Louisiana Constituents for Safe Childbirth

Midwifery Rules and Water Birth- And why you should care!

Water Birth Ban for CPMs and Consumers

19

Mar 2016

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In 2012 the Midwifery Care Act was passed. For the past 2 years, the Medical Board of Examiners has been working on the Midwifery Rules for those laws. In the next coming weeks we will be sharing our thoughts on these rules. This blog addresses the limitations on water birth in the Louisiana Midwifery Rules.
If you haven’t seen the Midwifery Rules, you can read them here.
Here is the excerpt regarding water birth:

midwifery draft exerpt

 

Despite ACOG’s position on water births being labeled as opinion, the midwifery rules draft defers to ACOG’s opinion for deciding whether water births are allowed. Their opinion is that there is minimal benefit to water immersion therapy.

The Benefits of Water Birth

Benefits for Mother:

  • Warm water is soothing, comforting, relaxing.
  • In the later stages of labor, the water has been shown to increase the woman’s energy.
  • The effect of buoyancy lessens a mother’s body weight, allowing free movement and new positioning.
    Buoyancy promotes more efficient uterine contractions and improved blood circulation resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby.
    Immersion in water often helps lower high blood pressure caused by anxiety.
  • The water seems to reduce stress-related hormones, allowing the mother’s body to produce endorphins which serve as pain-inhibitors. Thus, decreasing the need for epidurals and pain medications and their side effects.
  • Water causes the perineum to become more elastic and relaxed, reducing the incidence and severity of tearing and the need for an episiotomy and stitches.
  • As the laboring woman relaxes physically, she is able to relax mentally with greater ability to focus on the birth process.
  • Since the water provides a greater sense of privacy, it can reduce inhibitions, anxiety, and fears.

Benefits for Baby:

  • Provides an environment similar to the amniotic sac.
  • Eases the stress of birth, thus increasing reassurance and sense of security.

What are the risks to the mother and baby?

Water birth has increased in popularity over the last 30 years and unfortunately, there has been little research on the possible risks of water birth.In Europe, some studies have found similar perinatal mortality rates when comparing water births and conventional births.
According to the Royal College of Obstetrician and Gynecologists, there might be a theoretical risk of water embolism, which occurs when water enters the mother’s blood stream. Though the British Medical Journal is 95% confident in the safety of water births, they see a possible risk of water aspiration. If the baby is experiencing stress in the birth canal or if the umbilical cord becomes kinked or twisted, the baby might gasp for air with the possibility of inhaling water. This would be a rare occurrence because babies do not normally inhale until they are exposed to air. They continue to receive oxygen through the umbilical cord until they start to breathe on their own or until the cord is cut.

The final potential risk is that the umbilical cord could snap as the baby is brought to the surface of the water. This can be prevented by using caution when lifting the baby up to the mother’s chest.

You’ve heard about what the professionals’ opinions are, but what about the consumers???

While ACOG may not be convinced that water birth has many benefits, this mama is! I gave birth to my second daughter in our large garden tub. I labored on a birth ball and standing/swaying until I felt that being immersed in water would help me. I was in transition, the most intense part of the first stage of labor. As soon as I got into the tub I noticed an immediate decrease in the intensity of the pain I was experiencing. I felt lighter, the contractions were less intense, it was a huge relief. Just the movement of the water itself was soothing. Listening to the sounds of water is therapeutic in general, and I definitely experienced this during my labor. I had my baby girl with no tears or injuries to her or myself, in comparison to my first, a non-water birth, in which I had significant injury to the perineum (And my first baby was a pound and a half smaller than my water birth baby!).

DSC01166
This testimony of water birth is not unique to my experience. There is a reason water birth is increasing in popularity. Midwives should be allowed to assess their clients to determine if a water birth is a safe option for them. This birthing option should not be limited or taken away.

Whether you have ever had a water birth, would one day like to birth in water, or don’t care either way, this is another way our rights and options as birthing woman are being stripped from us. 

Many women choose midwives as their care providers because of the natural pain relief options that are available when under the midwifery model of care. Rules such as this are tying the hands of Louisiana midwives and further limiting birthing options in Louisiana.

Supporting Midwifery Care supports Consumer's choices

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What are your thoughts so far? We would love to hear from consumers!

 

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