Choosing Waterbirth: Reclaiming the Sacred Power of Birth (5 page)

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I watched this phenomenon with my first baby's birth. He was so quiet and wideeyed; you could feel his curiosity as he looked around. That moment to me was like no other. I felt as though I were looking into the midnight sky, his little eyes were that vast. I couldn't imagine sacrificing that moment for anything, short of something needed to maintain the baby's life. It was too moving, precious, and wonderful.

This is the benefit of waterbirth for a baby—a kind, loving, and gentle entry into this world.

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Chapter 7—

Waterbirth Explained

Birth is termed waterbirth when the lower portion of the laboring woman is immersed in water during the delivery stage of her labor, allowing her baby to be born directly into the water. Water labor is when a woman remains immersed for the duration of her labor, then exits the tub prior to actual delivery. Both water labor and waterbirth offer advantages for the mother, but only waterbirth offers the advantage of a gentler entry for the baby.

In most cases, regular tap water is used to fill the birthing tub. Early on, salt was added to the water in order to more closely mirror the amniotic fluid, and to add a sanitizing effect. This was found to be unnecessary, and today is no longer common practice. The water temperature is kept at approximately ninetyeight degrees, which is body temperature.

In a waterbirth, it is generally recommended that the laboring woman not enter the tub until her active phase of labor, when her cervix has dilated beyond four centimeters and her contractions are coming regularly. Getting in before this can slow the labor down instead of facilitating it. This is not a hard and fast rule, but a general practice that can be used as a guideline in determining when to begin filling the birthing tub.

Once the woman has entered the tub, she may remain in the water for the duration of her labor or she may get in and out according to her inclination. A woman may exit the tub if her labor slows down even though she is well into the active

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phase, which sometimes happens. Getting out and walking around or squatting at this time may help to make her contractions stronger or more regular. She will also get out to allow the practitioner to check her cervix for dilation, or to use the bathroom. Some women spontaneously get out of the tub immediately before the baby is born. Other women plan to get out and never do. Rarely will a woman be able to predict exactly how and what she will be feeling when the moment of birth comes.

Planning for both these possibilities is a good idea.

Fathers or other birth helpers may also want to get in the tub. Whether or not you are interested in doing this is something to consider when you are selecting a tub, which I will go into later in this chapter in greater detail. If the father or birth helper is planning to get into the tub with you, they should shower or bathe first. There have been no known incidences of infection in babies born in water to date, but it never hurts to be careful.

Once the baby is born, either the mother, the father, or the birth attendant will bring the baby up to the surface to breathe. It is not necessary to rush the baby to the surface once it has been born. It will still be receiving oxygen from the mother as long as there is blood flowing through the umbilical cord (this can be felt as a rhythmic pulsing when the cord is held between the thumb and forefinger), but you do want to bring the baby up fairly quickly. There have been cases where a baby was kept under water for up to fifteen minutes, while the umbilical cord was still pulsing, with no negative effects. This has been the exception, not the rule. The general consensus is that the baby should be brought immediately to the surface once it has been born, gently lifted and placed on the mother's chest.

After the birth, the mother and baby may remain in the water for as long as they like. This is nice, as the babies seem to enjoy stretching out and relaxing in the wider space.

The placenta, or afterbirth, which will come out anywhere from a few minutes to a half an hour after the baby is born, Page 28

can either be birthed directly into the water, or into a container while the woman remains standing in the water, or the woman may exit the tub first and birth the placenta once she is out. This is simply a matter of preference.

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Chapter 8—

Making It Happen

Any woman having a normal, healthy pregnancy and not considered a high risk is a good candidate for waterbirth. Abnormal conditions such as prematurity, which results when true labor begins before the thirtyseventh week; abnormal presentations such as a footling breech where the baby's foot is presenting first; and complications with the placenta, or with the delivery itself, which require medical intervention—these are a few of the conditions that contraindicate water labor and waterbirth. Disease or illness of the mother, specific to or independent of her pregnancy, or of the baby, which require careful medical supervision, also contraindicate waterbirth.

If your pregnancy has progressed normally and healthily and you decide that waterbirth is for you, you will be happy to know it is becoming much easier to locate a practitioner and to secure a tub. There are currently over 600 practicing doctors, nurses, midwives, and nursemidwives worldwide who are qualified to help you with your waterbirth. To find out who attends waterbirths in your area, contact Karil Daniels (Point of View Productions, 2477 Folsom Street, San Francisco, CA 94110, phone: 4158210435, email: [email protected]). She keeps a resource list of all the people who attend waterbirths in the U.S. and abroad. She will charge you a minimal fee for either the entire list, or to search for someone in your area.

Home waterbirths are still much more accessible than birth center or hospital waterbirths as the home birth community Page 30

has been actively implementing the use of tubs of water for labor and delivery. However, new birth centers are cropping up all over, and even a few hospitals are starting to provide tubs for women to labor in, though they still balk at actual delivery in a tub.

If having immediate medical support close at hand is important to you, you may find that you have to travel to make your dream of waterbirth a reality. I gave birth to my first four children at home, fortyfive miles from the nearest hospital. All four pregnancies had been healthy and without complications so I felt comfortable with my decision. During the early part of my fifth pregnancy, complications arose which, though not serious, were worrisome enough for me to opt to deliver my baby in a birth center where I knew medical assistance was immediately available should I, or my baby, need it.

I was fortunate in having a birth center fifty miles from where I live, which meant I only had to travel during labor, but did not have to stay in the town until the baby was born. Other women I know have left their homes, and in some cases, their countries in order to be able to give birth in water. Consult Karil Daniel's list to find out where the nearest birth center or hospital offering waterbirth is. Once you have that information, you can decide whether or not having a waterbirth is important enough to you to travel for the birth.

