Water Birth
What is Water Birth?
water birthIt is one of the natural birth methods in which part of the labor or the moment of birth of the baby takes place in a specially prepared birthing pool filled with warm water [1].
The aim of this method is to support the expectant mother to have a calmer, more comfortable and controlled birth process. Thanks to the relaxing effect of warm water, the expectant mother can cope with contractions more easily, manage her movements more easily and participate more actively in the birth process.
in recent yearswater birthis increasingly wondered by expectant mothers who want to have a natural birth experience. A Cochrane systematic review published in 2018 examined 15 clinical studies involving 3,663 women; demonstrated that water birth has potential benefits in terms of drug-free pain management [2].
However, like every birth method, water birth should be evaluated individually. Not every expectant mother may be suitable for water birth. For this reason, the decision to give birth in water must be made by a gynecologist and obstetrician, taking into account the course of pregnancy and the health of the mother and baby [3].
Article Summary
Water birth; It is a birth method that helps the expectant mother to have a calmer, more comfortable and controlled birth process, but must be planned with a doctor's evaluation.
What Will You Find in This Article?
- What is water birth?Under the heading, it is explained under what conditions and how the birth takes place.
- Advantages of water birthIn this section, the possible contributions of warm water to relaxation, freedom of movement and pain management are discussed.
- How to give birth in water?In this section, the birthing pool, position options and how the water birth process progresses are explained.
- Who can or cannot give birth in water?The headings explain eligibility criteria, risky pregnancy situations and medical conditions that need to be taken into consideration.
- Istanbul water birthand postnatal process headings summarize how the application is followed by an expert team and under appropriate hospital conditions.
What are the advantages of water birth?
One of the most important advantages of water birth is that the mother is in a more comfortable birth environment. While warm water promotes physical relaxation, it can also help calm you down mentally.
Follow-up plan during pregnancy and birth; It should be created by evaluating the medical history of the expectant mother, the week of pregnancy, findings about the baby, and the conditions of the center where the birth will take place [1][2].
According to the Cochrane systematic review, being in water during the first stage of labor can reduce the need for epidural analgesia and support the mother's active participation in the birth process [2]. American College of Obstetricians and Gynecologists (ACOG) recommends women with uncomplicated singleton pregnancy, ages 37-42. It states that staying in water can be evaluated in the first stage of labor in expectant mothers between weeks and weeks [3].
Possible advantages of water birth include:
- It may help make labor pains easier to tolerate.
- It can increase the mobility of the expectant mother.
- It can support muscle relaxation.
- It can reduce stress and tension during labor.
- It can offer the expectant mother a more private and calm environment.
- It can support active participation in the birthing process.
- It may contribute to reducing the need for medical intervention such as epidural in some expectant mothers [2].
Of course, these advantages may not apply equally to every expectant mother. The water birth experience may vary from person to person. Therefore, the best approach is to evaluate with the doctor who monitors the pregnancy whether water birth is suitable for the expectant mother.
How to Give Birth in Water?
Water birth is performed in a sterile and appropriately temperature birthing pool specially prepared for birth. The expectant mother is usually taken into the pool during the active period of labor. During this process, the expectant mother can choose the position she feels most comfortable in the water; He can sit, stand on his knees, squat or try different positions with support.
The decision on the method of birth is not based on a single criterion; It should be given taking into account the safety of the mother and baby, previous birth history and current examination findings [2][3].
The buoyancy of the water makes it easier for the mother to move. This can make changing positions during labor more comfortable.
Water birth can be performed in two different ways:
- The expectant mother goes through some of her labor pains in water, and the birth takes place outside of water.
- Under suitable conditions, the birth of the baby can also take place in water.
Which method is preferred is determined by the mother's condition, the baby's heartbeat, the progress of the birth and the doctor's evaluation. ACOG emphasizes that there is not yet sufficient data on the safety and benefit of immersion in the second stage of labor (the pushing and delivery stage), and therefore the practice should be approached with caution [3].
“The purpose of water birth is not to completely eliminate pain; it is to make the birth process more manageable, calm and controlled for the expectant mother.”
What is the Purpose of Water Birth?
The main purpose of water birth is to make the birth process more comfortable and natural for the expectant mother. Warm water can help relax muscles; It can support the expectant mother to use her body more comfortably. This may contribute to making labor pains feel more manageable.
