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Waterbirth: The Gentlest of Natural Births

As a midwife of longstanding, I truly believe that waterbirth is the single best thing to happen to natural birth! Not only does it provide women with an alternative method for pain relief, but it also provides them a sacred space to labor and deliver their babies.  Women are also much more likely to accomplish an unmedicated birth during waterbirth because water immersion decreases adrenaline while increasing endorphins and oxytocin, producing the perfect hormonal cocktail for the initiation of the most important bond a human will ever experience.

Best of all, women often report that even though they had people around them during their waterbirth, they felt completely alone to bond with their babies after the birth; this is nature at its finest.  Delivering in the water is a wonderful and fulfilling experience for both mother and baby.

How Safe Is Waterbirth?

In April 2014, waterbirth made national headlines when the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) released a joint opinion statement that questioned the safety of waterbirth. In their statement, they suggested that waterbirth should be treated as an experimental practice only occurring in the context of a clinical research study. Their conclusion was based on their opinion that waterbirth does not offer benefits and may pose risks for the newborn.

In response to the statement, the American College of Nurse Midwives (ACNM), the American Association of Birth Centers (AABC), and the Royal College of Midwives (RCM) released statements endorsing waterbirth as a safe, evidence-based option. Additionally, the AABC released preliminary data from nearly 4,000 waterbirths from birth centers all over the United States, supporting waterbirth as safe for mothers and their babies.

When waterbirth is offered within proven guidelines, it is safe.  My practice has offered waterbirth since the year 2000 without any complications directly related to the birth being in the water. More than 1,000 beautiful, healthy waterbabies later, we have living proof that waterbirth is safe.

Just as there are with dry births, there are normal childbirth complications during waterbirth, but they have been successfully managed. In fact, waterbirth has been found to decrease the transmission of Group B strep, which has been known to lead to pneumonia in newborns.  An article published by Cohain looks at the studies included in a Cochrane review of immersion in water during labor and birth (Cluett et al). Cohain states: “The (Cochrane review) literature provides a single case of early onset newborn Group B Strep (GBS) among 4,432 waterbirths, suggesting that low-risk women who give birth in water may have a far lower rate of newborn GBS than women who have a dry birth. The last reported rate of newborn GBS for dry births was 1 in 1,450.”

The 2006 joint statement from the Royal College of Midwives, “Immersion in Water During Labour and Birth,” states that “All healthy women with uncomplicated pregnancies at term should have the option of water birth available to them and should be able to proceed to a water birth if they wish.”

Benefits of Waterbirth

Waterbirth has been found to benefit both mother and baby in a number of ways.

For Mom

  • Buoyancy of water improves a woman’s ability to move around and change positions in labor. Water immersion also decreases energy expenditure for the mother.
  • The tub creates a safe place for the mother to labor, where she feels “held,” warm, and supported.
  • There is a significant decrease in pain.  Women are more focused and have greater control of their labor.
  • Waterbirth has been found to decrease blood pressure and stress hormones while elevating endorphins and oxytocin.  Because of this hormonal shift, labor progresses more efficiently with less discomfort to the mother.
  • There are more controlled deliveries.  Mothers are able to hold their babies on the perineum more easily to allow stretching and decrease trauma to the vulva.  They feel less pain and pressure and so are less out of control themselves as the baby delivers.

For Baby

  • Waterbirths offer a gentle entrance into the world directly into Mommy and Daddy’s arms.
  • They subject the baby to less medicine because the mother is better able to tolerate the pain of her labor.
  • A huge dose of oxytocin from the natural birth assists in wiring the baby’s brain to connect emotionally with others.
  • Naturally born babies breastfeed instinctively.
  • Waterbirth fosters in mothers an ecstatic state that leads to deeper bonding with their baby, children and partner.

For the World:

  • These births creates mothers who are strong and confident in their ability to mother.
  • They provide the optimal circumstances from the start of life for children to learn about love and to form intimate relationships.
  • Waterbirths deepen family relationships.
  • This method of birthing decreases costs to the healthcare system by lessening intervention in labor and birth that can lead to complications.

Lisa Lederer, CNM, IBLCE, became a midwife after the VBAC birth of her second daughter in a midwife-owned birth center. She graduated with Roxann Mitchell from the University of Medicine and Dentistry in 1994. Lisa worked for four years in birth centers then joined Roxie Mitchell and Cindy Redmond at Hackettstown Regional Medical Center. Lisa, along with Roxie and Cindy, established The Midwives of New Jersey in 2007, which became an independent practice in December 2010. Lisa has been married to her husband, Warren, for 26 years, and the couple has four daughters.

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