The "how to" and the benifits of water-birth discussion thread. - Page 4

[mwherbs]

could be regional as well before I lived here we lived in the northern desert and it was 110 in the air in the summer and here we can be 115 easy and women are somewhat adjusted to the temps maybe I know that when we were just filling at 98-100 women were cold when they got in of course the thermometer is a float one so maybe it is just getting the hot top--so we fill hotter now and no complaints--- so mom should not be sweating and baby's heart rate should not speed up - if it does much then try to cool the water off but this has happened with women who have wanted very hot water--- I also think that having mom test the water with her arm before she gets in helps.

[momileigh]

I'm planning a waterbirth in an honest-to-goodness, full-sized jacuzzi hot tub. I'm excited about it because it is big, has the jet-streams, and you can easily regulate the water temperature to stay at a certain degree of your choice. It belongs to my mother-in-law and I'll have the baby at her house.

Some questions:

As long as I replace the chlorinated water in it with fresh water, is there any other detail I need to consider? How long before the birth should I put the birth-water in?

How do you drain the water out of it? Do I need a special pump?

If I get out of the tub for whatever reason, am I going to be very cold? (The house will be warm I'm sure but I mean after getting out of the warm water will I feel cold.) I'm a little afraid of being cold and wet and "in the moment" and it turning very miserable. With my dd's birth I wasn't calm at all, I was rather frantic the whole time once the contractions got tough. I'm hoping for a slightly calmer experience with the water birth but I know with my tendancy to freak out that it isn't a guarantee. My point is, is a high-strung birther like me going to regret getting wet if I have to leave the water? (No way to really answer that, but any thoughts?)

And finally, and perhaps most importantly: what do you think of having a water birth with a midwife who has never attended one before? (She's attended plenty of births but none born in the water.) In answering this please remember that I am NOT likely to be cool-headed during labor or delivery, and may definately need guidance from a midwife. I'm not the UC type. Is there some reason to suspect that this combination (me going somewhat nuts, a midwife who'd never done a waterbirth) could turn out to be dangerous?

These are some rambling questions but please weigh in!

[mwherbs]

why has your midwife never attended a waterbirth before? I know it could just be the luck of the draw but we have been doing births in water since the 80's and probably older midwives could say even longer. The past 5-6 years it has been a very popular way to birth so I have seen many more in recent years. The reason I am asking is about it is so you can find out if she has a fear or prejudice or if it is just chance/population she has been serving. She may be just fine and game to learn or she may be wary and end up guiding you out of the water near delivery.

[milk4two]

Waterbirth: I wouldn't do it any other way.

[Alexander]

Originally Posted by dubylyu

As long as I replace the chlorinated water in it with fresh water, is there any other detail I need to consider? How long before the birth should I put the birth-water in?

?

Birth water?

I'd recomend the chlorinated tap water.

You are covered with germs from every-which-where.



How do you drain the water out of it? Do I need a special pump?

Originally Posted by dubylyu

My point is, is a high-strung birther like me going to regret getting wet if I have to leave the water? (No way to really answer that, but any thoughts?)

Water births are calming experiences. Have soft lighting, (no candles), nice music (eg the way of the dolphin or Paclebel) and warm soft towels all around.

Originally Posted by dubylyu

And finally, and perhaps most importantly: what do you think of having a water birth with a midwife who has never attended one before? (She's attended plenty of births but none born in the water.) In answering this please remember that I am NOT likely to be cool-headed during labor or delivery, and may definately need guidance from a midwife. I'm not the UC type. Is there some reason to suspect that this combination (me going somewhat nuts, a midwife who'd never done a waterbirth) could turn out to be dangerous?

Not dangerous IME because everything is nearly the same. Just in water. She should "want" to do it though, and have at least read some lit on the subject.

Don't have her come though the door to find you in the pool!!!

a

[mom2threenurslings]

Great thread! Thanks Alexander and everyone else!

I've had one birth center waterbirth, which I LOVED and am planning a home waterbirth.

