Water birth: the basics

Water birth
Water birth 

What is a water birth?
A water birth is when a woman gives birth to a baby when submerged in water (usually in a birthing pool or tub). A certified doctor or midwife should supervise a water birth, and must be present the entire time a woman is labouring in water.

With proper medical attention, water birth is a legitimate and safe way for women to give birth because babies are born with an innate impulse, called the “dive reflex” that stops water from entering the airways. The dive reflex is only interrupted and there is only a chance of water inhalation if the newborn baby is not fully submerged in the water when delivered. So the decision must be made ahead of time, whether to give birth in the water or to simply labour in the water and then give birth outside the tub.

Soap, essential oils or bath salts should not be added to the water of a birthing tub as the environment should be kept very sanitary. If a woman needs to have a bowel motion at some point throughout labour, the waste will be removed by the professional overseeing the water birth. If this is done and birthing tubs (including drain pumps, hoses, filter nets and jets) are cleaned according to strict hospital hygiene standards, the risk of infection is very low.

Water temperature should be warm, and the room with the birthing pool or tub should be well-ventilated. A good guide is to keep the water between 32 and 37 degrees Celcius. Any higher than this and the temperature of the mother may get too high, which can result in unusual patterns in the baby’s heart rate.

What are the benefits of a water birth?
Because there have been very few studies on water birth, the personal experiences of mothers who have had water births and the medical opinions of people who are trained and experienced in water births, account for the majority of the feedback on what the advantages are of giving birth in water.

- Many experts believe that a water birth is an effective way for a woman to manage pain while in labour, both for the lower back and abdomen pain that is experienced due to contractions, and for vaginal pain because waters softens the skin around the perenium, which greatly reduces the amount of pressure on the pelvic floor as the muscles are stretched taut, and consequently decreasing the possibility for tearing and episiotomy.

- For women who are seeking a more natural delivery, deciding in favour of a water birth helps them stay strong during the extremely painful stages of labour, rather than asking for drugs, because there is less pain and because using pethidine or an epidural during a water birth is not usually permitted. The process is seen to be as more “natural” and not as a medical intrusion, and generally an IV or saline drip is not inserted. However some hospitals and birthing centres allow mothers to use gas and air during water birth to cope with pain.

- Because being immersed in water mimics the sensation of being in the amniotic sac in the womb, babies that are born by water birth are said to be calmer and less prone to sensory overload.

- Water birth encourages the release of hormones such as oxytocin, endorphins and vasopressin, which make it an ideal birth method for women who are anxious about childbirth and pain.

- The loss of gravity in water is said to enable a woman to be more in tune with contractions and contort her body in a way that helps the baby descend efficiently.

- Because warm water promotes good blood circulation and oxygenation to the uterine muscles, a baby is less likely to suffer from a lack of oxygen, which without improvement, can require an immediate vacuum extractor, forceps or caesarean delivery.  In this way, water birth is said to make it easier to have a healthier baby.

When is a water birth not recommended?
Certain complications during labour may require a water birth to be abandoned in the best interests of the mother and the baby, so other practices can be employed to deliver the baby safely. These complications include bleeding, foetal distress seen through heart rate monitoring, excessively prolonged labour, abnormal presentation such as breech or tranverse positions, high blood pressure, shoulder dystocia, premature birth, the presence of meconium (which is actually your baby’s first stool) in the birthing pool which necessitates suction if it impairs the baby’s oxygen supply, or if oxygen flow to the placenta is obstructed in any other way.

Water birth can slow down the progression of labour in some cases, due to the therapeutic effect of being in the water that leads to a hormonal response in a woman that reduces uterine contractions. To prevent this from happening many midwives suggest that waiting until the active phase of the first stage of labour when the cervix has dilated to at least five centimetres, to get into the water. If this does happen during labour, spending some time out of the birthing pool may help to speed things up again.

Many medical professionals also prefer a mother to get out of a bath or birthing pool for the third stage of labour when the placenta is delivered in order to better monitor blood loss and be able to act quickly if there are any problems.

Where can I have a water birth in Australia?
Here is a list of the hospitals and birthing centres in Australia that currently offer water births to expectant mothers or allow women to labour in water (although actual delivery in water may not be permitted):

ACT
Calvary Public Hospital
Haydon Drive
Bruce
(02) 6201-6111

Canberra Hospital (Birth Centre)
Yamba Drive
Garran
(02) 6244-222

NT
Royal Darwin Hospital
Rocklands Drive
Tiwi
(08) 8922-888

Darwin Private Hospital
Rocklands Drive
Tiwi
(08) 8920-6011

NSW
Royal Prince Alfred Hospital (Birth Centre)
Missenden Rd
Camperdown
(02) 9515-6111

Royal Hospital for Women (Birth Centre)
Barker St
Randwick
(02) 9382-6111

St George Hospital (Birth Centre)
1 South Street
Kogarah
(02) 9113-1111

Camden Hospital (Birth Centre)
Menangle Rd
Camden
(02) 4364-3000

Liverpool Hospital
Elizabeth St
Liverpool
(02) 9828-3000

Royal North Shore Hospital (Birth Centre)
Pacific Highway
St Leonards
(02) 9926-7111

Ryde Hospital (Birth Centre)
Denistone Rd
Eastwood
(02) 9858-7549

John Hunter Hospital
Lookout Rd
New Lambton
(02) 4921-3000

Wyong Hospital (Birth Centre)
Pacific Highway
Wyong
(02) 4394-8000

QLD
Mackay Base Hospital
475 Bridge Rd
Mackay
(07) 4968-6000

Gold Coast Hospital
108 Nerang St
Southport
(07) 5598-9000

Townsville Hospital (Birth Centre)
100 Angus Smith Drive
Douglas
(07) 4796-1111

VIC
Geelong Hospital
Ryrie St
Geelong
(03) 5226-7111

SA
Women and Children’s Hospital (Birth Centre)
72 King William Rd
North Adelaide
(08) 8161-7000

Mount Gambier & District Health Services (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Wehl St
Mount Gambier
(08) 8721-1200

TAS

Launceston General Hospital
Charles St
Launceston
(03) 6348-7792

Calvary Hospital (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
49 Augusta Rd
Lenah Valley
(03) 6278-3333

Hobart Private Hospital (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Argyle St
Hobart
(03) 6214-3000

VIC

Monash Birth Centre
246 Clayton Rd
Clayton
(03) 9594-6666

Barwon Health-Geelong Hospital
Ryrie St
Geelong
(03) 5226-7111

The Bays Hospital (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Vale St
Mornington
(03) 5975-2009

Latrobe Regional Hospital (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Princess Highway
Traralgon
(03) 5173-8000

Mercy Hospital for Women (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
163 Studley Rd
Heidelberg
(03) 8458-4444

WA

King Edward Memorial Hospital for Women
347 Bagot Rd
Subiaco
(08) 9340-1800

Mercy Hospital Mount Lawley (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Thirlmere Rd
Mount Lawley
(08) 9370-9222

Kalgoorlie Regional Hospital (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Piccadilly St
Kalgoorlie
(08) 9690-1300

Albany Regional Hospital (Women are able to labour in water but must be out of a pool or bath when actually giving birth)
Warden Ave
Albany
(08) 9892-2222

Discuss water births in the EB birth forums.

Water birth encourages the release of hormones such as oxytocin, endorphins and vasopressin, which make it an ideal birth method for women who are anxious about childbirth and pain.