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Labouring and giving birth in water: tips from the 2013 home birth conference

Giving birth and labouring in water, Homebirth Assocation Conference 2013, Mind the Baby Blog, www.mindthebaby.ie
‘All you need is love, Love is all you need’ by Amanda Greavette http://amandagreavette.blogspot.ca

Waterbirth in Ireland was the theme of this year’s Home Birth Association annual conference on Sunday. If you were following me on Twitter, your timeline would have been bombarded with a blow by blow account of the day. Between myself and my fellow Irish Parenting Blogger David who was representing Birthingmamas on the day, I think there probably wasn’t one inch of the conference we didn’t cover!

The biggest take away for me was that water birth – whether you’re talking about just labouring in water or both labouring and delivering your baby in water – is most definitely not the preserve of women planning a home birth. Having access to birth pools in both hospital and home births is a great option for labouring mothers and the over riding recommendation seems to be “get thee to some warm water!”.

We heard great speeches from renowned UK midwifery lecturer Ethel Burns and Philomena Canning, Dublin-based self employed community midwife, who between them have over 70 years of midwifery and water birth experience. Ethel took us through her fascinating 2012 research on outcomes for women using a birth pool and Philomena spoke about her experience and the benefits of water birth.

Here’s some facts you may not have been aware of:

  • All midwifery units in the UK have a birth pool. We have very few in Ireland
  • Use of a birth pool during the first stage of labour decreases the need for analgesia (pain meds), results in less augmentation of labour, more spontaneous delivery, less infection, reduced pain perception and increased maternal satisfaction. That’s an awful lot of good things.
  • Evidence also shows that using a birth pool results in more intact perinae, no increase in extensive perineal trauma, and no increase for minor or major primary post partum haemorrhage
  • It is not necessary to wait until you are x many centimetres dilated to get into a birth pool. You can get in when you want to get it in.
  • If you are interested in or planning a natural birth, Ethel’s research proves that both labouring in water, or labouring and delivering in water, increase your chance of having a normal birth. Ethel also pointed out that data shows that if you are a healthy first time mother with no complications, you are in a very high risk group for an emergency C-section. Getting yourself into water for your labour will reduce your chances of this happening.

Both Ethel and Philomena gave great tips on the practicalities of using a birth pool:

  • Ethel recommended that the temperature of your birth pool should be slightly cooler than your normal bath temperature but said that you shouldn’t get hung up on temperature. Cooler is better and be comfortable. Philomena agreed that your own comfort was key and suggested a temperature between 37 and 38 degrees.
  • Philomena stressed that the most important thing about using a birth pool is to make sure that your partner does a trial run of filling the pool beforehand. You need to know how much water you’ll need, how long it takes, that the hose, taps, nozzles etc all work together.
  • From a timing perspective, Philomena recommended that if you’re having a home birth, don’t wait for your midwife to arrive before preparing the pool. Have it filled and ready to go before you think it’s time to call her – otherwise you mightn’t make it that far!

Philomena made three really important points about water birth and natural birth. She said that mothers will always benefit by going with nature as much as you can and that the great thing about a water birth is that it keeps your caregivers away from you and “hands off”. She also called water birth the epidural of home birth. Having laboured in a birthing pool myself I can attest to that last one and also add “but much more pleasant”. 🙂

You can access Ethel’s research at this link here if you’d like to read more. As was mentioned a number of times at the conference, birth pools are so widely available now and quite affordable, so there’s no reason why you couldn’t decide to have your own birth pool at home to labour in before going into the hospital if that’s what you wanted to do. Given the relatively few birth pools available in Irish maternity units it’s certainly something to consider.

There were a number of other topics discussed at this year’s home birth conference including policy developments in home birth in Ireland in the last 12 months and women’s rights in childbirth to choose both where and how they deliver their babies. I’ve covered those same issues here myself in the last couple of months so you might be interested in reading my earlier post, Giving Birth Is a Feminist Issue and my guest blog on Feminist Ire.