[momileigh]

Thanks for the replies:

1. My midwife serves mostly women out in the "sticks" who give birth the way their mothers and grandmothers did. They are often too far to get to the hospital especially with the blizzard-like conditions that often plague us. They aren't really "choosing" homebirth and researching their options as much as they are doing what must be done, so waterbirth has apparantly just not been something women have requested. She doesn't do a high number of births, either, and that might be part of the reason. (She's doing 4 from now through the fall.)

2. When I say replace the chlorinated water, I mean the heavily-chlorinated hot tub water. There is more chlorine in a hot tub than in a public swimming pool because of people's propensity to pee in them, plus they are smaller, and the warm water would encourage germ growth. Am I wrong to assume that large amounts of chlorine (eye-burning chlorine) would not be good to birth in? The tap water is well-water, not chlorinated... should we add some chlorine?

I really, really hope that the water is calming enough for me! I know that I tend to overdramatize things and react rather ridiculously to pain (a skinned elbow a few weeks ago incapacitated me for nearly a week) but when I see videos or read about water births and everything is so calm, I really hope that it can be more like that this time.

Oh, and PS. the soft lighting is in the bag! There's one of those knob-regulated overhead lights in the room and you can turn it on very, very dimmly. But what do you do if its in the middle of the day? (I always picture birth happening at night.) Should we have all kinds of drapes for the windows? Hmm, that could get complicated... the tub is in a kind-of sun room with all windows across one wall.

[mwherbs]

birth is such a different feeling I am a real baby when it comes to sickness or pain. If i get a hangnail you will hear me talking about the pain and I will usually put some thing on it like saint john's wort oil. My mother went to New York instead of say in town when I had my first because she though it was going to be too upsetting to be around me in so much pain--- and guess what I handled it, and with the 2 homebirths the water was comforting. Do you normally like warm water and baths is it a trigger for relaxation for you? It is for many so it will probably work for you. if you are worried about getting chilled keep the room warm and some towels in the drier that someone can fetch for you or you could put them in a stack with a heating pad so when you get out there is some warmth. take care and have a great birth

[momileigh]

I do love the water, especially warm water. I know that birth is totally different from, say, the pain of breaking your toe or something, but for me w/ dd it still was quite painful and I was climbing the walls. Mostly it was like the worst gas pain ever. I have no idea if water is supposed to help with that or not, but this being my 2nd baby I'm hoping the whole thing is easier water or not.

My mw's main concerns with waterbirth are that she can't wipe the face off before the body is delivered, which she says makes the need to suction practically nonexistant in her experience. Also, she thinks I might lose some natural lubrication and not have the benefit of oil on my perineum, perhaps causing an abrasion. But overall she agrees that if I don't want to leave the water, I should not. She says in all the births she's been to where they labored in water, even at ones where they had planned to birth in the water, the mom instictively got out right before the baby came. I don't know... maybe I'll be her first, maybe I'll want to get out.

[pamamidwife]

Originally Posted by dubylyu

My mw's main concerns with waterbirth are that she can't wipe the face off before the body is delivered, which she says makes the need to suction practically nonexistant in her experience. Also, she thinks I might lose some natural lubrication and not have the benefit of oil on my perineum, perhaps causing an abrasion. But overall she agrees that if I don't want to leave the water, I should not. She says in all the births she's been to where they labored in water, even at ones where they had planned to birth in the water, the mom instictively got out right before the baby came. I don't know... maybe I'll be her first, maybe I'll want to get out.

Ok, so I'm just wondering: how many births does your mw do? Is she an older mw?

Wiping off the face before the body is delivered is NOT necessary. Heck, no. In fact, suctioning the baby is a HUGE no-no - not evidence-based, not necessary, not helpful at ALL. No, no, no, no.

Water provides nice counterpressure. No need to oil the perineum. No need to have her fingers in you. No, no, no, no.

I want to stay nice here, and respect your mw, but she sounds like a mw talking from 1979!

I would urge you - really URGE you - to have her contact Barbara Harper from Waterbirth Intl. http://www.waterbirth.org/spa/index...._id=5&Itemid=1 with her concerns. This is really vital. Because, I will tell you one thing - her fear about waterbirth and meddling with your labor and the birth of your baby will create a negative experience for you. She will be fighting against what your body will intuitively want to do.

