Let’s be honest, you probably came for the wine and cheese. But now I have you here, why not spare a few minutes to learn how water can make your labour and birth so much easier! I promise it will be worth it.
We’ve listed seven things every Mama should know about labour and birth in water. As a Private Midwife, the majority of my clients use some form of water to bring their babies earth-side. I see time and time again how amazing it can be. I’ll never forget when a client, a second time Mama and Midwife, got into the bath in labour and shouted at me “this is so good! Everyone HAS to experience this!”.
I also used both the bath (birth pool) and shower to birth my own son, through a very long labour, without medical intervention or drugs. I know for sure if I didn’t have the water I would have opted for the drugs. This is one thing I really didn’t want, purely because I always see how it can start the cascade of interventions. I knew the importance of being unmedicated, active and upright in labour, unhindered by being stuck on my back or strapped to a monitor.
But enough about me, here are seven things you need to know about how water can make labour and birth easier for you.
Hormones Of Labour
The first thing you need to understand is how the hormones of labour work. Very basically explained, anything that helps increase your oxytocin and endorphins, and reduce adrenaline, is ideal in promoting a shorter, easier birth.
Oxytocin is the hormone of love. It helps the uterus work well in labour for an easier birth, and gives us that euphoric, empowered feeling and receptiveness to our newborn babes.
Endorphins are our body’s own natural pain reliever! Meaning the more endorphins, the less pain. Endorphins are what give you that out-of-body feeling…. la la labour land as I like to call it. This is crucial to the physiology of labour and birth, as our thinking brain has to turn off so our primal brain can take over.
Adrenaline, the fight or flight hormone, can scare away contractions, increase our sensation of pain, and induce fear and tension, fuelling the fear-tension-pain cycle.
The good news? Water in labour increases oxytocin and endorphins, while reducing adrenaline. Here’s how…
Pain Relief And Perception Of Pain
So why does water work so well? We’ve already looked at the hormones of labour, so you now know that water increases your endorphins and oxytocin, which equals less pain. Think of when you’ve had a long day and jump into a hot shower, that aaaaah feeling, you want to sit on the floor and feel the water run down your face washing away the stress. That’s endorphins, and they feel good.
But, you also need to know this. Touch receptors in our body, are bigger than pain receptors. So if we do anything to elicit the touch receptors, the pain receptor signals to our brain will be hindered.
Just say you hit your shin on something. Ouch! Your automatic physical response is to rub it, because it helps. But it actually doesn’t take away the pain. What is happening is your touch receptors are firing from the sore area being rubbed, and these trump the pain receptors which are trying to send a signal to your brain saying “pain!”. The signal is hindered, and it doesn’t feel as sore as it first did, so we can cope a lot easier, and perceive the sensation to be less.
In exactly the same way, feeling the hot shower spray against your lower back or abdomen during labour, or being submerged in deep warm water, elicits your touch receptors and hinders the pain signal. Making it far more possible to ‘cope’.
Safe And Private
Dr. Sarah Buckley, Family Physician and author of Gentle Birth, Gentle Mothering, teaches on the necessity for women to feel private, safe and unobserved in the birth environment, for the hormonal cocktail to unfold.
Choosing the right care provider and support people is one of the most crucial factors in ensuring this is understood, respected and afforded.
Labouring in a birth pool also aids such an environment. It is your own space, like a nest. The deep water gives a sense of privacy, and it limits the amount of unwanted touch and chatter. Any time I’ve seen a Mama labouring in a pool, it’s been like a trigger for people to stop and realise ‘she’s in her zone, let her be’.
If the bath isn’t for you, even the shower can support feeling private, safe and unobserved. Showers aren’t usually within the large open birthing room, they are in the attached, smaller bathroom. Like an ensuite. This means less space for machines, and clutter and crap. More intimacy, less light and noise. Less institutional posters that shouldn’t be in the birthing environment like ‘remember the 5 steps to hand hygiene’ with the hideous superbug caricature. Ultimately, a more supportive environment to let the primal work happen.
Make Labour Easier
We’ve already discussed the many ways water makes labour and birth easier. But let’s talk about labouring in a bath/birth pool specifically. Labour has been likened to running a marathon. And it’s true. It is a huge physical feat. Whether you’re a fitness junky, yoga goddess, or haven’t exercised since primary school cross-country, labour and birth is hard work.
Fortunately, the buoyancy created in a birth pool means there is far less strain on your muscles, abdomen, and legs, and you are more easily able to relax your body and rest in between surges (contractions). It’s important that the pool is deep enough and warm enough though. Ideal depth is water to your nipple line, at 37 degrees (Celsius).