You might also like to read my Shopping List for a Home birth and for nostalgia’s sake, I started this blog this time last year the weekend of the 2012 home birth conference when Ina May Gaskin was in town so you might like to check out A Lot of Midwifery is about Loosening the Butt!

Happy water labouring!

Information is power

photo credit: Sebastiano Pitruzzello (aka gorillaradio) via photopin cc
photo credit: Sebastiano Pitruzzello (aka gorillaradio) via photopin cc

I’ve been thinking about my post yesterday on the Home Birth Association’s conference because I think I told a lie towards the end. I made a comment about not being interested in convincing women to have a homebirth like me. It niggled at me all day because I think it’s only half true.

If I’m honest, I think I’d like women to at least think about having a natural birth. And when I say think about it, I suppose what I really mean is to educate themselves about pregnancy, birth and labour so that they know what they’re letting themselves in for and can make informed decisions about how they’d like to birth their baby.

Otherwise, how would you know that there’s a chance that an epidural might slow down your labour, or might start off a cascade of interventions that you’d prefer not to have? How would you know that keeping fit and active during your pregnancy can help with your labour? Or that being well rested and not working like the clappers up until the last minute will help you go into spontaneous labour and ensure you have the energy to birth your baby? How would you know that you can’t have a shower or go to the toilet for a few hours after an epidural whereas with a natural delivery you can usually stand up and walk with your baby in your arms to bed or to the couch or wherever you need to be? How would you know that being up on your feet and moving around can help move your labour along by using gravity to move your baby down and that being on your back isn’t really ideal, unless of course it feels right to you at the time? (Myself and my husband practised many labour positions but on the day, all my body wanted to do was stand.) By the way, I’m not anti epidural at all. In fact I think they’re fantastic when you need them. I just think sometimes when women don’t have all the information on the side effects and risks they can be too quick to ask for one and be unprepared for what happens next.

I had my baby with the community midwives in Holles Street and I remember so clearly a couple of things they told me. At the start of my pregnancy, they handed me an information pack that had printed in block capitals YOU HAVE NINE MONTHS TO PREPARE FOR THE BIRTH OF YOUR BABY, USE IT WISELY. I read that, took it on board and ran with it. I think it paid off for me. Later in the antenatal classes, the midwife once again said “it’s up to you to be prepared for your labour and one of those things is you need to ensure you are WELL RESTED.” I’d never heard anyone talk about that before. I had worked with women for 10 years who talked about lying about their dates so they could work up til the last minute to maximise their maternity leave at the other side. Which of course is perfectly understandable.

But no one had ever mentioned to me that it could affect the birth. When I told my mother I planned on finishing work a month before my due date, she was delighted. She was also the first mother I heard say “well, you need to be well rested to get through a natural birth”. And then I heard her say it again, and again. And I felt sad for her because I know she worked up until the bitter end on all her pregnancies and had very little maternity leave because that’s how it was done in her day. She obviously understood and probably remembered her need for rest and strength at the time.

Finally, I remember a midwife talking to me about the line of birthing options. Picture a straight line where at one end your baby is in your arms and along the line is a series of stops, like a DART or subway map. The stop furthest away from your final destination is labouring at home and maybe having your baby there. If that doesn’t work out for you for whatever reason, the next stop is labouring at home for as long as possible using all your toolkit of natural pain management, then delivering your baby naturally in the hospital. If your natural toolkit isn’t working for you, next stop gas and air, and so on until next stop epidural and maybe some people stop at C-section before pulling in at your final destination of happy healthy baby. The midwife was explaining that choosing homebirth was just one extra stop at the beginning of your journey to give you a chance to have a natural birth if you wanted one. I’d like to think that every pregnant woman would be informed about all of the stops on their journey – pros and cons – before they decided which stop to jump on at to reach their wonderful final destination. Because knowledge is power and knowledge takes away the fear of not knowing or understanding what’s happening to you in the moment. Power and fearlessness are a great combination when you’re working hard at having a baby. That’s all!