Warm Welcome: A Water Birth Revolution

By Shelley P. Albini
Issue 103, November/December 2000

Early one Monday morning in July I was standing on my porch steps waiting for my sister-in-law to drive me to St. Mary's Hospital, where I planned to deliver my baby into a tub of water--a water birth. Anticipation filled my body between contractions: I wondered if I would make it, if the water would be the right temperature, if everything would be as I'd pictured it in my mind's eye.

When I became pregnant with our third child, my husband, Mark, who is an obstetrician, suggested that a water birth might be a gentle way to bring our baby into the world. We both knew that it was not a coincidence when he came across a brochure advertising the first International Water Birth Conference to be held in South Carolina during the fifth month of the pregnancy. It was just what I needed to be able to decide if a water birth was for me.

During our first afternoon there, before the workshops began, a woman waved at me from across the pool. An obstetrician from Russia, she told me in broken English that she had performed many water births. Late on Saturday, she showed a video of a young woman who knelt in a pool of water and released the baby into the water as she focused on her breath. I held this powerful image in my mind until the moment I gave birth.

That day and the next were filled with lectures about the physiology of taking the first breath, how different people integrated water into their maternity care, and how different cultures birth. Michael Rosenthal, a physician from a California birth center, said, "To change birth, we need to change the mental image of birth." That was key in changing my comfort level.

Now that I was convinced, I hoped that I'd be able to have the birth I wanted in the setting I wanted--the hospital. I'd had two positive hospital births and had no desire to have my baby anywhere else. At my next appointment, I asked my obstetrician how open-minded he felt that day. He smiled and asked why. "I want to have this baby in a tub of water," I said. He sat down. After sharing all the concerns that I knew he would have, he said that he'd work with me. My husband Mark and I gathered data to answer his questions about the risk of infection, the ability to monitor the baby, and the logistics of the process. He got the necessary permission from the hospital administrators. When everyone, from the top down, said yes, it seemed meant to be. I was grateful.

To prepare for the experience, I wrote a birth plan, describing what I hoped would happen. This helped me visualize the birth from beginning to end. We rented a tub from Oregon, one that we had seen at the conference, and had it delivered to our home a month before my due date. (I had both my daughters before their due dates and didn't want to take any chances.) As my last labor took only four hours, the tricky part would be getting the tub to the hospital and setting it up quickly enough. I hoped to be able to give Mark as much notice as possible. The universe had other plans.

The day after the tub arrived, at 35 weeks, I began having contractions. I thought that this was it, the moment I had waited for, but after a few hours of intermittent contractions, they stopped. This happened four other times in the next four weeks. I became very anxious each time, not knowing if this was the moment to begin putting our birth plan into motion. Vacillating between frustration and surrender, I struggled with my hope that everything would be perfect.

On the morning of July 29, I woke up at 6:15 with the feeling that something had changed. Mark examined me and found that I was 6 centimeters dilated! He ran out the door to set up the tub. Our two daughters (ages five and eight) were prepared to attend the birth, and the older one went with him. The younger one stayed with me while I called my sister-in-law to pick us up.

As we entered the Emergency Room, an orderly swept me up in a wheelchair and took me to the labor and delivery floor. When we got off the elevator, I saw a hose running down the length of the hallway. "That's my room, at the end of the hose!" I directed. The orderly wasn't sure what to make of this and took me to the central desk. Sure enough, we followed the hose into my room, where the tub was beginning to fill up. Miraculously, I had only two small contractions in the 20 minutes it took to get from my house to the hospital room. Once there, I had a few more that were stronger and was fully dilated by 7:15 a.m., just as the tub was ready.

Climbing into the tub brought a sense of relief and well-being. The water was 100° F, close to body temperature, and I couldn't help but relax. My husband sat behind me in the water, supporting my body as well as my process by encouraging me to remember what I had visualized so many times. I recalled the Russian woman and focused on my breath. The warmth of the water seemed to make it easier to concentrate.

I didn't want to push and chose to allow the baby to come down the birth canal at his own pace. It was easy to squat as the water supported me. Once the head was out, I decided to rest and leaned back against my husband. Seeing on many videos that the baby would take a breath only when its mouth had contact with the air helped me to know that the baby was safe underwater. I wanted to feel the head and remembered to reach down and caress his hair. After three minutes, at the request of my doctor, I pulled up my knees and gently pushed. Our 8-pound, 10-ounce son was born into the water and tenderly lifted up by my doctor and me. Bringing him to my chest was a magical moment. He seemed to hardly know that he was part of our world now.

