benefits of water birth
Water birth can help to make your birth a natural one, and ease the baby's transition from the womb into its new world. Look at the benefits of using water in birth - from the relief of pain to the general well-being of the mother and baby.
POTENTIAL BENEFITS FOR THE MOTHER
relaxation
hormone release
pain relief
fewer pain-relieving drugs
buoyancy and mobility
comfort and rest
privacy
autonomy
fewer interventions
higher likelihood of intact perineum
instinctive behaviour
maximised blood supply to the uterus
shorter labour
lowered heart rate and blood pressure
creation of a supportive environment
positive perceptions of labour and birth
bonding with the baby
Relaxation
This is probably the most important effect of the warm water, and can have dramatic effects on the woman's physical, mental and emotional well-being.
How may being in the water enhance relaxation?
Almost all of us will equate the idea of lying in deep, warm water with stress
reduction. It is not understood completely just why this should be. Certainly
water can make us feel good through warmth, pleasurable sensations on the
skin and the support of its buoyancy. These effects are probably combined
with less understood responses to do with our spiritual, emotional and ancient
connections to water, perhaps even to our watery origins. A theory suggests
that being in water allows the brain to relax deeply because it is such a
low-stimulus environment. Due to the constant temperature and pressure of
the water, the brain is registering 'no change' in the messages it receives
from the skin, and can thus 'doze', in a neutral, primitive state.
As the woman becomes more relaxed
- she is more able to relax her pelvic floor and to allow her cervix to open.
- the muscles of her uterus and womb are able to work more efficiently, and to rejuvenate better between contractions.
- her relaxed muscles will require less oxygen, so more is available for labouring and for the baby.
- there is a rise in the levels of endorphins. These are the body's 'feel-good' hormones and help reduce pain.
- there is a rise in the level of the hormone oxytocin, which stimulates contractions, leading to quicker dilation and a shortened labour.
- there is a reduction in the levels of 'stress hormones' such as adrenaline, which can make labour more painful and slower, and cause feelings of anxiety.
- she experiences less fear and less pain.
Hormone release
Hormones are chemicals made in the brain that act as the body's messengers. The complex balance of different hormones affects the body physically, mentally and emotionally.
When a person is feeling under emotional or physical stress, they will produce more ' stress hormones' such as adrenaline. These are responsible for many changes in the body - such as an increase in heart rate, blood pressure and breathing rates, greater muscle tension and anxiety - known collectively as the 'fight or flight' response. As a result, blood is redirected away from the uterus, and contractions and dilation become less efficient and more painful. Stress hormones may even stop labour altogether, at very high levels. They also inhibit the production of the beneficial hormones - oxytocin and endorphins. In this way, stress can set up a 'downwards spiral' of pain, fear and tension.
In contrast, when someone feels relaxed in a safe, warm environment - such as in a birth pool! - they will produce less stress hormones, with a reversal of the effects listed above. Levels of oxytocin and endorphins are increased. The endorphins are able to block pain at the nerve endings and they also induce a sense of well being, confidence and calm. Oxytocin is the hormone responsible for stimulating contractions. These combined effects mean that contractions are more efficient, dilation is quicker and pain is reduced. So now we have an 'upwards spiral', of relaxation and reduced pain and fear.
Pain relief
The pain experienced by a woman in labour is influenced by many inter-dependant factors. Physically, by what her contractions are uniquely like, the size and weight of her baby in relation to her own body, her mobility, her positions, how tired she is, preparation, etc. Emotionally, by factors such as her expectations, the levels of support she feels, privacy and by her own personality. Each woman will react differently to any situation, and there is a large variation in how she perceives and tolerates pain.
Water cannot provide total pain relief in the way that an epidural may. But it does provide an optimal environment for enabling the woman to manage her labour. It may well help bring about a state of mind whereby the woman finds that her perception of pain is altered, or that her pain threshold is increased. Self-help techniques such as focused breathing, visualisation, making noises, movement, massage etc. will further enhance the pain-relieving properties of water. It may be helpful to think of contractions as bringing 'intense sensations' or 'energy rushes', rather than 'pain'.
How may being in the water help reduce a woman's labour pain?
