Empowered Birth: water birth

Last month, my colleague Sarah and I delivered a presentation on water birth as part of the mandatory update training that all midwives undertake annually.

We felt unhappy that in previous years training around water births had focused on risks and potential problems. We observed a bias being taught that created anxiety, raised doubts and diminished our colleagues’ confidence. There was no balance, and certainly no attention given to physiology or what a smooth birth might look like where mum and baby are healthy and well. We proposed a session on updating water birth skills as we had witnessed some apprehension and lack of intention in facilitating births in water. In the birth centre, we find them magical, and we learn so much about the physiology of both mum and baby when they are immersed in warm water. Through the training, we wanted to reduce overcaution in promoting the use of a pool and to iron out any outdated myths surrounding water birth, particularly considering it has been part of midwifery practice and the birthing experience in the UK for almost 30 years.

I arranged a one-to-one session with the UK’s leading water birth midwife, Dianne Garland. She and her American counterpart, Barbara Harper, have been advocating the use of water in labour and birth since the practice was adopted. Dianne has recently been teaching Chinese midwives about using water, and often presents in Europe. She is phenomenally knowledgeable, and she does a huge amount of work to promote water births and to debunk alarmist views about poor outcomes and unsafe practices.

In Blue Mind, author Wallace J. Nicholls discusses why humans need to be by water, and how water affects and benefits our peace of mind, confidence and being in the world. It makes sense to me now, that when we are at our most vulnerable (yet powerful) in the moment of giving birth, why water is the most supportive environment. It has the power to hold us, in our minds and in our bodies. Not only do we feel safe and held, but we are also protected by the pool edges from too much touch and interference from others, leaving us with a profound sense of control.

Below are some of the ways in which water can create a powerful and positive birthing environment.

1. When our bodies are submerged in water, our brains instantly still our thoughts and worries, and the primitive brain can access the parasympathetic nervous system. This leads to the hormones for labour being released perfectly to synchronise with the baby’s hormonal system.
   
   
2. The brain can manage labour and birth using its normal stress adaptive processes. Stress is a normal response to the challenge of pushing a baby out, and being in water enables these internal processes to remain within a normal range. The body is provided with the resources it needs to cope and stay fully functioning and healthy.
   
   
3. Being in water reduces the effect of gravity on our bodies, so the pelvis opens more easily, and ligaments, muscles and fascia give space to baby in ways they don’t out of water. When we are buoyant, our muscles don’t have to behave in the same way.
   
   
4. Because the hormones flow freely and the pelvis opens smoothly, the baby is uninhibited from moving lower and can use micro movements to push themself down and out. Their cardinal movements are not impeded. As witnesses, we see the baby’s efforts once the head is born: the eyes open and close, sometimes they cry, and the rotations they make with their head and neck to align shoulders in the pelvic outlet assists the kick out into the water with the following contraction.
   
   
5. A water birth after a birth where epidural, forceps or ventouse have been used will take a bit longer. We understand (even when we cannot have this awareness) that it will take the mother a bit more time to feel able to push her baby out unaided. It’s something we can discuss after the birth as part of what mum’s perception of her experience was. In this way, it becomes a healing birth experience.

From the additional updating, reading, and conversation with Dianne, I have become revitalised myself. Water is helpful in obvious and subtle ways; everyone will benefit from using it, and yet many do not realise this or get the chance to try it. Sarah and I intend to remind our colleagues of how valuable it is for mothers and babies, and to encourage them to promote the use of water in their practice.

I wish you all an opportunity to experience warm water in your labour and birth, so you can share the magic, awe and wonder it brings for you and your baby.

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Eleanor Copp supports families across the UK, currently online. relaxedparenting.co.uk 07929 857 608

 

 

 

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References

Dianne Garland, Revisiting Waterbirth: An Attitude to Care (Red Globe Press, 2017).

Wallace J. Nichols, Blue Mind: How Water Makes You Happier, More Connected and Better at What You Do (Abacus, 2018).

Photography by Himalee Rupesinghe - facebook.com/himaleerupesinghephotographer

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First published in Issue 76 of JUNO. Accurate at the time this issue went to print.