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Are Water Births Safe for Moms and Babies?

 

Are Water Births Safe for Moms and Babies?

I get lots of questions from pregnant mothers, regarding the safety of water births. There’s a lot of women who deliver at home because they are interested in a water birth and though I’m supportive of home birth, I think it’s a little sad we don’t offer them in hospitals as a safe alternative.

There is a question that they aren’t well studied, and I think that is a valid argument. We don’t know how safe it is to have a baby in the water, compared to out of the water, but the exciting part is that people are finally starting to look at this and doing some research around it.

There was a study in The Green Journal of Obstetrics and Gynecology that was published in October 2020, and it was a retrospective study involving 583 women. They took that group of women that was interested in water births and compared them to a similar pool of women who had what you might call “land births,” or births that did not involve water immersion.

Water birth in general is considered any birth where at least part of the labor occurs immersed in water. That can either be during the first stage or the second stage of labor. The first stage is the initial phase of labor, while the cervix is still dilating and the second stage of labor is the pushing phase and when the baby actually emerges.

During the retrospective study that they did in October 2020, the women who had some degree of water immersion in the second stage had a lower risk of complications compared to the group that did not have water immersion, which was an interesting and unexpected finding. I think the concern going into it is that there would be a higher rate of NICU admissions for babies that were born with a water birth, but the rate was actually significantly lower. In fact, it was about a third as high compared to the babies that were born without water immersion. The risk was about 2.5%, but that was about two-thirds lower compared to the group that didn’t have the water immersion.

There’s also a lower risk of lacerations to the mom. When babies come out sometimes there is some tearing down in the vaginal and vulva area and there is actually a lower risk of those lacerations for babies that were born with some degree of water immersion.

The one risk that did arise from the water birth was a very small rate of something called cord evulsion, which is when the umbilical cord separates after birth before it is clamped and cut by the doctor. The rate was about 0.08% for water birth babies. It’s not very high, but it’s something worth looking into. Sometimes if a cord evulsion occurs the baby might require some additional support, such as a blood transfusion because there can be bleeding from the cord. Despite the cord evulsion that they noted, there was no higher risk of babies getting admitted to the NICU, so again I think it opens the door for conversation and is worth talking about.

We often use water immersion for pain control techniques during the first stage and I think we’re just at that cusp where we are starting to look to see how safe it is in the second stage.

I’m hoping that more studies will be done and that it will be a reassuring practice. If it is reassuring when they look into it more, maybe more hospitals with offer this and that will encourage some of the women who have been looking at home births to feel comfortable with hospital births, as well.

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