Despite the fact that waterbirth has been around for quite some time now, and numerous studies have shown that it can be a safe option with an experienced birth attendant, ABC news this week spoke out against water birth.
The news report was triggered by the announcement that Giselle Bundsen had given birth at home in a bathtub. While ABC admitted that studies have shown warm water relieves labor pain, they stated that “to learn more about this method of birth” they would turn to their resident expert, Dr. Tim Johnson, who in turn interviewed an obstetrician, Dr. Laura Riley, medical director of the labor and delivery unit at Massachusetts General Hospital. ABC did not interview any expert who was experienced in water birth.
After listening to the interview (you can watch it here), I was left wondering if Dr. Riley has ever actually seen a water birth, and where she got her ideas about women giving birth in water. Having personally been the midwife at dozens of water births, without a single complication, I question the following statements by Dr. Riley (my comments are in parentheses):
- A few studies “suggest” that women who labor in water are more comfortable, but there are also studies suggesting that it doesn’t really work (Really? The Cochrane Review states, “Evidence suggests that water immersion during the first stage of labour reduces the use of epidural/spinal analgesia.”¹)
- The baby is submerged in water and this may prevent the baby from “taking a good vigorous cry” when it’s first born. There have been case reports of stillbirth, and babies who needed positive pressure ventilation because they never had the chance to take that good first breath. (As a midwife who’s attended many water births, I have seen numerous babies born who never had “a good vigorous cry”, but simply, peacefully, began breathing and turned pink without ever crying. For a fascinating theory on why babies start breathing after birth, read Dr. George Morley’s article entitled Why Do Babies Cry?
- Babies can breathe in amniotic fluid but they can’t breathe underwater once the cord is cut. ( Obviously, we are mammals, and mammals are air-breathing. What this statement is not recognizing is that babies don’t “breathe” in amniotic fluid. They make breathing motions, but no air is taken into their lungs. At a water birth, the cord is not cut while the baby is underwater. Every responsible care provider I know of brings the baby’s face out of the water immediately after birth so that the baby can breathe AIR. The cord may be cut shortly after birth, or may be cut when it stops pulsating, but would never be cut and the baby left underwater).
- There are some reports of babies who’ve had serious infections because, obviously, it’s difficult to sterilize the water. (How sterile is a birth on a bed? Many women have a bowel movement while giving birth, and this can be difficult to keep out of the birth canal and off of the baby. The provider’s hands may have sterile gloves, but once they touch the vagina, they are no longer sterile. Most provider’s hands are maneuvering, checking, and repeatedly touching the birth canal and the perineum. . .not sterile at all.)
- I suspect that getting into the water at 9 months pregnant is a little bit tricky. (Is this the biggest concern you can come up with, Dr. Riley? Should this even be mentioned as a reason to avoid water birth? I suspect that Dr. Riley is used to seeing women with epidurals who are unable to move their own bodies from one side to another on the bed. I have never seen a 9-month pregnant woman with a healthy attitude toward pregnancy who had any problem moving in and out of a birthing tub. Especially when she knows it will help ease her discomfort.)
The water births I have attended have been overall the most peaceful, calm, and gentle births for both mother and baby. I believe water birth can be a safe option if common sense is used–baby is brought to the surface immediately so there is no chance of aspirating water. Once again, we see physicians in authority speaking out against something they have never personally witnessed and know little about.
For more research on water birth and the pros/cons surrounding this topic, see Barbara Harper’s list of research articles.
1. Immersion in water in labor and birth. Cochrane Review. Retrieved 2.2.10 from : http://www.cochrane.org/reviews/en/topics/87.html
I too am sure that Dr Riley has never witnessed a water birth in her life. Like you I have attended many water births and every outcome has always been good. Babies generally dont cry when they are born in water, probably because the transaction from fluid to fluid is so gentle that there is no need for them to cry when their little bodys hit the cold air as they do when born on dry land.
I totally agree with you about the non sterility of a dry land birth , sometimes I havnt even had time to put on gloves! In our birthcentre we clean the pool with a very strong cleansing agent (ensuring it is all washed away afterwards of course) and therefore the evironment is as clean as we can possibly make it. The baby isnt born into a sterile world in any case.
As for her silly notion of the cord being cut before the baby is taken out of the water , I really cannot begin to imagine where she got that idea from! Apart from the impossible logistics of cutting anything underwater did commonsense not just kick in to say that this would naturally be a procedure which would occur once the baby was safely on mums chest? I have attended waterbirth seminars which also advocate that delivering the placenta whilst mum is still in the pool is also no longer considered unsafe practice (Dianne Garland).
Once again this is a case of doctors thinking that ‘they know best’ and writing with their lawyer stood over their shoulder.
You know, reading this just left me a bit dumbfounded. Let’s look at the points, shall we?
Studies “suggest”. Well, how about talking to those who have actually had a waterbirth, instead of studying it in the sense of looking for a way to discredit it?
The baby can’t breathe underwater…..duh! I have to wonder about the intelligence of someone who would even make that remark. The diving reflex will keep the baby from taking a breath until the Mother or midwife brings the baby to the surface.
Baby could get an infection. So, what…..babies born in a bed in the lithotomy position never get infections? Sure they dont, except, that sometimes they do.
Getting into the water is tricky. Huh? This one I don’t get. I was still riding my horses, team penning and breakaway roping up until ONE WEEK before my son was born. Somehow, I don’t think a tub of water would have been much of a challenge.
These arguing points they listed are idiotic, I can refute them, and I did NOT have a water birth, or even an unmedicated birth. I despise hysterics and drama, and that’s all this is. Dumb.
I watched this video yesterday and was pretty much yelling at the screen; it was so infuriating to see the misrepresentations, ignorance, and outright dishonesty that was given in this video. It was frighteningly inaccurate. I too was upset that they chose to interview a person who was obviously (a) biased against waterbirth, and (b) completely inexperienced in waterbirth. They did not even have the courtesy to interview people of disagreeing viewpoints – they just left waterbirth experts completely out of the equation. Is there someone to contact about this to object? Thanks for writing this all out.
Yes, the episode appeared on Good Morning America, and it was the health feature entitled “Are Water Births Safe?” with Dr. Tim Johnson and Dr. Laura Riley. You can comment at this linkhttp://abcnews.go.com/Health/water-births-safe/comments?type=story&id=9730010
Comment on the Good Morning America waterbirth feature
Forgive my ignorance but if a baby is alert and shows good color, why is a “good cry” needed?
I just recently had an unplanned waterbirth. Unplanned because, well, I just could not get the visual of bodily fluids and possible excrement in the water off my head. But my husband, doula, midwife and her apprentices could not have dragged me out of the tub once I was in it.
That said, it was pretty amazing how my daughter looked as she was born. She was the pinkest newborn I’ve seen. The eyes were so alive and she was so alert.
Your question is not ignorant at all. You bring up excellent points. For years, it’s been thought that the “good cry” was necessary for the first expansion of the baby’s lungs, and to replace air for fluid that is normally in an unborn baby’s lungs. Recent studies have questioned whether this is the case. It has been found that the initial pressure needed to expand an infant’s lungs for the first time is not as high as first believed. Advocates of gentle birth, from Dr. Leboyer to waterbirth prononents, agree with you–if the baby is pink and breathing regularly with a normal heart rate, there is no need to make it cry.