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Posts Tagged ‘birth pool’

Waterbirth, what a birth!

Tuesday, April 5th, 2011

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):

Simply Birth

Birth Affloat

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!!!

Birth pool

Bigger than it looks, Patrick and I both fitted inside!

My birthing experience: Part 2 (Warning: Graphic)

Sunday, March 20th, 2011

Leading up to the birth of my second baby, I felt more nervous and anxious than first time round. I had very mixed emotions about my first labour and birth. My hopes and dreams of a beautiful, normal, homebirth had been shattered. But, I had been fortunate enough to be transferred to a place where I felt comfortable and I was able to have a vaginal birth, albeit not completely normal (see my previous post for the full story).

I thought about it a lot, and I still could not imagine labouring and birthing anywhere but my home. It’s where I feel comfortable. It’s where my family dwell. Everything I love is there. I can be myself. So with much trepidation and nervousness I booked in once again to the St George Hospital homebirth program.

I was very blessed that my good friend and midwifery mentor and legend was able to be my caseload midwife. The same midwife that had assisted me to bring Levi into the world. It was so special and important to me that she be my midwife again. We did and still do have such a strong connection, that had only been made stronger by my first birthing experience. She understood my devastation and grief for not having achieved my homebirth goal. We had worked through it together for the last one and a half years.

While I was pregnant I did a lot of extra brainwork to ensure I would be able to manage, cope and stay calm even if the same outcome happened. This included yoga, deep breathing and relaxation, reading through the ‘Calmbirth’ course notes and seeing a psychologist to work through the reasons things didn’t go to plan. I feel like I really missed out on vital information by not doing these things during my first pregnancy. First time round I had been ready physically by exercising and doing yoga, but I had not prepared my mind adequately for the challenges of unexpected outcomes. This time I made sure I was ready.

So… The whole pregnancy I had had a feeling I was having a girl, except for the very last week. The more overdue I was, the more convinced I became that the baby was a boy. Silly unproven theory I know, but I think the feeling was deeper than just guessing. I had not enjoyed being pregnant. Sciatica, tiredness and pubic symphysis dysfunction (pregnancy hormones cause loosening of ligaments, so pubic bones rub together, excruciating!). Not to mention the exhaustion of being pregnant while looking after a toddler. Hats off to anyone who’s done it. Although pregnancy wasn’t fun, I was bursting with excitement to meet my new baby. I was also even looking forward to seeing what this labour and birth would be like.

40+5 days and 40+5 degrees, or so it felt. It was Australia Day and it was stinking hot. I had been having mild period-like pain all day but didn’t think too much of it because I had felt like that a couple of times that week already. By lunchtime though, I was pretty sure I would be having a baby soon. Levi had an especially long sleep (I think he just knew I needed time to prepare myself and rest). At 4pm we went to a friends house for a swim to cool down. It was that hot that an almost labouring woman would venture out for some watery relief. When we got home at 6pm things really heated up. The waves came every 2-3 minutes, lasting about a minute, though I wasn’t really counting. I decided it was time to get the labour plan into action. So, I tried calling my mum to pick Levi up so she could put him to bed at her house and he wouldn’t have to be disturbed halfway through the night. She wouldn’t answer. I tried her mobile. I tried her home number. I tried dad’s mobile. NO ONE ANSWERED! I was getting a bit worried now. I called my brother (who still lives with my parents) and he told me they were at an Australia Day BBQ with friends. Great. I would have to ring their friend’s house and everyone would know I was in labour. The absolutely last thing I wanted. No one knowing = no expectations. But I got over it and finally got in contact with mum.

As mum was leaving with Levi she gave me a kiss and said that this might be an Australia Day baby after all. It was about 7:30pm. I laughed and said there was no way, as there were only a few hours left of Australia Day. I thought maybe by 6am or so I might meet this baby. As I was kissing my precious only child goodbye, I felt sad. It was more than just the normal “I’ll miss you” kind of sad. It was a loss of him being my only child, my precious gift, my special one. We would all have to make room in our lives and hearts for this new creation. So with an extra big hug and kiss, my mum and my world left.

I perked up quickly at the thought that I was in labour and feeling so fine. I was getting excited! I brought in the washing and tidied the bomb site that was our house, in between pacing up and down the corridor and deep breathing/blowing through contractions. I remember one particular contraction just after going to the bathroom, I was leaning on the sink and drawing figure eights with my hips. I smiled and spoke silently to my baby, “we’re doing well, we’ll do this together, can’t wait to meet you little one”.