Soft And Open
Birthing in water, whether shower or birth pool, can help ease crowning for a gentler birth, with fewer rates of significant tears.
The perineum, that bit of tissue between the vagina and anus, becomes very stretchy when giving birth. Your hormones will ensure that. I hate the analogy of ‘pushing out something the size of a watermelon’, but yes, a baby’s head is a lot larger than we perceive our lady bits capable of. Birth is the only time the perineum can stretch that much and become so open. It IS perfectly capable, our bodies are designed to do it.
Warmth to the perineum has been found to increase the elasticity of this area by softening the tissues. This prevents significant tears (third/fourth degree tears which involve anal sphincter) and rates of episiotomy (cutting of the perineum). The running shower water, or being submerged in a warm bath is, therefore, a perfect way to support the perineum to become soft and open, for a gentle birth.
Womb To World
A baby’s transition from womb to world is one of the most important and vulnerable moments in their lifetime. It can occur really gently, or really poorly. Waterbirth for a well baby can facilitate a gentler transition. They are born from the warm, dark and wet womb, into a warm, dark and wet environment. Instead of into a bright, noisy, cold room.
I’ve observed many babies be born through water, and many born on land. There is often a stark difference in the behaviours between the two in their first few hours of life. The water babies commonly being more calm and alert, instead of distressed and agitated.
This isn’t to say birth on land is a distressing event for a newborn, but we can’t deny the gentleness that comes with birth in water, for both Mama and baby.
Myths About Waterbirth
If you’ve read this far, you’re probably keen to consider labour or birth in water, so there are some myths and common questions surrounding waterbirth that we want to dispel for you.
I don’t like the idea of birthing in water, so the bath isn’t for me –
Women will always birth best where they feel comfortable. If waterbirth isn’t for you, you can still reap the benefits of water in labour by using the shower, or using the birth pool for ‘warm water immersion’ in labour only. Your Midwife will be able to guide you in getting out when they can see external signs that your baby will soon be born.
Could my baby drown or inhale water? –
One of the biggest misconceptions, and biggest fears about waterbirth is that baby will take a breath underwater and choke or drown. When a baby is in the womb, they are oxygenated by the placental circulation via the umbilical cord, their lungs are bypassed and filled with fluid. When they are born in water, this continues briefly.
Midwives know not to stimulate a baby under water so that they don’t gasp, and the transition from the warm womb to the warm water means they don’t take a gasp on their own until they are brought out of the water. When their face is exposed to the air, their lungs are triggered to transition from fetal circulation to newborn circulation. There is no statistical increase in morbidity or mortality for well, term babies born in water versus on land.
It just sounds so gross –
Some women worry that they will be in a bath full of birth muck. In reality, birth is not clean, nor is it meant to be. Babies are exposed to blood, amniotic fluid, the vaginal flora and… Mama’s poo. This is all beneficial in laying down their gut flora and microbiome. When you birth out of water, all this muck runs down your legs, into your toes, fingernails, the works. That’s why many women who birth using water report feeling much cleaner afterwards, but baby is still benefited from exposure to all the beneficial bacteria. Research has disproven the historical concern that waterbirth increases the risk of infection for mother and baby.
But I can’t have any drugs if I’m in the bath or shower –
Actually, you can! It is not safe to have narcotics like morphine, fentanyl or pethidine while you’re in the bath. And for obvious reasons, the epidural is out. But you can have nitrous oxide, aka ‘the gas’. The gas works while you’re inhaling it, but after a few breaths of fresh air it is out of your system and very safe for baby. The other benefit of the gas is that it can start at a low level, and be turned up higher as required – so it can increase in strength as the labour intensifies. Also, the tubing attached to the mouthpiece can be extended quite a long distance, so even if the gas isn’t portable, in most cases it can still reach you in the bathroom.
I need to be monitored in labour, does that mean I can’t use water? –
There is most definitely monitoring equipment, both dopplers and wireless cardiotocography (CTG) machines, that can be used in water. This is a question to ask the hospital you are birthing at. Every different hospital in every different state in every different country have their own policies, guidelines, and facilities surrounding waterbirth and warm water immersion in labour.
It’s important to remember that policy is not law, and you should consider whether your options for non-pharmacological pain relief are limited due to facilities and operational bureaucracy, or because you and your baby’s individual circumstances and safety are being considered.
So there you have it, birth and water most definitely go together like wine and cheese. And if you still can’t get wine and cheese off your mind, check out our post on how to safely enjoy alcohol while breastfeeding!