Water Birth Safety

[Jaimee]

Recently a discussion about the safety of water birth popped up in another thread.  The discussion revolved around whether birthing in water is safe for the baby.  It seems that most of the information out there is not peer reviewed as there have not been any large scale studies done.  I would like to continue the discussion outside of that thread since we were hijacking the OP's original question.  For those of you that posted in that thread, please feel free to re-post your information here so that it's all in one place.

I birthed my first in water and felt that it was a safe experience.  Water birth has been deemed safe by several hospitals and most birth centers.  I have talked with many midwives about water birth and all agree that it is safe.  But, I I was recently challenged to find actual scientific, peer reviewed support for this belief.  I have come across a few sites and resources that may be of interest and I would love to see what other information is out there.   So please post your opinions and your resources.

Thanks!

BMJ Article comparing perinatal mortality rates of waterbirth vs. birth outside of water.  Conclusion was there is no significant difference: http://www.bmj.com/content/319/7208/483.abstract

2009 Cochrane Report.  Conclusion was that of the trials they compared there was no evidence of adverse effects on the neonate, but more research needs to be done: http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD000111/frame.html

Royal College of Obstetricians and Gynaecologiest's joint statement with the College of Midwives.  They support a woman's right to choose to birth in water: http://www.rcog.org.uk/womens-health/clinical-guidance/immersion-water-during-labour-and-birth

Overview of water birth research by Baby Centre, which includes numerous references: http://www.babycentre.co.uk/pregnancy/labourandbirth/waterbirth/whatresearchsays/

The often cited Barbara Harper, RN article from Midwifery Today Magazine that explains why water birth is not dangerous and includes references to studies: http://www.activebirthpools.com/articles/Midwifery%20Guidelines%20and%20Research/Waterbirth%20Basics%20From%20Newborn%20Breathing%20to%20Hospital%20Protocols%20by%20Barbara%20Harper,%20RN.pdf

[Jaimee]

I received this message from another CNM:

It doesnt really make sense that the baby could swallow the pool water and aspirate it. First of all, until the baby is exposed to air it doesnt take a breath. The lungs are squeezed during birth to get the fluid out and prevent aspiration. As soon as the body is born the baby is pulled out of the water. Even if the baby swallowed water, it is unlikely that it would aspirate. There is usually some fluid in the lungs following birth which is absorbed with breathing in the first day or so. Occasionally, even a baby not born in the water sometimes has difficulty absorbing the fluid in the lungs and can need help or even develop pneumonia, so being born in a tub is pretty irrelevant.
 

Does anyone else have opinions or resources?    This was a fairly active debate in the other thread!

[MittensKittens]

I have heard the opinion that, if the baby is born into water that is too cold (colder than the temperature in the uterus), that could shock the baby into trying to breathe before it reaches the surface. That would be something to keep in mind for women who are having a waterbirth. Heated pools seem to be the way to go. 

[Jaimee]

I had heard this about temperature as well.  Then I heard the opposite, that the dive reflex (not to breathe) only happens in cold water.  Later I ran across this article, again by Barbara Harper, about water birth and water temperature: http://data.memberclicks.com/site/wi/MIDIRS_article_BH.PDF.  Her conclusion (referencing a few studies done in Russia and Germany) is that the water temperature should simply be whatever is comfortable for the mother.

[Jaimee]

 for more info/opinions. 

[Springshowers]

I've seen videos of waterbirths (in documentaries) where the baby stays underwater for 30+ seconds. My midwives told me with my last birth (a waterbirth) that as long as the baby is not exposed to air they will not breath.. but if they were to fall through air into the water they might take in water.