2 hours before birth, still with a smile on my face

At 9pm I said to hubby that I just didn’t know when to call the midwife and my sister to come. I had no idea how I was progressing, this labour felt so different to last time. So he sat down next to me and timed my contractions. After about 45 minutes he announced that I was contracting for a minute every second minute (obviously not a midwife). So we decided to call in the troops. It was now 9:50pm. After he hung up the phone, I had a huge almighty contraction. I looked up at him and said “I don’t like this anymore”. The next wave came and I heard this loud deep earthy trembling roar. I realised only after the pain eased that the roar was coming from me! I was beginning to feel the need to push. OH MY GOODNESS! I can’t be at this stage already, it’s only been a few hours, my midwife’s not here, my sister’s not here and worst of all we haven’t even started filling the pool!

My sister arrived at 10pm- record time. She knew as soon as she walked in that it wouldn’t be long. She could hear that I was pushing through my breaths. She told me later, how she thought she and hubby were going to have to catch the baby by themselves. Meanwhile I was on my hands and knees on the floor and kept looking at the pool being filled agonisingly slowly. I kept yelling “The baby’s coming, hurry up, I can’t wait, is the pool ready yet?”. My midwife arrived at 10:10pm and later she told me she could feel the stress in the air, though everyone was very calm externally, they were happy and relieved to see her face. She called her backup midwife to come (there are always 2 midwives present for the birth in this program), but knew she wouldn’t make it because she had a minimum 40 minute drive to make.

Finally at 10:20pm the birth pool was full enough for me to get in. I had absolutely no strength in my legs and it took the help of both my sister and the midwife to awkwardly drag me into the pool (hubby was still busy filling the pool with buckets so it could be deeper as it was only just deeper than my hips). The water felt amazing. The buoyancy and coolness penetrating my skin and calming me further. I hadn’t imagined a cold bath. The water had been scorching hot with Levi’s birth, but this cool sensation felt just perfect for this birth.

My midwife whispered in my ear, “you don’t have to rush this, just take your time”. This was a great reminder and made me refocus and try and breathe the baby out rather than frantically pushing. This was different to last time as I had had to push with all my might because Levi had pooed and they were worried he might become distressed. So, on my hands and knees, trying to breathe through the contractions while every fibre of my being was screaming at me to push, resulted in my blowing some serious raspberries against the plastic wall of the pool. Why hadn’t anyone told me how helpful raspberry blowing could be? It was great!

I could feel myself opening up to allow this precious being to come further down. Again it felt different to last time. Now it was a stretching, opening, releasing, groaning of my body, rather than the unbearable pressure and pain from last time. My midwife said that the baby might be born in the caul (still in the bag of waters) but as she got ready with the amnihook (like a crochet needle to pop the bag) I felt my waters pop. Suddenly that stinging sensation was there again and before I could breathe I could feel a head and body slipping gently out of me and into the water. As my husband lifted the baby out of the water he said “it’s a boy”.

I was in disbelief. I started balling my eyes out. I quickly rolled over into a sitting position so I could meet my new little man. I couldn’t fathom the experience I had just been through. “I can’t believe it’s over, oh my goodness I’ve had a baby, he’s out, I’m finished, I can’t believe it”. He was stunningly perfect. His smooth skin still totally covered in vernix (waxy cream like coating to protect the skin during a baby’s development, not usually seen in overdue babies). Cradled in my husbands arms was beautiful creamy white, angel baby. A few minutes later I gave a gentle push and out came the placenta, almost no blood at all.

Adoring our gift

I had been impatient to hold this new creation, though felt too shaky and wanted to birth the placenta first. Once I had done this, I excitedly and with an abundance of tears, lovingly enfolded my beautiful baby boy into my arms. He was much bigger than I remember Levi being. He almost immediately started to suckle. We sat there together in the water, gazing into each others eyes, I soaked him in. That’s when the back up midwife arrived. She had missed the birth by about 10 minutes. It didn’t matter. I had been hugely blessed. I was restored. I once again had faith in my body’s ability to birth a baby safely and normally. I had even managed to have an Australia day baby when I thought it would be impossible to birth that quickly. The adventure of parenting two little boys had begun!

“Children are a heritage from the Lord, offspring a reward from him.”- Psalm 127: 3.