Understanding Birth Methods in Water (Water Birth)

Water birth

Water birth is a method of giving birth that is carried out in a water-filled birthing pool. Although it seems to offer the mother more comfort during the birthing process, the newborn baby will also feel the same condition when it is in the amniotic fluid in the mother’s stomach. This water birth method should not be done carelessly by all women. For the water birth process, we will be given several options, namely sitting, squatting or other positions that are comfortable for the mother when pushing in the water. Of course it is different from normal birth and caesarean section, where the mother has to give birth lying on the bed.

Water birth is one of several types of birth. Apart from the water birth method, there are also normal birth methods, caesarean section, gentle birth, and hypnobirthing. So, it is very important for moms to determine the method of delivery while preparing various birth preparations. During the process of giving birth in water or water birth, the mother will be in a tub or small pool filled with warm water. The aim of using water during childbirth is to make the process easier and relieve pain and discomfort that the mother may experience. Somewhat different from childbirth that takes place in a hospital, the process of giving birth in water or water birth is usually carried out naturally. This means that the mother will not be given drugs, anesthesia (anesthesia), or a caesarean section. It is the buoyancy of water that will provide the mother with assistance during the process of giving birth in water.

However, this does not mean that giving birth in water is free from pain. In fact, the pain during water birth will still be there. However, the process of giving birth in water or water birth usually offers a new environment and experience that is more relaxed and comfortable. The method of giving birth in water is more commonly used when mothers give birth at home. On the other hand, this method of delivery is rarely or even not used when pregnant women give birth in hospital. Even so, mothers still need to practice breathing techniques during childbirth and how to push during childbirth so that the process runs smoothly.

Some facts about giving birth in water (Water Birth)

Giving birth using an unusual method, aka in water (water birth) requires more preparation. Moreover, hospitals that offer birthing using the water method in Indonesia are still relatively rare.

Here are some things about giving birth in water or water birth that need to be understood:

Water birth has several benefits for mother and baby

1. Water birth is a birthing method that can help shorten the duration of labor. Usually, the use of anesthesia or epidural anesthesia in the spine is not really needed.
2. Water helps lower the mother’s blood pressure, thereby reducing the mother’s anxiety during childbirth.
3. Water can also reduce levels of stress-related hormones. That way, the mother’s body will produce endorphins which can help reduce pain.
4. Giving birth in water can also reduce the risk of tearing the mother’s vagina. This is because water acts to make the perineal lining of the vagina more elastic.
5. Meanwhile, for the baby itself, giving birth in water creates an environment similar to amniotic fluid. As a result, the baby will feel more comfortable when born using the water birth method.

Water birth makes the first stage of labor easier
Using the water birth method during the first stage of normal delivery can help reduce pain. The first phase usually begins when the birth (cervix) opens, and labor contractions occasionally appear, although not too often. Before starting the water birth process, the mother does not need anesthesia like childbirth in general. The warm water in the pool can help the mother’s body to be more relaxed and calm, so it can help create comfort. In the end, this can help the mother store much needed energy during the water birth process or giving birth in water. Besides that, because it is in the water it is usually easier for mothers to move and change positions, compared to being in bed. To make it easier, mothers can also make various natural induction efforts or eat food so they can give birth quickly in advance. However, mothers still have to consult a doctor before doing so.
Water birth is not necessarily safe for babies in the second stage of labor
The second stage of water birth is when the cervix is completely open and dilated. At this stage the baby is ready to come out through the vagina. Unfortunately, it is not yet known for certain what is the safest way to remove a baby from the vagina during a water birth. Aaron Caughey, from the American Congress of Obstetricians and Gynecologists (ACOG), explains this. According to him, giving birth while not in the water will make it easier for the mother, if there are problems or complications during childbirth. Treatment can be given more quickly if the mother’s position is not in water, aka she is not undergoing a water birth.
Meanwhile, if suddenly a caesarean section is needed immediately while your body is in the water, it usually takes around 4-5 minutes to remove it. So, water birth may take longer to provide immediate relief for the mother and baby. On the other hand, the American College of Obstetricians and Gynecologists also says that giving birth in water has not been scientifically proven to provide benefits for mother and baby.