Please. Contact Barbara. By phone. Share with her some of these ideas that your mw has. It just is so...well, dated. Does your mw read anything like Midwifery Today? Does she keep up on her continuing education?

I'm sorry, but there are so many red flags that I don't know where to start. Please contact Barbara. If you really want a waterbirth, your mw needs to be re-educated. Definitely. This will be good not only for your birth, but for other women under her care.

I apologize, again, if I'm out of line, I'm just really concerned about what your midwife believes to be true.

I want to add, also, because I'm just going too far I think, that even the University of Nebraska Medical Center allows waterbirths!

[mwherbs]

For the pain you describe the water helped me tremendously, for some women who do not like the tub often a hot shower helps, sometimes a woman doesn't think the tub or shower is helping until they climb out then they are right back in.


wiping a face down is a simple way to avoid using a bulb. But I have found that most babies don't even need any suction at all, yes babies some babies will cough and sputter but will bring the mucous up just fine., I do carry a bulb around just in case a baby needs some resuscitation I would rather use a bulb than a delee- and there are some studies around that indicate that it is just as good as a delee. as for lube in the tub water births over all have a reduced tear rate . your midwife may have some very good hands and practice at avoiding/preventing tears, I have worked with traditional gals who are golden at assisting no tears in hundred's - thousands of births. But a bit of reading will help assure her that it will be alright or she can contact someone like Marina Alzugarary( Marina is an older very EXPERIENCED midwife who may have some helpful information for you midwife) or Barb Harper who has been mentioned before or probably best would be another midwife she knows and trusts to tell of her own experiences.

[cottonwood]

Have you had your well water tested? Is it safe to drink? I wouldn't worry about it then.

My second was born in the water... I hear you about lubrication being washed away, I think that is a legitimate concern, I mean that's exactly why I don't like having sex in water but I have to say that with my waterbirth there was zero tissue damage, whereas with my first birth (not a waterbirth) in which there was lots of oil and perineal massage, I had minor tissue damage that was nonetheless very painful. I suspect that had something to do with my not being able to produce the hormones necessary to make the skin stretchy because I was inhibited and stressed out and it was painful to have someone working away on me down there. Being in the tub was, on the other hand, very relaxing, and I felt like it gave me some privacy and protection from that kind of violation, in other words there was less interference with the hormones doing what they could do to make the birth easier.

It's interesting what your midwife says about all the women she's seen instinctively getting out of the water. I never specifically planned to have a waterbirth, but with my second I did feel better staying in the tub because of the people in the room, so if it were not for that, I don't really know instinctively what I would have done, but I have to wonder, because while I labored in the water throughout transition of my third birth, I did instinctively hop out just before the baby emerged.

Briefly, I have to take issue with the idea that the normal natural process is potentially injurious to the mother unless supplemental procedures (such as perineal massage and support) are done, and I question whether these procedures help at all, and I think that it is likely that they are an interference more than anything. But that's sort of OT for this thread. If you're interested in delving further into that issue, do a search, it's been talked a lot in the past here at MDC!

[Marlet]

Originally Posted by Alexander

Water birth.

The water should definitely not be higher than the mother's body temperature.

a

I haven't read the entire thread so sorry if someone else has mentioned this.

I have heard so many things about the water temperature being in a certain range and that it is a very strict thing to go with. Is it really? I know they say body temperature but for me that doesn't help. I am chronically low on body temp. My "high" is about 96. That's if I'm lucky and it's wamr outside AND inside. I wear jackets and long sleeves most of the summer and freeze in shorts. The doctors check my temp twice to be sure the thermomator is not defective because of how low I am. It's not fair to me to only be able to keep water at body temp. I would freeze to death! I understand not wanting to have the baby in water WAY hotter than the mothers body temp cause of shock and others factors but if I only wanted to labour in water couldn't I make it hotter? I've decided against labouring in water because of this. I have been told by so many people that you can't have it greater than body temp. but like I said, that doesn't work for me. I get too cold too fast and it would be more of a hinderance than anything. Sorry for the ramble.

[pamamidwife]

The rule of thumb is that the water should be as hot or cool as the mother wants it.