Symptoms that occur during pregnancy do not always have the same meaning; In cases such as bleeding, severe pain, regular contractions or decreased baby movements, evaluation is required without delay [1][3].
The purposes of water birth can be summarized as follows:
- Enabling the expectant mother to relax
- Making it easier to cope with labor pains
- Creating a calmer birth environment
- increase freedom of movement
- Supporting the natural birth process
- Strengthening the mother's active participation in birth
Water birth is not a method that completely eliminates pain. However, for some expectant mothers, it may help the birth process feel smoother and more controlled [2].
Is Water Birth Risky?
Water birth can be a safe option when planned under appropriate conditions. However, as with every birth method, there may be some risks. ACOG defines possible risks associated with water birth as follows: infection from the rebirth pool, difficulty regulating the baby's body temperature, umbilical cord damage, respiratory distress, and in rare cases, asphyxia [3].
In the postpartum period, physical recovery, mental status, breastfeeding and infection findings should be monitored together [1].
Possible risks of water birth include:
- risk of infection
- Problems with the baby's breathing
- Stretching the cord
- Need for urgent intervention during birth
- Mother's overheating
- Difficulty in close monitoring of the baby
- Restriction of movement when leaving the pool
Due to these risks, it is important that water birth be performed with an experienced team and in an appropriate health institution. The basic principle in water birth is to increase the comfort of the mother while not compromising the safety of the mother and baby [1].
What are the Requirements for Water Birth?
The first and most important condition for water birth is that the mother and baby have passed the necessary health checks. ACOG recommends that health institutions that will perform water birth; It states that comprehensive procedures should be established for patient selection, pool hygiene, infection control, mother-baby monitoring and emergency response protocols [3].
General eligibility criteria for water birth are:
- Singleton pregnancy and head position
- 37-42. being between weeks of pregnancy
- Uncomplicated, low-risk pregnancy
- Normal heartbeat of the baby
- No active infection or bleeding
- Confirmation of suitability by doctor's general evaluation
Who Cannot Have a Water Birth?
Water birth is not recommended for women with certain health problems or risk factors. According to ACOG and NHS guidelines, water birth is contraindicated in the following situations [3][4]:
- High-risk pregnancies such as preeclampsia, gestational diabetes, or serious heart disease
- Twin or multiple pregnancy
- Risk of premature birth (before 37 weeks)
- The baby is breech or in an abnormal position
- Signs of fetal distress or growth failure
- Presence of active infection or infectious disease
- Risk of heavy bleeding
- Condition requiring oxytocin infusion
Evaluation is made by examining such prerequisites. Alternative comfort methods (shower, position change, massage) may be recommended to patients who are determined not to be suitable for water birth [4].
Istanbul Water Birth
Water birth, which has recently emerged as one of the alternative birth methods, is also performed by expert teams in appropriate hospital conditions in Istanbul. The water birth method, which has become widespread in Europe for about 30 years, is becoming more and more known in our country.
Water birth; It is performed in specially designed and sterile birthing pools that allow the mother to move easily. One of its main benefits is that it helps relax the muscles, relaxing the mother. Every stage of the process proceeds under the control of the doctor and midwife.
How Many Hours Does Water Birth Take?
Just like traditional birth, the duration of a water birth can vary depending on many factors. The first stage of labor (opening of the cervix) can take an average of 6-12 hours. The active phase, which is the baby's exit from the birth canal, usually lasts between 20 minutes and 2 hours.
The muscle relaxant effect of warm water can positively affect the birth process; However, since staying in water for a long time may negatively affect the mother's body temperature and the temperature of the water, it is generally recommended to limit the time spent in the pool to 1-2 hours [4].
What is the difference between water birth and normal birth?
The most important difference between them is the environment in which birth takes place. While normal births usually take place in a delivery room or hospital bed, in water birth the expectant mother receives support in a warm pool. The buoyancy of water makes it easy to change position; Warm water can contribute to muscle relaxation and pain relief [2].
While medicated pain management options such as epidural are more commonly used in normal birth, water birth stands out as an approach that supports drug-free pain management. On the other hand, there is the opportunity for faster medical intervention in normal birth; When complications develop, the team can intervene more effectively [3].
Does Water Birth Reduce the Chance of Caesarean Section?