Conditions that do not allow giving birth using the water birth method

Not all pregnant women can give birth in water (water birth). This is because water birth can pose fatal risks for the mother and baby if it is not carried out with the correct procedure. Giving birth in water has its own risks for the mother and fetus, as also explained by the American Pregnancy Association. Therefore, to reduce the risk of water birth, pregnant women are required to be in good and healthy condition.

The following are several maternal conditions for which it is not recommended to use the water birth method:

Having pregnancy complications, such as gestational hypertension, preeclampsia and gestational diabetes.
Age under 17 years or over 35 years.
Are pregnant with twins, triplets or more.
The baby is too big.
Giving birth prematurely or being born prematurely because the baby needs special care if it is born prematurely.
Have had a history of caesarean section or difficulty during previous births.
The baby was in a breech position so a caesarean section was needed.
Mother has an infectious disease.
Mother has a fever of more than 39 degrees Celsius.
Excessive vaginal bleeding.
Difficulty tracking the baby’s heartbeat.
Have you ever experienced dystocia or obstructed labor? This is because the baby’s head is outside the vagina, but one of the shoulders is still inside during the previous birth.

Basically, giving birth in water is only recommended for gestational ages between 37-41 weeks and the baby’s head is down.

Risks arising from the water birth method

Giving birth in water has some risks for the baby. Babies who experience stress during the process of giving birth in water or water birth can have difficulty breathing smoothly. This condition can cause serious complications in the baby’s breathing, such as meconium aspiration. Meconium aspiration occurs when the baby inhales meconium (the baby’s first stool) in the amniotic fluid during the birth process.

Here are some of the risks of giving birth in water (waterbirth) for babies:

The baby is having seizures.
The baby’s umbilical cord was damaged when he was lifted to the surface of the water.
Baby has difficulty breathing.
The baby’s body temperature becomes too high or too low.

Even though it is rare, babies born in water are at risk of experiencing certain infections and diseases. One example is Legionnaires’ disease due to inhaling water droplets containing Legionella bacteria. Legionnaires’ disease in babies of mothers who give birth in water can become severe or even fatal.

Preparations that need to be made before giving birth in water (Water Birth)

Before undergoing a water birth, there are several things that mothers may have to do to ensure the process runs smoothly, namely:

Consult a doctor or midwife first.
Make sure the condition of the mother and fetus is truly capable of carrying out a water birth. If possible, then look for a doctor or midwife who can help the mother give birth in water. Because, not all doctors or midwives may be willing because they don’t have previous experience.
Determine the place where the water birth will take place.
If in a hospital, the mother must look for a hospital that can provide facilities for water birth (for example, a water tank for giving birth). If you want to have a water birth at home accompanied by a qualified obstetrician, midwife or medical team, the mother of course has to provide various things.
The things that mothers must prepare if they want to have a water birth or give birth at home are as follows:

- A tub or pool of water for giving birth.
  Choose a water tub that is large enough for the mother to sit comfortably and deep enough so that the water reaches the mother’s armpits when sitting in the tub. Make sure the water tank is cleaned before the mother uses it to give birth. Mothers can use plastic children’s swimming pools which are usually quite large.
- Water source to fill into the tub.
  The water used for the birthing process must be completely clean from germs and have a temperature of 35-38 degrees Celsius. The water used must be warm according to the mother’s wishes so that the mother feels comfortable in the tub. Mothers can get this warm water directly from the tap at home, connected to the tub via a hose. Another way to give birth in water can also be done by boiling water first until it reaches the desired warmth and then filling it into a tub. Mothers may need to add a cup of salt to the water bath to prevent the skin from becoming wrinkled when staying in the water for a long time.
- Determine the room to be used.
  Choose a room that is large enough so that the water tank can fit inside. Also choose a room with a cool temperature, not too hot or too cold so that the mother is comfortable. Make sure the floor in the room is strong enough to withstand the weight of a fully filled water tank.
- Do a simulation before starting.
  Try doing a simulation starting from preparing the tub, to filling the tub with warm water. This method aims to enable mothers to determine how long it takes to prepare before the process of giving birth in water begins.

In essence, for every birth method chosen, you must still consult with a trusted doctor or midwife. So that all processes run smoothly, safely and the mother and baby are healthy and safe.