Waterbirth is so gentle on mother and baby!  About 90% of our mothers do choose to birth underwater and we love giving them the option to stay in water for the birth if that's what feels right to them.

Here are a few of the questions many mothers have when considering an underwater birth.

Is underwater birth safe? 

Yes, water birth is safe.  Just as safe as having your baby out of water.  Many studies have been compiled showing the safety and efficacy of water birth.

What prevents the baby from breathing underwater? 

There are 4 main factors that prevent the baby from inhaling water at the time of birth:

1. Prostaglandin E2 levels from the placenta which cause a slowing down or stopping of the fetal breathing movements. When the baby is born and the Prostaglandin level is still high, the baby's muscles for breathing simply don't work, thus engaging the first inhibitory response.
2. Babies are born experiencing mild hypoxia or lack of oxygen. Hypoxia causes apnea and swallowing, not breathing or gasping.
3. Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. So, even if water were to travel in past the larynx, they could not pass into the lungs based on the fact that hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence.
4. The last important inhibitory factor is the Dive Reflex and revolves around the larynx. The larynx is covered all over with chemoreceptors or taste buds. The larynx has five times as many as taste buds as the whole surface of the tongue. So, when a solution hits the back of the throat, passing the larynx, the taste buds interprets what substance it is and the glottis automatically closes and the solution is then swallowed, not inhaled.

How long is the baby in the water after the birth?

Here in the US, practitioners usually bring the baby out of the water within the first ten seconds after birth. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth videos that depict leaving the baby under the water for several moments after birth and the babies are just fine. Physiologically, the placenta is supporting the baby with oxygen during this time though it can never be predicted when the placenta will begin to separate causing the flow of oxygen to baby to stop. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to gently scoop the baby out of the water, without hurrying, and place him into his mother's arms.

When should a laboring mother get into the water?

A woman should be encouraged to use the labor pool whenever she wants. However, if a mother chooses to get into the water in early labor, before her contractions are strong and close together, the water may relax her enough to slow or stop labor altogether.  That is why some practitioners limit the use of the pool until labor patterns are established and the cervix is dilated to at least 5 centimeters.

There is some physiological data that supports this rule, but each and every situation must be evaluated on its own. Some mothers find a bath in early labor useful for its calming effect and to determine if labor has actually started. If contractions are strong and regular, no matter how dilated the cervix is, a bath might be in order to help the mother to relax enough to facilitate dilation.

Therefore, it has been suggested that the bath be used in a "trial of water" for at least one hour and allow the mother to judge its effectiveness. Midwives report that some women can go from 1 cm to complete dilation within the first hour or two of immersion.  The first hour of relaxation in the pool is usually the best and can often help a woman achieve complete dilation quickly.

How is the baby monitored during a water birth?

The manufacturers of monitoring equipment and handheld dopplers have all developed waterproof varieties of monitoring equipment. In a typical water birth, the baby’s heart tones are listened to every 30-60 minutes during the first stage and every 5-15 minutes during pushing contraction or every 15 minutes during second stage.

Can I have a water birth at my local hospital? 

In most hospitals, it is not available at this time.  But that is why an out of hospital birth may be a good option for mothers who are low-risk enough to have a water birth as an option. Waterbirth International is diligently working with families who want to have a water birth in a hospital environment.  Contact Waterbirth International at www.waterbirth.org for more information and to help bring water birth to your local facilities.