Abstract : Background: For almost every community, people have been using water baths to alleviate stress, relax muscles and minimize pain. It is also not recent.
The first waterborne we know about in Europe was in France. It is currently practiced in Delhi, Mumbai, Goa, Kochi, and Hyderabad in India. The Tulip Women’s Health Care centre has the privilege of delivering the first water baby to India.
However, several physicians such as Igor Charkovsky, Michel odent, Mechael Rosenthal and Grantly Dick-Read officially introduced it in Russia, France, England and the US respectively. Dr. Odent published his results of the first 100 water births in the lancet in 1983. Giving birth to water (rather than working in it) is a relatively recent development in the western world.
This article will mostly focus on Water birth. In this article, I talked about water birth and the positive and negative aspects of water birth. The childbirth of the water is the process of labour; to feel the mother more relax and less painful experience. The theory behind the birth of the water is that the baby has been in amniotic sac for nine months and giving birth to similar environment is gentler for the baby and also helps to minimize stress for the mother.
Introduction : The childbirth of water is the method of giving birth in warm water in a bathtub.Some females want to give birth to baby in the water and get out for delivery. And a mother whose labour was incredibly long and demanding was helped into a warm bath. Shortly after immersing herself in the pool, her labour progressed, she started pushing and in the bath she gave birth to her child.1
Midwives, beginning centres and increasingly more obstetricians accept as true with that decreasing labour pressure and transport will minimize fatal complications. Water birth always occurs under the supervision of a professional healthcare provider. This cycle of birthing has gained much recognition over the last few years.
Few to no studies have been conducted on birth in water or even less on the use of water in the early (latent) stage of work relaxation, but the standard data so far has no longer demonstrated any hazards. Sadly, not all of us are fit for birth in water anymore.2
Adolescence is the time to plan for great responsibilities to be learned, a time for discovery and expanding horizons, and a time for ensuring safe, all round growth. Puberty is also a time of behavioral change when reproductive capacity is established. Midwives are with woman offering supportive and beneficial relationships for the family as they share the intense and meaningful childbirth experiences. Nursing students need to develop analytical skills and relevant knowledge of midwifery based on their personal experiences and practice to become professional helpers.
Review of Literature : Criteria for water birth:
• Women’s weight less than 100 kg
• Cephalic presentation
• A healthy mother who can get out of the pool quickly
• Women’s who has normal temperature , pulse and blood pressure
• Women’s who has normal contractions
• Women’s who has no history of seizures.2
Benefits for Mother:
• Its help to increase the sense of control
• Relaxing, secure , warm and drug free environment
• Less need for pain relief as pain threshold appears increased
• A dimmed room and birthing pool may feel more private than a bright labour ward, helping you relax even more
• Women’s have less painful contractions
• Minimize the need of analgesic(pain relief) during labor
• Minimize need for labour-intensive medications.
• The period of labor is Shorter
• In third stage of labor water has been shown to boost women’s power
• The buoyancy effect decreases the body weight of a mother and allows for free movements and new posture.
• The upward force exerted by a fluid facilitates increase powerful uterine contractions and increased blood circulation leading to stronger uterine muscle oxygenation, less mother discomfort and more oxygen to fetus
• It’s also helps to decrease blood pressure which is caused by anxiety.
• Water appears to reduce the hormones associated with stress, allowing the body of the mother to develop endorphins that act as pain-inhibitors.
• It’s reduce the tearing the water soften the tissue of perineum (the area between vagina and anus) making them more supple and able to stretch to accommodate the baby’s head as it passes through. This also means less need for episiotomy.
• It’s help to provide calm and quite environment which helps you feel safe and secure while delivery
• During labour, the lady feels comfortable; she can relax emotionally with a better willingness to concentrate on the childbirth process.
• In which women’s have a greater sense of privacy, which can help to minimize anxiety and fear
• The relaxing effect of warm water helps to provide endorphins which promoting the body’s herbal ache remedy mechanism women’s are more likely to be born naturally.
• The experience of labor is more enjoyable
• It creates a peaceful environment
• It help to speed up the labor
• It improves the confidence of women
• In which minimize the chances of tearing because water helps to relax the pelvic floor muscles and soften the perineum.
• Breastfeeding can be encouraged immediately.3
Benefits for Baby:
• A more gentle birth for the fetus.
• Environment provides same like as the amniotic sac.
• Relieves the stress of birth , thus increasing reassurance and a sense of security.3
Risk during Water birth
• Both may have chances to get an infection.
• Baby shouldn’t start breathing until he comes out of the water and into the air.
• Baby body temperature can be either too high or too low
• Child may have seizure or can’t breath.4
Conditions which are not suitable or birth in water
• Herpes: Herpes passes readily to water, so she will thoroughly address the risk with her health care provider.
• Breechpresentation: Although water births have been done with first presentations on the bottom or the legs.