[momileigh]

Originally Posted by pamamidwife

Ok, so I'm just wondering: how many births does your mw do? Is she an older mw?

Wiping off the face before the body is delivered is NOT necessary. Heck, no. In fact, suctioning the baby is a HUGE no-no - not evidence-based, not necessary, not helpful at ALL. No, no, no, no.

Water provides nice counterpressure. No need to oil the perineum. No need to have her fingers in you. No, no, no, no.

I want to stay nice here, and respect your mw, but she sounds like a mw talking from 1979!

I would urge you - really URGE you - to have her contact Barbara Harper from Waterbirth Intl. http://www.waterbirth.org/spa/index...._id=5&Itemid=1 with her concerns. This is really vital. Because, I will tell you one thing - her fear about waterbirth and meddling with your labor and the birth of your baby will create a negative experience for you. She will be fighting against what your body will intuitively want to do.

Please. Contact Barbara. By phone. Share with her some of these ideas that your mw has. It just is so...well, dated. Does your mw read anything like Midwifery Today? Does she keep up on her continuing education?

I'm sorry, but there are so many red flags that I don't know where to start. Please contact Barbara. If you really want a waterbirth, your mw needs to be re-educated. Definitely. This will be good not only for your birth, but for other women under her care.

I apologize, again, if I'm out of line, I'm just really concerned about what your midwife believes to be true.

I want to add, also, because I'm just going too far I think, that even the University of Nebraska Medical Center allows waterbirths!

I appreciate your concerns and will look into contacting that person, reading the articles, etc. I think maybe I wasn't clear about some things because some of the "red flags" you specifically mentioned I do not believe are a factor, so let me see... I would guess that she does not do a lot of "continuing" education because she's never had any formal training in the first place. She is totally a lay midwife who apprenticed under another lay midwife. She has read a lot of books. No formal training in the pedigree at all. She may be somewhat from 1979, heck, there might be some 1779 or 1479 in her as well. But when I was talking to her, she just had this amazing quiet confidence that birth is best with minimal interferance. She doesn't even like to catch the baby, she prefers to have the baby's father do it. She only does cervical checks if a woman insists on it. In the "hundreds" (she doesn't keep track but says that the low end is 200) of births she has attended, she has had one hospital transfer, which she says was unnecessary but the couple insisted that they were going to the hospital. In other words, she has never said to anyone, "We should think about transfering to the hospital." She also says that she never sees tears... the last time she saw tears was when she was an apprentice. Although she knows how to suture, she doesn't carry that equipment because she does not ever need it. She's got two natural products to stop hemorages (sp?) and had never opened either of them. She's never seen a "poor outcome" (death, injuries, etc.) to moms or babies. Like I said, she doesn't suction, but she attributes that to the fact that she wipes off the face. When I told her that I read that water-born babies don't generally need suctioning she thought out loud that maybe the water washes the face off a bit. She said that the midwife who never wiped the face ended up suctioning about half the time (with a bulb syringe) so that's why she always does it. She does not carry oxygen or a deLay. She DOES have a fetoscope and a brand-new doppler that she prefers because she says she can't hear quite as well as she used to. (I think she's in her early 40s, MAYBE late 30s even.) She also never breaks water, although she says she "can" do it. (I asked her what interventions she could possibly do, advisable or not.) I think I said before that she isn't "against" waterbirth... she just has never actually seen one. She did not ask the moms who had planned one to get out of the tub, she says they just stood up and delivered or climbed out and delivered on the toilet or floor. But she says that all of them were in bathtubs, and since my hot tub is MUCH bigger than a bathtub, it could be very different. Oh, and finally I should add that when she explained how she avoids tears, she wasn't talking about putting her hands "in" mom or even supporting the perineum manually in any way: she says she just likes to use olive oil and the one time that she coaches mom's pushing is to ask her to blow instead of bear down while the head pops out. This sounded good to me because I blasted my daughter out (under the PUUUUUUSH! coaching of the hospital staff) and her head and body came out all in one shot. I had a 2nd degree tear that the doctor would only say "isn't as big as an episiotomy" so I thought I got off easy. Anyway, this midwife is the least interventionist of the three in the area that I know. The "best" midwife in our area (who I actually think is great, she just charges a bit too much for me) did three of my friends' births: one had a 2nd degree tear and oxygen was administered to the baby, another was a hospital transfer and vacuum extraction, the third was a happy-healthy-easy waterbirth. (All three were "supposed" to be waterbirths, only the last one was.) So, right there, my mw beats those stats with two hands tied behind her back. I should add that amazingly she says she would not recommend hospital transfer for prolapsed cord... she says she can just put that cord right back where it came from if need be. She did that at the breech twins delivery (one was a footling, the other frank). She says the only way she'd ever "send" someone to the hospital would be for placenta previa or abrutia. When I told her I'd have a doula present, at the very first she was concerned, because she said, "She might think I'm not doing enough." When I explained that my doula and I had gone through the same doula training, which is very, very anti-interventionist, she became immediately supportive. (As doulas we had all the "cons" of every possible intervention pounded into our heads, and I'll be darned if I have trouble remembering any pros to most of them.) Anyway enough rambling! And really I do appreciate the concerns and will look into the ones that I feel are important, for sure. I have quite a while to go yet, and she has invited me to assist on three upcoming births, so I'll get to see her in action (or inaction) as well.

