Saturday, April 7, 2012

You Think You Want a Water Birth?

In order to consider a water birth, you must first find a provider and a facility that is prepared to offer that to you. You will be asked to sign a consent similar to all the other consents stating that you have been informed of the risks. You must be attended at all times by a reliable adult while you are actually in the tub. Before entering the tub, you will be monitored for about twenty minutes to achieve a reactive strip ( three accelerations meeting standards ). Then fetal and maternal vital signs will be intermittently reassessed. Not doulas nor dads are allowed to make any decisions about when the tub is appropriate; only your provider makes that decision. And you will be asked to agree to all directions given to you by the the provider, including exiting the tub.

You must be aware that there are contraindications that will disqualify you from this experience such as prematurity, significant bleeding, hypertension, diabetes, kidney failure, maternal infection, active genital herpes, HIV, hep B antigen, positive hep C antibody, any abnormality during monitoring ( fetal distress ) or any condition ( such as meconium, pitocin ) that requires continual monitoring. The list continues: multiples, high risk pregnancy, large baby, VBAC, malpresentation, narcotic use for analgesia during labor and delivery, epidural and most importantly, anything that the provider considers disqualifying at any time, at her discretion.

What  might you hope or wish for while considering a water birth? A staff that accepts your preferences in a professional and caring  manner. Contaminated water will be bailed.  Use of doplar after every contraction. Baby immediately surfaced. Help exiting tub and delivery of placenta in bed. Immediate inspection and necessary repair of perineum. A shower soon after that. Immediate bonding for dad.

So how does one decide after meeting all the qualifications for water birth, that this is indeed your wish? There are purported benefits for the baby: a more natural transition from amniotic fluid into water, familiar environment ( dark and warm ), perhaps less birth trauma, And maternal benefits: warmth, comfort, constant support, ease of movement, perineal support, reduced sensory stimulation, increased relaxation, vasodilation = effective oxytocin release which is supposed to mean fewer contractions.

And what might be considered risks? Difficulty in monitoring fetal well-being and labor progress, difficulty  in intercession with intrapartum complications, increased risk of fetal aspiration ( slippery baby ),  increased risk of infant infection, difficult infant temperature regulation, APGAR scores will be delayed if baby is born underwater.

I say welcome to parenthood a lot, don't I? Well, I am saying it again.  If you wish for a water birth, if you meet the qualifications, if you understand the risks, then you get to decide if you want to try for a water birth. Remember that hopes and wishes are just that. Every labor and delivery is different and ultimately it's what happens in the moment that will encourage your provider to proceed or change the plan. But you have to know all about water birth before you can make an informed choice. I hope this helps.