Photo: Courtesy of Julia Dunn
When Julia Dunn was pregnant with her second child, she knew she wanted a different birth experience than she had with her first baby, who was delivered in the hospital with an epidural. “My first birth was good, but I felt like having an epidural and not feeling the labour and birth of my daughter was the opposite of gratifying,” she says.
Dunn decided to have a water birth the next time around. She delivered her second baby in a tub at the Toronto Birth Centre and was happy with her decision. “I liked the feeling of not being in a hospital surrounded by sterile equipment, fluorescent lights and machines,” she says. “My second delivery went so well that I decided to have my third baby in a tub, too.”
Many people have positive experiences with water births, but they’re not for everyone. Here’s what you need to know about a water birth to help you decide if it’s right for you and your baby.
Many women choose to labour and deliver their baby in a tub because of the relaxation benefits of water, says Carly Beaulieu, practice lead for Lucina Midwives in Edmonton, Alberta. That was certainly the case for Dunn. “Most of my labour was spent in the car, getting to the birth centre,” she recalls. “My contractions out of the tub were incredibly intense, but once I was submerged in the tub, I felt a wave of relief and comfort from the warm water.” The buoyancy of the water and the ability to move around and change positions easily also helped Dunn.
Beaulieu explains that being fully immersed in water lowers your blood pressure and allows you to feel more relaxed. This, in turn, allows oxytocin to flow, which brings on contractions. “Contractions can also feel shorter and less intense in the warm, soothing water,” she adds.
A water birth may be less stressful for your baby as well, and they may even cry less. “It may seem odd to practitioners who are used to babies being cold and crying as a sign that they are vigorous and well,” she says. “But these babies are still vigorous and well; they just sound and look a little different.”
While some doctors may allow a woman to labour in a tub, they will not deliver the baby in the water. If you want to stay in the water for the baby’s birth, you’ll need a midwife to be your care provider. Because it can be hard to get a midwife, it’s a good idea to seek one out as early as possible in your pregnancy. A midwife can perform a water birth in your home, at a birthing centre or at a hospital if allowed.
Water births are appropriate in low-risk pregnancies, says Beaulieu. However, if there are complications, such as placenta previa or vaginal bleeding, or if the baby is preterm or breech, you can’t deliver in the water. If you’re delivering multiples, talk to your midwife about your options—Beaulieu has a colleague in Edmonton who recently delivered twins in a tub, but not all midwives will be comfortable doing so. (In Alberta, midwives must oversee twin and multiple births in a shared-care situation with a physician.)
The tub where you deliver needs to be completely sterile to reduce the risk of infection and subsequent complications for you and your baby. That means that any type of pool or tub with jets is off-limits, as they are hard to clean. If you’re delivering at a birth centre or hospital that has a tub, the facility’s protocol will dictate that it should be cleaned and tested for bacteria regularly. If you’re delivering at home or in a hospital that doesn’t have a birthing tub, you’ll need to rent one. These are typically deep, inflatable pools with a disposable liner for sanitary reasons. You’ll need to set it up somewhere in your home that’s close enough to a tap (for filling up) and a toilet (for draining afterwards).
If you deliver your baby in water, you won’t be able to have any other type of pain relief, such as an epidural. That said, many people choose this method because they want an unmedicated childbirth, like Dunn.
Dunn says her ultimate goal was a healthy delivery, and she would have given up her hopes of a water birth if needed. Beaulieu says there are times when they ask the labouring woman to get out of the tub, including if something seems off with the fetal heart rate, if the mother’s temperature goes up too high (which could indicate that the water is too hot) or if there is a bacterial infection (possibly related to the baby’s first bowel movement). If the mother’s water breaks before labour, some care providers will avoid a water birth due to an increased risk of infection, even if the evidence isn’t strong, says Beaulieu. However, at her clinic, they will still deliver a baby in water if the mother’s water has broken.
Whether you’re in water or not, delivering a baby is exhausting and, chances are, you’ll be feeling a little out of it once your baby is born. But your midwife will jump into action, catching the baby, carefully unwrapping the umbilical cord if needed and pulling the baby out of the water quickly. But don’t worry: Your baby has something called a “dive reflex,” which means they have tiny receptors on their skin that help prevent them from breathing water into their lungs by signalling the airway to close instinctively. Most of these receptors are on your baby’s face, so your midwife will carefully pull your baby out, head first, being careful not to damage the umbilical cord. Beaulieu explains that this dive reflex may not kick in if there are complications during the delivery, like an abnormal fetal heart rate, which is why they wouldn’t allow the baby to be born in water in this situation. But in a delivery that’s progressing normally, the risks are low. “We’ve done more than 4,000 water births over the past 10 years,” she says. “Even though there aren’t a lot of good randomized, controlled trials, it's safe to say that over the course of thousands of water births, you don't have babies going into the NICU or having problems and infections.”
Some women stay in the water to deliver the placenta, but others are no longer comfortable because the water is dirty or cold. It’s up to you to decide when to get out. Beaulieu likes to have a place right next to the tub, set up with a towel, where the mother can easily lie down when she gets out. In each of her water births, Dunn stayed in the water until the placenta was delivered and the baby was checked over by the midwife. She got out when she was ready to be examined.
Dunn has no complaints about her water births. “Maybe the bloody water would gross some people out, but I was in the zone,” she says. “It didn’t bother me. My recovery was also faster with my water births than with my hospital birth. I kicked myself for not doing it with my first child.”