Over the last few decades there has been increasing interest in using immersion in water for labour and birth. There are always two sides to any argument. The enthusiasts report a reduced need for maternal analgesia, reduced vaginal and perineal trauma and reduced labour time. The skeptics argue that there is increased risk of infection to both mother and baby and also a risk of water inhalation for the baby. So what does the research say?
The Cochrane Library is a collection of systematic reviews of many randomized controlled trials all over the world, on varying topics. What this means is that a bunch of independent professionals within the field being examined, look at all the research available and draw conclusions on a certain topic. This often shapes or changes clinical practice to bring about quality improvements. Their catch phrase is “Independent high-quality evidence for health care decision making”.
The Cochrane Library has a review entitled “Immersion in water in labour and birth” that was published in 2009 (It’s important for research to be current, anything older than 10 years old really needs to be revisited). This is the conclusion summary that was made by the Cochrane Pregnancy and Childbirth Group:
Immersion in water during the first stage of labour significantly reduces women’s perception of pain and use of epidural/spinal analgesia. Eleven trials were of an adequate quality to include in this review. Of these, six reported that water immersion during the first stage of labour significantly reduced epidural/spinal analgesia requirements, without adversely affecting labour duration, operative delivery rates, or neonatal wellbeing. One study showed that immersion in water during the second stage of labour increased women’s reported satisfaction with pushing. Further research is needed to assess the effect of immersion in water on neonatal and maternal morbidity. No trials could be located that assessed the immersion of women in water during the third stage of labour, or evaluating different types of pool/bath.
So to me, it’s pretty clear – do what feels right for you. There is no conclusive evidence to say waterbirth is harmful to you or bub (hopefully future research will only reinforce and not change this). Of course, hygiene is very important. Always disinfect the the pool or bath thoroughly between uses and fill with fresh water when in labour. There have been some cases (nearly 20 years ago) of a few babies contracting legionella diseases (some fatal) from being born in spas that are kept full and warm 24 hrs a day and only cleaned between births with filters and chemicals. This is not particularly a problem in Australia (unless you are planning on birthing at home in a constantly warm spa), as I am unaware of any hospitals or birth centers that have one of these type of pools.
It will depend on the hospital that you go to, as to whether you will be able to labour and/or birth in water. If waterbirth is something you’re interested in, here are some questions to ask your preferred hospital:
1) Am I allowed to labour/birth in water?
2) Do you have a birth pool in every room?
3) Is there any circumstances where a woman would not be allowed to labour or birth in water?
4) Are all midwives/doctors accredited to do waterbirth?
If you aren’t happy with the answers, look elsewhere! Homebirth is also an option, if you would like to birth in water. If there are no publicly funded homebirth programs in your area, try looking for an independent midwife. Independent midwives cost money but some are now Medicare eligible. Midwives will sometimes offer birth pools for hire for homebirths. If they do not offer pools to hire, then have a look at the following websites where you can hire or buy one for yourself (to buy, they range from around $200 up to $800 for a professional repeated use tub with pump and other extras):
During my first birth I absolutely loved the birth pool (I used the smaller La Bassine “made in water” birth pool). It was the most fantastic pain relief. It was so comfortable and I could move around freely. Although I didn’t birth in there, I was ecstatic to have labored in water. For my second birth I only just made it into the pool and bub was born 9 minutes later! But those 9 minutes were heaven! I loved the buoyancy and relief.
So all I can say is, try it!!!