If you choose to birth at home, it will be easier to implement, but will still present some challenges. The first will be finding an experienced practitioner to be present at your birth. There is no substitute for a good, qualified practitioner, as she can spot trouble before it becomes serious. Unfortunately, midwifery is still outlawed in some states. If you live in one of these states, travel may again have to be part of your agenda.

Another thing to remember when considering where and how you will birth your baby is that birth is unpredictable. Medical knowledge that is used to screen out abnormalities, coupled with good prenatal care, has allowed for a giant leap in making birth safer for mother and baby. But birth still Page 31

carries some risk. Having your baby at home does not specifically put you or your baby at greater risk. The infant mortality rates remain the same, or are slightly lower for a planned home birth than a hospital birth. However, if you are in the hospital, and an emergency should arise, the facilities are immediately available to cope with the problem.

Your second challenge when planning a home birth is securing a suitable tub, which, again, is not as difficult as it was eleven years ago when I had my first baby. We got around our tub difficulty by going to the local feed store and trying out the watering troughs until we found one that would work. Providing good depth at three and a half feet deep, with plenty of room at two and a half feet wide and five and a half feet long, it was not the most aesthetically pleasing tub, but it did do the trick. Being made of fiberglass, our tub also had insulation value, which was important in trying to keep the water temperature constant.

You can find tubs online both for sale and to rent at Aquadoula, P.O. Box 1132, 110 9th Ave. S., Edmonds, WA 98020; website: www.aquadoula.com; phone: 8882172229; email: [email protected]. To rent a tub will cost a couple hundred dollars; to purchase it will cost around a thousand dollars.

It is a good idea to check out what actual birthing tubs are available, but you should not limit yourself to only that. Waterbirth, like all birth, allows for a lot of variation.

I know of women who have given birth in bathtubs, kiddy pools, portable spas, traditional Jacuzzi tubs, tubs specially made for birthing, and even in the warm waters of the ocean and the much cooler waters of the Black Sea. So long as the tub you select is deep enough to cover your abdomen and roomy enough for you and whomever you may wish to have with you to stretch out and move around in, you should be able to enjoy the benefits of laboring and delivering in water. Your tub should be clean, and preferably not have been used for anything else, with the exceptions being a bath or Jacuzzi tub, which can be thoroughly cleaned prior to the birth.

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Where you put your tub is also an important consideration. It is not often that you will have eighty or a hundred gallons of water all in one place. Before you decide where to put your tub, you will have to check to see which part of your flooring will support its weight. Prior to our first baby's birth, Nilakantan crawled under the floor and reinforced the floorboards to make certain the floor would hold the weight.

Another consideration for placement is the water itself. If possible, you should place your tub on linoleum or concrete to prevent the water, which will invariably be tracked out during the birth, from ruining your carpet or wood flooring. An alternative would be to lay a large plastic drop cloth, which can be found at your local hardware or paint store, over the floor to catch the water and protect the wood or carpet.

You also need to make sure you have a clean hose, preferably new, with which to fill and empty the tub. A hose adapter, also available from a hardware store, will allow you to hook your hose directly up to your kitchen sink. You should practice filling and emptying your tub a few times before the actual birth. This will let you know how long it will take to fill, how long the water temperature will hold before you need to add more hot water, and will give you a few trial runs to discover unforeseen problems and deal with them before the birthing event.

Drain your tub by siphoning, or through an existing drain, into a bathtub or shower or, if you live in the country, you can run the water out into the yard. Your tub can then be cleaned and stored for future use, or sent back if it was a rental.

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Chapter 9—

Birth Basics

Every woman's body knows how to give birth, and left to itself, in the majority of cases, would do so without trouble. But not every woman knows or believes this and this selfdoubt is often what causes women to be apprehensive and fearful of birth. Making yourself familiar with the nature of birth, and the actual process your body goes through, can help to alleviate these feelings.

The first thing to learn about birth is that it is variable. Just as no two snowflakes are exactly alike, no two births will be either. Don't expect your birth to follow the textbook description as an exact, orderly event. Books about birth were written after taking many births into account and averaging the outcomes. You can apply them to your birth in a general sense, but don't expect your experience to mirror them exactly. Remembering this will help you to feel less anxious when what is happening within your body does not duplicate what you read in a book.

The second thing to learn about birth is that it is a natural and normal process. It is not an illness or a condition that automatically requires medical intervention. Your body is able to give birth just as it is able to pump blood, breathe air, or digest food. These processes are automatic, yet are often affected by other things, like what we do or how we feel. When we are under physical or emotional stress, our heart rate and our rate of respiration go up, while our rate of digestion goes down.

Learning to relax and let go of tension at

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these times does not make these processes work, but it does allow them to work better. Childbirth is like this. There are many things you can do to aid your body in giving birth more easily, even though inherently every woman's body can birth a baby.

The third thing to learn about birth is the actual process. This will allow you to understand what is going on in your body, and this can help you to be more accepting of the physical experience.

Birth is broken into three stages. First, during the dilation stage, your uterus begins the rhythmic tightening and releasing—contractions—that result in the thinning and opening of your cervix, the opening at the base of the uterus that leads to the birth canal. Second, during the pushing stage, your baby is pushed by both the uterine and the abdominal muscles out the cervical opening, between the pelvic bones, down the birth canal, and out. Third, the placenta, which refers to the approximately two and a half pound organ developed during pregnancy for the sole purpose of supporting your baby in the womb, detaches from the sides of the uterus and is pushed out.