Waterbirth

Mayanglamban, Prempati (2016) says that Water birth is an ancient technique that plays
a crucial role in reducing labour pain for women during normal delivery and avoid cesarean
section. The mother in labour is immersed in pool of adequately warm water. With increased
tension, fear, anxiety and stress level, many pregnant women are opting for water birth
technique for the delivery of their babies. In opinion the Avery (2013) and Sprague (2011)
Women who utilize hydrotherapy for labor and birth should be deeply immersed in the water
to cover the belly and up to the breast. “Full immersion” promotes optimum physiologic
responses, primarily the stimulation of oxytocin and vasopressin.

Practitioners who have a track record of high percentage of normal vaginal deliveries,
who have the experience and patience to let women labour at their own pace, who can
provide one to one care and support, monitoring constantly both the mother and baby, and if
required, have the infrastructure to safely and quickly intervene when required. Water is
known to be relaxing, rejuvenating. A warm bath at the end of the day refreshes. Michel
Odent in 1960s used this medium to give pain relief in labour, one of his patients was so
comfortable there, that for delivery, she refused to get out of the bath tub and delivered a
calm baby under water. This accidental under water delivery made him do extensive research
and he came to the conclusion that water is safe for both mother and baby. This is
subsequently found out to be true by thousands of mothers all over the world according to
Mayanglamban, Prempati (2016).

Based on study Kolivand M (2014) they says that no maternal or neonatal complications
were observed in either study or control group. This can indicate the safety and advantages of
water birth. Appropriate selection of water birth candidates is the main factor for water birth
safety. Evidence suggests that application of this method during the first stage of labor for
low-risk pregnant women reduces the use of analgesics and duration of the first stage of labo

Mollamahmutoglu(2012), Sprague (2011), Avery ( 2013), Dahlen(2013) and Henderson

(2014) says that water birth have some benefit. The first the water helps provide relief to
women in labour and facilitates child birth. These benefits include increased satisfaction with
the birth. The second water birth can reduction in the perception of pain and increased
endorphin release and increased relaxation, Reduction in the need for pharmacologic pain
relief. Next, More ease for assuming various labor/birth positions (due to buoyancy) that
leads to increased functional diameter of the true. Shorter first and second stage of labor due
to a reduction in stress hormones and catecholamines, which inhibit oxytocin and labor
progres. And the last water birth can less perineal trauma and less postpartum hemorrhage.

Avery (2013) and Harding (2012) says that The research shows that contraindications for
waterbirth include mothers desiring a VBAC (vaginal birth after a cesarean), Pitocin
augmentation/induction or where telemetric EFM is not available. Maternity units may elect
to add to the list of contraindications the use of analgesia or anesthesia, multi-fetal gestation,
and gestational age less than 37 weeks.

Wax J and Ecker J (2016) says that Immersion in water during the first stage of labor
may be appealing to some and may be associated with decreased pain or use of anesthesia
and decreased duration of labor; however, there is no evidence that immersion during the first
stage of labor otherwise improves perinatal outcomes. Immersion therapy during the first
stage of labor should not prevent or inhibit other elements of care, including appropriate
maternal and fetal monitoring. In contrast, the safety and efficacy of immersion in water
during the second stage of labor have not been established, and immersion in water during the
second stage of labor has not been associated with maternal or fetal benefit. Given these facts
and case reports of rare but serious adverse effects in the newborn, the practice of immersion
in the second stage of labor (underwater delivery) should be considered an experimental
procedure that only should be performed within the context of an appropriately designed
clinical trial with informed consent. Although not the focus of specific trials, facilities that
plan to offer immersion in the first stage of labor need to establish rigorous protocols for
candidate selection, maintenance and cleaning of tubs and immersion pools, infection control
procedures, monitoring of mothers and fetuses at appropriate intervals while immersed, and
protocols for moving women from tubs if urgent maternal or fetal concerns develop.

Kolivand M (2014) says that no maternal or neonatal complications were observed in

either study or control group. This can indicate the safety and advantages of water birth.
Appropriate selection of water birth candidates is the main factor for water birth safety.
Evidence suggests that application of this method during the first stage of labor for low-risk
pregnant women reduces the use of analgesics and duration of the first stage of labor.

In opinion ACOG (2014) Academy of Pediatrics (AAP) Committee on Fetus and

Newborn and the American College of Obstetricians and Gynecologists (ACOG) Committee
on Obstetric Practice assessing the use of water as a part of labor and birth, relieving or
shortening labor and adding to maternal satisfaction . However, a Cochrane Review of the
literature included 12 trials (3243 women). Water immersion during the first stage of labor
significantly reduced epidural/ spinal analgesia without adversely affecting labor duration,
operative delivery rates or neonatal well-being. One trial showed that immersion in water
during the second stage of labor increased women’s reported satisfaction with their birth
experience (Cochrane, 2009).
 References

1. Kolivand,M., Almasi, A., and Heydarpour,S. (2014). Comparison between the

Outcomes of Water Birth and Normal Vaginal Delivery. Journal of Midwifery and
Reproductive Health. Vol.2. No.4.: 220-226.

2. Mayanglamban, Prempati. (2016).Water Birth: A Boon for the Mother.International

Journal of Applied Research.Vol 2. No.10.:12-14

3. Morrisville,NC.(2015).Water Labor & Water Birth.International Childbirth Education

Assosiation.103

4. Taylor H;Kleine I;Bewley S;Loucaides E;Sutcliffe A.(2016).Neonatal Outcomes of

Waterbirth: A systematic Review and Meta-Analysis. Arch Dis Child Fetal Neonatal
Ed. Vol.1136. No.10. 1-9.

5. Wax, Joseph R; Ecker, Jeffrey L. (2016). Immersion in Water During Labor and
Delivery. American College of Obstetricians and Gynecologists.Vol.133. No.4. 758-
761