The most significant factor is likely to be the effects of relaxation, outlined above. The more relaxed a person, the more endorphins they will produce. Endorphins act as painkillers in a similar way to pethidine, but without the side-effects. They produce a sense of well being, or even euphoria, so that the pain is still felt, but in a more detached or diffuse way. Relaxation also reduces feelings of fear and stress, which can amplify any pain. So the woman feels less overwhelmed and more able to accept pain and to cope with her labour. These hormones also have an amnesiac effect, so much of the pain is quickly forgotten.
The water enables the woman to move around freely and to find comfortable positions for labour.
In addition, a good supply of oxygenated blood optimises the removal of waste products (toxins and carbon dioxide) from muscles. These can build up in a working muscle - including the uterus - and contribute to pain.
Fewer pain-relieving drugs
Because water provides such effective pain relief, it may reduce the need for additional analgesics such pethidine and entonox, and so in turn limit the possibility of side-effects for both mother and baby.
Water birth is associated with a large reduction in the number of women requiring an epidural. Epidurals have many well documented side-effects for the mother and baby.
Buoyancy and mobility
The buoyancy of the water counteracts the effects of gravity and many of us enjoy the feeling of weightlessness when we float in water. With her body supported in this way, the pregnant woman may find it easier to find, and to maintain, comfortable positions in which to relax and to labour.
It is now known that mobility is very important during labour and that changing position may be just as beneficial as the actual position adopted. In a birth pool, the mother is usually able to change positions quickly and easily when she wants to. She might find it useful to move in and out of a certain position as the contractions come and go. By moving according to her impulses, she may be able to find relief from pain, and help the baby to move down through the pelvis.
Being in the water reduces strain on muscles, joints and ligaments. Buoyancy results in less pressure on the abdominal walls, which may lead to improved blood circulation and more efficient contractions.
For all these reasons, women with back problems, disabilities or obesity may find the buoyancy especially helpful. Because abdominal pressure is reduced, those with a previous caesarean section may wish to consider a water birth.
Comfort and rest
The mother is supported and comforted by the warmth and serenity of the water. Sensory input and distraction are low, which makes it easier for her to relax deeply.
In the warmth and buoyancy of the water the mother is able to rest better, and even to sleep, in between her contractions, and so conserve energy for the work of labour.
Privacy
Women in labour often value the secure and private space contained by the pool. It can feel like her personal sanctuary. It is important that she has privacy, low lighting levels and minimal disturbance to feel that she can safely 'let go' and act upon her instincts.
Autonomy
Being in a birth pool empowers a woman by allowing her to be more in control of her body and her labour. Therefore, she may feel less anxiety or fear. And no-one can come near to her without her consent!
Fewer interventions
The use of a birthing pool is invariably associated with a non-intervention and low-technology approach to the care of the mother, and with a natural birth.
The woman is less likely to have procedures such as the artificial rupture of membranes or an oxytocin drip, and episiotomy rates are dramatically reduced. Continual foetal monitoring is not possible under water.
After a labour in water there tends to be far fewer forceps deliveries, ventouse deliveries and caesarean sections.
Higher likelihood of intact perineum
This can be explained largely by the theory that the warm water relaxes and softens the perineal tissues, making them more elastic and better able to stretch without tearing as the baby's head crowns.
In addition, the water itself acts like a counter-pressure, against which the mother may find it easier to push more steadily during the second phase. Thus, the crowning of the baby's head is more gentle and controlled.
When in the pool, she is likely to be able to give birth according to her instincts and at her own pace, so she can allow time for the tissues to stretch gently.
If there should be damage to the perineum this is generally a minor (first degree) tear - there is a much lower proportion of more serious (second or third degree) tears when the woman labours in water.
Instinctive behaviour
Many mothers find that the watery environment enables them to focus inward and to get in touch with their instinctive body wisdom. For a truly natural birth, the mother needs to have confidence in her own innate wisdom, and to be able to listen to the messages from her body. To encourage this, she needs to feel relaxed, safe, supported, and not rushed. The privacy of the birth pool and the feminine qualities of the water can empower the woman to find her deepest resources to help through labour.
It is quite common for women to experience a change in consciousness when in the water - as if they had gone to 'another place' where time and the outside world are left behind. In such a trance-like state, it is possible to concentrate fully on what she is doing and to call upon her inner strengths. She finds it easier to lose her inhibitions and to trust in whatever she feels she needs to do during labour and birth.
Maximised blood supply to the uterus
Just like any other muscle, when the womb is well supplied with oxygen-rich blood, it is able to work efficiently and with less pain.