It is not correct to say that water birth definitely reduces the possibility of cesarean section. A Cochrane review shows that water birth does not make a significant difference to the rates of normal vaginal birth, caesarean section or instrumental birth [2]. Necessity of caesarean section; It depends on many factors such as the baby's position, heartbeats, birth progress and the mother's health condition. When medical necessity arises, caesarean section may be the safest option.
What is the Postpartum Process in Water?
The postpartum process in water is similar to normal postpartum follow-up. After the baby is born, it is evaluated quickly; breathing, heartbeat, color and general condition are checked. Skin-to-skin contact with the mother can be supported in appropriate cases. For the mother, bleeding is controlled, placenta separation is monitored, blood pressure, pulse and general condition are evaluated. The first hours after birth are important for both mother and baby; Therefore, medical follow-up continues after water birth [1].
Misconceptions About Water Birth
There are many misconceptions about water birth. The most common are:
"Water birth is completely painless."
No. Water birth does not completely eliminate pain, but it can make it easier to cope with the pain [2].
"Every expectant mother can give birth in water."
No. For water birth, the mother and baby must have suitable conditions [3].
"Water birth definitely prevents cesarean section."
No. If medical necessity arises, a cesarean section may be required [2].
"The baby breathes in water."
Immediately after birth, the baby is brought to the water surface in a controlled manner and takes its first breath when it comes into contact with air.
"Water birth can easily be done at home."
Water birth requires expert monitoring, sterile conditions and the possibility of emergency intervention [3][4].
“The decision to give birth in water should be evaluated individually by a specialist physician, in line with the pregnancy course, health status and expectations of the expectant mother.”
Comments of Mothers Who Gave Birth in Water
Here are some comments about mothers' experiences:
"It was an incredible experience for me. Water helped my body relax and make the pain feel lighter during birth. I felt stronger and more in control throughout the birth process."
"It was the method I chose for the birth of my second child. Considering the difficulties I experienced with my first birth, its relaxing effect made a big difference for me. I recommend this experience to everyone."
"I would say this to those who are thinking of doing it: create a good support team for pre- and post-birth. My wife and midwife were a great help to me during the birth process."
Frequently Asked Questions
Water birth is a natural birth method in which part of the labor or the moment of birth of the baby takes place in a special birthing pool.
The expectant mother is taken to the birthing pool at the appropriate temperature. The birth process progresses under the supervision of the doctor and midwife. Under suitable conditions, the baby can be born in water or birth can take place outside water.
No. Water birth is not painless. However, warm water can help the pain be tolerated more easily [2].
Low risk, singleton pregnancy, baby in head position, 37-42. It can be evaluated for expectant mothers who are between weeks and weeks and deemed appropriate by the doctor [3].
Water birth may not be appropriate if there is a multiple pregnancy, risk of premature birth, distress of the baby, active infection, heavy bleeding, or serious pregnancy risks (preeclampsia, gestational diabetes) [3].
Under proper monitoring, the baby is brought to the water surface in a controlled manner after birth. It takes its first breath when it comes into contact with air; Therefore, there is no risk of suffocation in correct application.
Generally, water birth is planned with drug-free pain management. In most cases, it may not be appropriate for expectant mothers who have an epidural to enter water [4].
Yes. Pregnancy follow-up, doctor evaluation, appropriate center selection and birth plan are important.
Yes. Water birth is an assisted form of normal (vaginal) birth in water.
References
- [1] WHO - Recommendations on antenatal care for a positive pregnancy experience- International recommendations for pregnancy monitoring, counseling and safe follow-up.
- [2] WHO - Intrapartum care for a positive childbirth experience- Guide for the birth process, birth support and safe care principles.
- [3] ACOG - Clinical Guidance: Obstetrics- Clinical guide archive for pregnancy, birth and women's health practices.
- Royal College of Obstetricians and Gynaecologists (RCOG) & Royal College of Midwives (RCM). Immersion in Water During Labor and Birth . Joint Statement No. 1.
- Cluett ER, Burns E, Cuthbert A. Immersion in water during labor and birth . Cochrane Database of Systematic Reviews. 2018;5:CD000111.
- American College of Obstetricians and Gynecologists (ACOG). Immersion in Water During Labor and Delivery . Committee Opinion No. 679. Obstetrics & Gynecology. 2016;128:e231-e236.
- NHS Forth Valley. Water Birth Information . Maternity Services Patient Information.