[momileigh]

Blueviolet, just wanted to add that I hear you about sex in water... how can that POSSIBLY be good?!? Please no one answer that. (Tried it once, that was more than enough thank you)

[pamamidwife]

Leigh, I'm sorry to have questioned your midwife the way I did. Looking back, I don't think it was appropriate.

[momileigh]

That's OK, it gave me a chance to re-evaluate how I feel about her as well. Dd was born in a hospital and this mw is definitely the other extreme entirely, and I need to be sure that I feel comfortable with her. Others questioning her helps me hash that out so don't feel bad! I think it is very easy to make snap judgments online with the limited info we are given; I know I do it.

[MyCalling]

Friday the 25th I birthed my 3rd and 4th water babies, boy/girl twins. When my son's head was born he openned his eyes and looked around while his body was still inside of me. My midwives had never witnesses a baby doing that. They say babies usually keep their eyes closed and look alseep at that point.

Is this common in anyone elses experiences? Everyone who saw said it was awesome...I couldn't see since his sister was still inside of me so my belly was too large. There was a picture taken so we are waiting to see if it comes out with his eyes open.

[cwaddick]

"When" and "how long" to be in the tub....

I'm planning my waterbirth (my 2nd: <beaming with pride>). I hadn't seen this subtopic elsewhere in the thread, so I thought I'd add:

Being in the water changes your experience of labor. If you are "early" in labor, being in the water can slow the progression of labor, causing your cervix to dilate more slowly. If you are "late" in labor, being in the water can moderate the pain of your labor contractions, making severely or even moderately painful contractions less painful.

The rule of thumb is that you get in the tub when your cervix has dilated to 8 cm or greater. Before the cervix has dilated to 8 cm, generally, being in the water will slow cervical dilation and slow contractions. ... I can't think of a good reason to slow labor down, but I'm sure it is helpful for something... maybe to make sure your DH gets home from work in time to be at the birth.

After the cervix has dilated to (or past) 8 cm, the water generally eases labor, but does not slow the progression of labor. It is for this reason that waterbirth is loved most. For a terrestrial birth, I can think of few comparable interventions that similarly ease labor (i.e. the hot rice sock applied to the lower back)... but that is not what this thread is about.

For the pushing stage, when the woman births the baby, the main benefit of being in tub is that the water relaxes the perenial tissue allowing the woman to birth the baby with greater ease. I can think of comparable interventions for terrestial birth (i.e. hot oil perenial massage), but these actions are not as dramatic as submerging your whole body in the water.

Finally, I haven't heard much about staying in the water after the birth. After my baby was born, I held him/her for over 10 minutes with those little feet in the water, and we just enjoyed the moment. Then, the midwives and my husband insisted that I look to see if the baby was a boy or a girl... and then, I held the baby for a while longer before I birthed the placenta. By that time, I was ready to be out of the water. Being in the tub with my newborn relaxed and comforted me and my baby.

-- Caitlin