birthing in water

We have been back in university for about 6 weeks now, working through two modules; Critical Appraisal and Normal Midwifery. I think I speak for many people in my class when I say Critical Appraisal is less than thrilling and it has been a struggle to learn new terminology, and at times I personally have thought ‘why do I need to know this to be a midwife?’ Sadly, I don’t think I have an answer to that question yet! However, this week during our ‘Normal Midwifery’ module, we had a whole day focusing on hypnobirthing and waterbirth. Focusing on waterbirth made me think about my own experiences of caring for a woman water birthing, which reminded me how when I witnessed this birth I just went round saying ‘this woman was amazing, she just breathed her baby out!’ Before I discuss this further, I think it is only right to look at some of the benefits of water birthing for all women;

Birthing pools were introduced into UK hospitals in the 1980’s, this decision was influenced by Michel Odent who worked in a French hospital. Michel Odent produced groundbreaking research on birthing in water, which was published in the Lancet. This research is still publicly regarded as a seminal moment in time, that changed possibilities for women’s birthing experience forever.

Being in water can make some women feel safe and secure, as the pool provides a private space. What I think is especially lovely is when partners wish to be in the pool with the woman, this makes the space their own. The midwife becomes an observer, listening into the baby’s heart rate and just being present, just in case the woman needs her. When women are using the pool the lights are generally down low, which creates a serene atmosphere. The warm water can be an excellent form of pain relief for some women and equally a lovely environment for the baby to be born into, as it mimics the amniotic sac. This is why some water born babies don’t cry initially, instead just adapting gradually to extrauterine life.

The birthing pool gives opportunity to remain active in labour rather than laying semi-recumbent. Being active has huge benefits for the labour process, especially remaining active in early labour, this can shorten the overall labour time. The topic of perineal trauma has been widely discussed regarding women who birth in water, with some researchers suggesting positive and negative elements. However, Walsh (2012) suggests birthing in water reduces the risk of perineal trauma and women are less likely to have an episiotomy. Birthing in water means the midwife is providing a ‘hands-off’ technique, in other words; not guarding the perineum. Instead the woman is in control, remaining upright and spontaneously pushing when she has the urge. How empowering this must be for women, to be completely in control over her own birth and just be listening to her body when it tells her what to do… WOW!!!

The woman I cared for was having her first baby, she did not go into the pool right away, she spent some time pacing around the room breathing through contractions but she appeared slightly uncomfortable as time went on. My mentor and I suggested that she try the pool as it might offer her respite and take the pressure off of her lower back. As soon as she got in the pool we could see that the water just took the weight off her back and seemed to calm her down and put her back in control. Her partner was present and was such lovely support for her, there was so much love in the room, it was hard not to just smile constantly with all the oxytocin flying about, after all it is the love hormone!

The woman was so amazing at just breathing calmly through her contractions, they were coming every 3 minutes by this point and were lasting just over a minute. I was not at all surprised after an hour of being in the pool when she said she had the urge to bare down… I was not surprised when she just carried on listening to her body and focused on her breathing to the point when she birthed the baby’s head without realising… When we said ‘you are doing amazing your baby's head is out’ she then screamed, which shocked us all as she had been so quiet. She screamed because she did not realise she had gently breathed the baby’s head out. We refocused her and she continued to breath until her next contraction when she birthed her baby into the water, just by breathing… Magical! Her partner was so very proud of her and smothered her and the baby with kisses, she stayed in the pool keeping her baby close to her. There was no rush to exit the pool, instead just keeping that lovely calm environment for the baby to gradually adapt to life outside of the womb.

Like so many of the experiences I have been privileged to witness, this is one I wont forget, especially when we are all studying our next module ‘High Risk’... This simply reminds me that birth is a natural process, it is not one to fear and it can be without complication. You just have to believe in yourself and your body...

We spoke about a randomised control trial regarding water-birth in class this week and watched this video: https://www.youtube.com/watch?v=dXto6Zxg0Qs&has_verified=1

From the award winning childbirth documentary "Waterbirth in the 21st Century" - filmed with Dr. Herman Ponette at the Henri Serruys Hospital, Ostend, Belgium

Women birthed in a clear pool, it is graphic but absolutely amazing to see what birth looks like in water. Something we all found amazing about it, is how the water is so very clear, no blood. It reminded me of the waterbirth I had seen...lovely clear water.

Thanks for reading everyone

Love love to you all

JP

x

You can read more about Michel Odent here: http://activebirthpools.com/birth-water-michel-odent-2/

And the book by Dennis Walsh (2012) I mentioned is called 'Evidence and skills for normal labour and birth: a guide for midwives' Page: 143 for waterbirth related information.