Over time the needs of pregnant women are profoundly changed by defining a new direction for all departments of obstetrics. Water birth is now considered a viable and safe alternative to traditional birth. The benefits of this practice, mainly represented by a greater maternal relaxation and a reduced demand for analgesia, have contributed to its spread and the enthusiasm with which people speak. As pointed out by the WHO, one of the primary goals of our work is to have a mother and a healthy baby, which is why it becomes necessary to listen to the wishes and preferences of the mother.
WHAT ARE THE BENEFIT OF THE WATER BIRTH?
When submerged in hot water, the mother reaches more easily a feeling of well-being; she can change position with greater easiness, then can relax and feel more at ease. The warm water helps relaxing the muscles, decreases anxiety associated with childbirth, reduces the release of catecholamines by stimulating the production of endorphins. They also improve the perfusion of the uterus and its contractions with a significant reduction in the time of labor. Also they increase the elasticity of the perineum and the birth canal with a significant reduction in episiotomies. But above all, giving birth in water enhances the feeling of control that the woman has on her body creating a greater satisfaction.
CAN ALL WOMEN GIVE BIRTH IN WATER? ARE THERE ANY LIMITATIONS?
The water birth is possible when pregnancy is considered at low risk. To labor in water is not permitted to women who have undergone a cesarean section or uterine myomectomy, women who suffer from hypertension, fever, diabetes, or rupture of membranes for more than 18 hours. It is therefore not possible in all those cases in which the mother has the need for a cardiotocographic monitoring during labor.
WHEN CAN THE PATIENT GO TO THE WATER?
The patient go to the water during the active labor and when there is a dilation of at least 3 cm, the cervix has disappeared and the contractions are initiated. The water temperature is 37°, the woman can choose to get in supine or semi-sitting position with the water completely covering her belly.
DO THE LABOUR PAINS OCURR IN WATER? HOW DOES THE WATER BIRTH WORK?
The woman in the water has much better chance of movement; she can choose the position she prefers and the operator who helps her succeeding in some cases between the contractions to float, thus easing the tension. At the edge of the pool, there is always the midwife who will assist the woman during any stage of labor and delivery, regularly auscultating the fetal heart beat and, if necessary, by performing the vaginal exploration. It will still be the woman to choose, again in the absence of any contraindications, whether to stay in the water even during the expulsion or if give life out of the water on the adjoining chair.
In the case in which the birth occurs in water, it is important that the fetal parts remain immersed up to the complete expulsion of the body; this is to avoid that the diving reflex blocks in contact with the air, thus inducing an untimely respiratory act. After birth the newborn must remain immersed in water in contact with the mother's body with her/his head covered to prevent heat loss. It is not yet clear how the literature of the afterbirth; this can also be done out of the water if there should be any doubt on the extent of blood loss during delivery of the placenta .
CAN THE DADDY TAKE PART IN THE WATER BIRTH?
During labor and delivery, women can choose to have who she preferes by her side.
ARE THERE ANY RISKS FOR THE NEWBORN WITH THE WATER BIRTH?
The scientific evidences show that giving birth in water does not increase the number of admissions to the neonatal intensive care; it does not affect on increasing the risk of infection and increasing the need for resuscitation of the newborn.
ARE THERE ANY CONTRAINDICATIONS FOR THE WATER BIRTH?
Yes, there are in the case in which the woman has undergone a previous cesarean section or a uterine myomectomy or suffers from diabetes, hypertension, and rupture of membranes by more than 18 hours, and fever. The water birth doesn't involve then all those situations where continuous cardiotocography monitoring is required during labor. The fetus must also be in the occipital position and must be proportionate to the measures of the mother's pelvis. In the case of premature delivery or the delivery over the term, the labor in water is not practiced as these conditions may result in emergency situations.
10 GOOD REASONS TO GIVE LIFE IN WATER
Mobility and also the level of comfort increase. In the water you can move more freely; the body is easier to instinctively assume the positions that follow the descent of the baby loosening stiffness, tension and pain.
It's experienced a feeling of lightness greater than the one during the traditional birth.
The water reduces the abdominal pressure. The contractions of the uterus are the most effective. The blood circulation is facilitated and the uterine muscles are more oxygenated, so the baby gets more oxygen and the discomfort is mild.
Thanks to the buoyancy of the water on the woman, it will be easier to relax and less energy will be consumed. In this way, the woman will have a further energy reserve to cope with the contractions.
With this mode of delivery in principle, there is less pain. The greater freedom of movement, the reduction of pressure on the abdomen, the intimacy that is created, the heat of the water and the tactile stimulation exerted, as well as the secretion of hormones that inhibit pain by increasing the relaxation, are all factors affecting the reduction of pain perception.
In some cases the contact with the hot water can stimulate and help the dilatation of the cervix (over 5 cm) by reducing the need to take medication that solicit in case of difficult labor.
Decreasing anxiety, it increases the ability to concentrate the mother.
A more humid environment like that of those who choose to give birth in water can facilitate breathing especially in cases in which the woman suffers from asthma.
Thanks to the moisturizing action of the hot water, it decreases the damage to the soft tissues of the vagina, vulva and perineum.
The impact of the newborn with the outside world, gravity, lights and noise is less traumatic.
DOES LITERATURE CONTAIN ANY DATA?
The results of a recent Cochrane Review show that women who choose to give birth in water during the first stage of labor make use or not epidural and spinal anesthesia/analgesia compared to women who choose the conventional childbirth. The same research shows differences in the duration of labor, in the frequency of operative deliveries and perineal trauma and in the reduction of the perception of pain for the benefit of women who choose to give birth in water. No differences were detected in the APGAR score in the neonatal outcome.