The experience of birthing in water had a lot of benefits, many of which I realized only after the birth. My healing was much easier. There were no cuts or tears. I was much more comfortable, which was surprising as my son, Mark, was 2 pounds larger than either of my daughters. The warm water replaced the need for medication, which allowed the baby and me to be bright and alert right after the birth. The exhilaration of creating this special birth for our son was beyond words.

The fact that I was a woman with a track record of uncomplicated natural childbirths and my husband was a well-respected obstetrician gave us the credibility we needed to get the permission for a hospital water birth. What about others who might want this experience?

Eager to spread the word, my husband and I joined forces with a wonderful childbirth educator, Janet Hall, and sent out invitations to everyone we could think of who might be interested in changing present birth practices. With my baby on my lap, I stuffed, licked, and addressed many letters. Two months later, dozens of people came to an all-day workshop on a Sunday in September. The energy was electric as midwives, childbirth educators, and present and future parents realized that they were not alone in their desire to create the type of birth they felt was right for them and their baby, whether it be with a midwife at home or a water birth in a hospital with understanding caregivers. Everyone simply wanted to have a choice. Many ideas were generated, and many connections were made. It was at that time, in 1996, that the idea of a birth center was "born."

Jump ahead to January 2000. My son and I were driving to the hospital to attend an opening ceremony for the Community Birth Center at St. Mary's Hospital. He was three and a half, and I was explaining to him that people can create change, even little babies. I told him about all the courageous moms who followed us and had their babies in water, helping hospital administrators see that this was something families wanted. I reminded him of all the meetings his dad and I attended, and how going one step at a time and moving through the process, however long it takes, brings you to the goal. He listened and smiled as if none of this was new to him.

FOR MORE INFORMATION

Organizations
The author found extremely helpful:
Global Maternal/Child Health Association, Inc., Barbara Harper, 503-682-3600, Fax: 503-682-3434, www.waterbirth.org [1]

Also check out:
AquaDoula, Connie Winings, 110 9th Avenue South, Edmonds, WA 98020, 425-672-7816, Fax: 425-776-2157, waterbirth@aquadoula.com [2]

Publications
Balaskas, Janet, and Yehudi Gordon, MD. Waterbirth. Thorsons UK, 1990.
Beech, Beverly. Waterbirth Unplugged: International Perspectives on Waterbirth. Butterworth-Heinemann, 1997.
Bertram, Lakshmi. Choosing Waterbirth. Hampton Roads, 2000.
Garland, Dianne, RM. Waterbirth: An Attitude to Care. Butterworth-Heinemann, 1995.
Harper, Barbara, RN. Gentle Birth Choices: A Guide to Making Informed Decisions. Inner Traditions, 1994.
Harper, Barbara. Opciones Para Un Parto. Suave Healing Arts Press, 1997.
Kitzinger, Sheila. The Complete Book of Pregnancy & Childbirth. Knopf, 1996.
Midwifery Today magazine, no. 54 (Summer 2000--dedicated to water birth.
Korte, Diana, and Roberta Scaer. A Good Birth, A Safe Birth: Choosing and Having the Childbirth Experience You Want, Appendix A. The Harvard Common Press, 1992.
Lichy, Roger, MD. Waterbirth Handbook. Gateway Books, Int., UK, 1993.
Limburg, Astrid, Beatrijs Smulders et al., Women Giving Birth. Celestial Arts, 1995.
Napierala, Suzanna. Water Birth: A Midwife's Perspective. Bergin & Garvey, 1994.
Odent, Michel, MD, rev. ed. Birth Reborn. Birth Works, 1994.
Odent, Michel, MD, and Jessica Jackson. We Are All Water Babies. Celestial Arts, 1995.
Waterbirth International, Waterbirth Resource Binder. Waterbirth International, 2000.

For additional information about water birth, see the following articles in past issues of Mothering: "Birth in the Black Sea," no. 61; and "Underwater Birth: Another View," no. 47.

Shelley P. Albini, MA, is a stay-at-home mom who is an independent distributor for Nikken. She and her family are currently building a straw bale house in a rural town in Connecticut. She can be reached at naturalmama@earthlink.net [3].