduce the need for drugs to
artificially stimulate labour.
 Lowering of blood pressure.
 Birth from water to water is a gentle
transition for the baby.
 Contd..

 Facilitates the second stage of labour.The warm water

softens the vagina ,vulva and perineum, leading to fewer
injuries to the tissues.
 Better parent child interactions.
 Reduces perineal trauma and eliminates episiotomies.
Possible hazards of labouring
and/or giving birth in water

 Infection
 Unpleasant environment
 Emergency situations
 Baby starting to breathe under water
 Neonatal hypothermia
 Inaccurate blood loss estimation
 Contraindications for water birth
 Women with medical problems such as diabetes, heart
diseases, kidney diseases, chronic mental illness
 Very high BP
 Severe pre-eclampsia
 Active herpes sore near vagina
 Previous caesarean delivery
 Induced labour
 Contd..
 Pethidine or similar drug taken during labour.
 Breech position
 Premature baby
 Multiple pregnancy
 Prolonged second stage
 Preparations for a water birth
 Midwife should discuss advantages and disadvantages
with mother
 Woman ‘s vital signs and fetal heart rate should be
within normal limits
 Use of a water proof Doppler is recommended to check
FHR
 Water temperature monitored by a floating thermometer
 Contd..
 Maintain adequate hydration and leave the pool to
urinate at regular intervals
 An alternative birth place should be set up near the pool
 Contd..
 Water temperature - 32 to 37 degrees C
 Amount of water should not be so deep
 Water quality – clean. Any blood clots,mucus,feces should
be removed
 Tubs – should be big enough to sit in comfortably. It
should be cleaned with a non abrasive cleaner and use 10
% solution of bleach and rinse thoroughly
 The birthing room – should be strong enough to support
the weight of the tub when its full
When is the ideal time to get in the
pool?
The optimal time is when the labour is established.
This is confirmed by the presence of regular strong
contractions as well as a cervical dilatation of at least
4 cm.
 What to eat and drink?

 Drink at least a half pint of water every couple of hours

to avoid dehydration
 Eat light and digestible food
 Birth positions
 Experiment with a variety of different positions –
kneeling , squatting , sitting or lying outstretched
 Some women prefer to have their partner in the tub to
hold them
 Pain relieving complementary
measures when inside the pool
 Massage
 Breathing exercises
 Aroma therapy
 Accupressure
 Guided imagery
 How long should the baby stay
under water?
If the temperature is kept constant and as close to
the body temperature as possible,the baby is unlikely to
start breathing under water. The risk of aspiration is
therefore minimal.
Prolonged submersion is however inadvisable since
the placenta may start to separate and thus risking
hypoxia for the baby
 How does the baby breathe?
The baby begins to breathe only after its face comes
out of the water and its skin and cord come in contact
with the cooler air.
What about the placenta?
Most practitioners advocate that the third
stage should be conducted outside the pool.
This has three theoretical benefits:
1)It reduces the risk of PPH
2)Accurate estimation of blood loss
3)Prevents water embolism
 Conclusion
All in all water birth is a very attractive option
for some pregnant women.
As in all areas , any new strategy should be
approached with an open mind weighing for
the pros and cons.