Waterbirth and baby's breathing

[0cean]

Hi!

I am about to (any day now) have my third child and this will be the second waterbirth/homebirth. My previous homebirth was great and the only out of ordinary thing was my son having a bit of oxygen soon after delivery due to not breathing much after birth. Also for the first few days he slept so much and had so little activity that he worried us a little but I hadnt thought much about that latley.

My midwife's assistant (she is also a certified lay midwife, just not fully practicing yet) mentioned something about waterbirthed babies not breathing/pinkening as quickley as out of water birthed babies and I have been wondering why. She is totally not anti-waterbirth, she in fact just had her son in water 4 months ago. Her comment was from her own experience and other midwives experiences and she seemed unconcerned about it. Now I have been noticing how many waterbirth stories also have babies needing oxygen and extra breathing stimulation.


My initial thought was that the waterbirth is so gentle and comfortable that there would be the lack of distress that causes crying, thus quickening the breathing/pinkening. Now I find myself wondering If there is some sort of natural expected order of hitting air just outside of the birth canal that is disrupted in waterbirth, causing some momentary confusion. Or amybe we should wait a little longer to force babies to breath as long as they are still attached to the umbillical cord. My son's cord was actually cut in order for him to get the oxygen, which looking back seems a bit odd.

I was just wondering what others thoughts on this were. Is this discussed anywhere else I might refrence?

[frogertgrl]

Re: Waretbirth and baby's breathing

Originally posted by 0cean My son's cord was actually cut in order for him to get the oxygen, which looking back seems a bit odd.

I have no idea why someone would cut off O2-rich blood supply in order to force breathing. Did your midwife explain this afterward?

I had a waterbirth with DS (15.5months ago) and he was pink right away. I do believe water is a gentler emergence and I do not support shock (bright lights, suctioning, slap on the back) for breathing.

As I understand it, your son was receiving oxygen via the umbilical cord. I don't know how long of a delay you waited until cutting the cord or if he was floppy, etc.

I think midwives vary in their comfort level with waiting for the child to breathe (cry?) and use oxygen accordingly. We didn't worry about it ahead of time and had the placenta still attached days later to ensure my son received all his blood.

[2much2luv]

I had a water birth with my dd last year. I think what you said about the water birth being more gentle and that they may just take their time to get breathing going seems the most likely answer to me.
i agree that they were completely wrong to cut your babes cord to give him oxygen. :

[Carolinamidwife]

Unless the cord was so short they couldn't get him to the oxygen I can't think of any reason to cut his cord. You're right though, waterbirthed babies do acclimate differently than landbirthed ones. There is a CNM who, after many years of study, composed an Apgar scoring system for use with water babies that takes into account a gentler introduction to extra-uterine life.

Amy

[0cean]

Well I just started to question the cord cutting for the oxygen, so we have not discussed it yet. The cord was short and we were several feet from the oxygen. I will have to do a little questioning to see how long we waited to do the oxygen, it wasnt immediatley, and we didnt do any shock measures to try to get the breathing stronger, just gentle face and back rubbing and a little gentle blowing on his face from me. My midwife this time is a different one (we moved) and I will ask her a bit about it too to see her perspective. She is a Nurse Midwife so her thoughts might vary some too.

[crazy_eights]

I believe there has been a shift in thinking about waterbirths. You can't compare then to landbased births in terms of expectations. No, they might not pink up as quickly as those born into the air, but from what I've heard it is b/c land babies are stimulated from the moment their head hits the air where as water birthed babies aren't until they are brought up to the surface. I wasn't at your first birth, so I can't say what was going on there. It might be that your practitioner wasn't used to the slower (but still normal) transition of a waterbirthed baby.

FWIW - I've had three labors in water, but only one born into the water. She never cried, but slowly turned pink and let out a little mew as I held her and she did great.

[moonglowmama]

I just read something about this recently in Susanna Napierala's book, "Water Birth: A Midwife's Perspective."

I'll quote: (from a section talking about the Apgar scoring for water births)
"The baby's color is usually pale at a water birth, because the carbon dioxide/oxygen exchange has not yet kicked in (although I have seen some pretty pink babies born into the water). If a baby has a dusky or bluish-purplish color, the baby should be brought to the surface immediately. All the five categories for an Apgar score can be used, except, of course the respiratory efforts at the first minute."

"Often water babies do not cry and are very peaceful when born. If the baby is very quiet and appears to be sleeping, watch for breathing movements. If these movements are not apparent within 15 seconds, start massaging the spine upward, ..."


That is a great book, and I would highly recommend it to anyone wanting to do a water birth. It has lots of practical information (like this) and beautiful birth stories and the author has great confidence in water birth.

[Cindi]

On Thursday I heard Rahima Baldwin (midwife, author: Special Delivery, You are Your Child's First Teacher, etc.) speak...and she was describing the experience of the baby through the passage of birth. I don't remember her addressing waterbirth specifically, but do remember her describing the first breath. She described the dramatic temperature change from inside the body to cold air outside (even 80 degrees is almost 20 degrees cooler than internal body temp) triggering a reflexive inhalation, in combination with the emergence from the birth canal, where pressure on the torso is released. She, or perhaps another speaker, also mentioned that suctioning is not usually necessary because of that birth canal squeeze--you can watch the mucous squeezed out of the nose and mouth, just before the release and breath. Like I said I don't think she commented on waterbirth (which I am planning myself) but I could imagine from that explanation that the transition through water might make for a less intense reflex for breathing. But considering how common waterbirth is in many traditions, and my very experienced midwife does mostly waterbirths, I am comfortable with going that route.

[Peppamint]

My ds (5 weeks old) pinked up right away but he also cried right away. We only had candles burning and the light in the next room on. He came very fast after my midwife broke my water so it was intense. He was a bit raspy his first day because we didn't suction him. We did wait a few minutes to cut the cord, my placenta came out three minutes after he did. Like I said, quick intense birth. I'm so glad I had the water!

My thought is it's usually a more gentle entrance and that's why waterbirth babies don't necessarily cry/pink up right away.

[velveeta]

Originally posted by busybusymomma


My thought is it's usually a more gentle entrance and that's why waterbirth babies don't necessarily cry/pink up right away.

I totally agree! My DS gave a teensy cry, and then snuggled down into my chest. It took him a few seconds to pink up, which my MW said was *very* common with waterbirth. His apgar scores were 8/9 due to the dusky color at birth. DH said that he didn't think that any scoring system that didn't give his baby a 10 was flawed! I agree! DS is a 10!


Jean