How may being in water encourage blood flow to the uterus?
- The muscles are not working against gravity when submerged so they need less oxygenated blood, and thus more is available to the uterus.
- Less energy and oxygen is needed to maintain body temperature because the water is at a similar temperature to the body; so more is made available to the uterus.
- A relaxed mother produces less stress hormones, which can cause blood to be shunted away from the uterus.
- Relaxed muscles need less oxygen. If less is being used by tense muscles, more is made available to the uterus.
Shorter labour
Studies have shown that the average length of labour may be reduced by 30% when the mother uses a pool. This is mainly due to beneficial effects during the first stage of labour - the dilation of the cervix -, which may be twice as quick in water.
How may being in the water shorten a woman's labour?
- More oxytocin is produced when the she is relaxed. This hormone enhances contractions and makes them more efficient.
- Less 'stress hormones' are produced when the she is relaxed. These can reduce and slow contractions.
- Tense muscles need more oxygen, so when the womb is relaxed there is more energy available for efficient contractions.
- When submerged under water the muscles having to work against gravity so there is more energy available for contractions.
- There is a good supply of oxygenated blood to the uterus, allowing it to function efficiently.
Lowered heart rate and blood pressure
How may being in the water lower a woman's heart rate?
- In water, the heart has less work to do as it is not acting against gravity.
- A relaxed mother produces less stress hormones. They cause the heart to work harder and blood pressure to rise.
- Blood pressure is naturally lowered as the warmth of the water brings about the relaxation and opening of blood vessels close to the surface of the skin.
Creation of a supportive environment
A birth pool seems to bring about an improvement in the general atmosphere of the labour room, bringing calm to all those present. In a hospital, it will often be associated with changes in the way in which the mother is cared for, which encourages her to feel in control, calm and emotionally supported, leading to a natural birth.
Positive perceptions of birth and labour
Midwives report that after using water new mothers are much more likely to describe their experience with words like 'calm' or 'peaceful' and 'satisfying' or 'empowering'. Mothers and midwives alike generally give positive accounts of using water, and most mothers say they would like the option of water for any future births.
Bonding with the baby
Midwives have reported that women are usually alert and highly receptive to their babies after a water birth, which enhances early bonding between them and in turn may help get breast feeding of to a good start.
POTENTIAL BENEFITS FOR THE BABY
Because of the continual physical, and psychological, interactions between mother and baby, the baby will share the same benefits of water as the mother during labour. An underwater delivery may also bring additional benefits to the baby.
relaxed mother
fewer pain-relieving drugs
fewer interventions
good oxygen supply
familiar environment
bonding with the mother
Relaxed mother
The baby receives its blood directly from its mother, via the placenta. When a mother is relaxed, her blood is likely to be rich in oxygen and to contain high levels of endorphins and low levels of stress hormones, which brings many benefits as described before. The baby will be aware of, and respond to, the mother's emotional state, so the relaxing and reassuring benefits of the water will also pass on to the baby.
Fewer pain-relieving drugs
The mother is less likely to need analgesics when she uses a birth pool. Drugs such as pethidine and epidural anaesthetics cross the placenta to the baby and can lead to several possible side-effects.
Fewer interventions
When the mother labours in water the baby is more likely to experience a natural birth, and less likely to be subject to interventions such as continual foetal monitoring, delivery by forceps, suctioning or caesarean section.
Blood supply to baby
As described above, a mother who is relaxed in the water will have a good circulation of well-oxygenated blood to her uterus, and so to her baby. A baby with a plentiful supply of oxygen is less likely to suffer from foetal distress.
Familiar environment
A baby is born under water the baby water will experience a gentle introduction to the world, with the softness and warmth of the water on its skin, and with muffled sounds and lights - quite similar to being in the womb.
At delivery, the baby must accustom itself to several huge changes - the experience of being born, the sensation of gravity and feeling its own body weight, new sense impressions, and breathing in the air. With an underwater birth, these experiences are introduced more gradually. Buoyancy counteracts the force of gravity, senses are muffled and the baby doesn't take a breath straight away - breathing does not commence until the baby's face meets the cool air.
Bonding with the mother
If mothers are generally more receptive to their babies after a water birth, then this will have obvious advantages for the baby in terms of promoting bonding and establishing successful breast feeding.