• She should talk thoroughly with her health care provider regarding problems .
• Women’s have excessive bleeding or maternal infection.
• Twinspregnancies: While water births have been productive with twin births all over the world, she should address this risk with her doctor thoroughly.
• Preterm labour: women’s are not allowed to be born with water when a fetus is premature (two or more weeks before due date)
• Severe meconium: Meconium mild to moderate is relatively common. since meconium floats into a tub’s surface, her health care professional must watch over it and either remove it, or get her out of the pool. In addition, muconium washes off the baby’s face and also comes out of the nose and mouth while the bay is still underwater. The woman will raise her pelvis out of it. If the water is stained and birth is imminent
• Toxaemia or preeclampsia: Families will address this risk in detail with their health care providers : mothers under seventeen years of age or older than thirty five years of age , complications such as preeclampsia or diabetes, if premature infants, mothers with a very big infant, mothers need to be closely monitored which can’t be done in the bathroom if the mother is contaminated.4
Eligibility Criteria for water birth:
• Pregnancy at low risk single pregnancy more than 37 weeks of gestation
• Foetus is in longitudinal lie
• clear amniotic fluid (if meconium is present, may work in the tub but may require birth in bed
• Normal fetal heart rate tracing
• Professional Nursing staffs are still attends while the tub is in operation.5
Contraindications of Water birth:
• Preterm labour
• Blood or skin infection transmissible
• Mother has fever above 100.4°
• Severe Menorrhagia
• Abnormal fatal heart rate monitoring
• Foetus have macrosomia
• History of shoulder dystocytic history
• Previous history of caesarean section
• Malposition, or multiple pregnancy.5
Locations where can water birth occur: At home, at some birthing centres and at hospital.6
Preparation for birth in water
• First of all, she needs to put together her thoughts (this consist of informed consent problems)and discover her very own motivations, incentives and expectations to want a water beginning, ask herself what made her want a water beginning, and why is it something she wants for herself or is she doing it because a person ales asks her to ? Continue to be versatile and permit goes of her expectancies that she might in some manner have to supply her baby.
• Examine how she will feel when her baby is born in water.
• She touch with her own anxiety
• Most important thing is she will develop and trust her own intuition
• The bath have to be wide enough to sit down in simply shallow sufficient for the water to attain an aperture degree, as a way to preserve a suitable diploma of buoyancy.
• The water should be easy: if it’s pure enough to drink, its natural enough to give delivery. Requires no chemical compounds but a cup of salt in keeping with bathtub can save you the skin from turning into wrinkled and waterlogged.
• Do not adds any essential oils if you are planning to be born in a bathtub unless you first dilute them in ml of milk.
• The temperature of the water have to be among 35c and 38c relying for your preference. Regulate the temperature for your consolation.
• When the water is too cold, you will lose body heat trying to stay warm, if she has shivering, she will become nervous because it’s assumed that cold people don’t get their placentas well formed.
• If the water is too hot, it will feel drowsy, overheated, and dilate all her vessels.
• Your blood pressure decreases so that you feel weak and after birth it is more likely to bleed.
• If she want heat locally, say on the back, use dry, wet clothing or hot packs while her kneel in the water.6
Planning for water birth:
• Figure out whether mother has to carry her own equipment after receiving permission from the hospital or birth centre for a water birth.
• When mother wants to give birth in her own bath at home, mother is likely to want a thermometer available to determine the temperature of the water. (Birthing tubs are fitted with a thermometer).
• When mother wants to buy her own supplies, let the insurance provider know about their plans as soon as they make them, so they will cover the cost.7
What happen when mother go for labour?
• Once mother goes for labour, call the doctor, fill up their tub after that and wait for her to arrive before getting in.
• Then, change the water of tub to maintain the temperature at 95 to 100 degree Celsius and it is not more than 101 degrees. (Otherwise the temperature of body would increase, thus raising her heart rate.)
• Have plenty of drinking water in her side, along with a few washing clothing her coach will damp her face or neck with cold water. With a Doppler underwater device the practitioner can monitor the condition of the infant
• Once it comes to pushing, ensure the family has already discussed their strategy with their doctor, because this is the most potentially dangerous aspect of a water birth, and experts warn against pushing and delivering under water.
• During the labour, their partner may be in the tub or pool with them to support them psychologically and then get out of the water when she’s ready to push the baby (literally) to play catch.
• Keep in mind that if she follows the advice of ACOG ( American college of Obstetricians and Gynaecologists Committee) and wants to deliver underwater, her baby is not only at risk for the above mentioned complications but the umbilical cord will break , cutting off the oxygen lifeline of her little one.
• That puts him in further danger because when the placenta is separated from the uterus (which can happen at any time after delivery)
• It can no lomger supply enough oxygen to your baby.
• When the baby arrives, his doctor places him upright on their chest.8
Process to deliver the placenta
• Doctor is likely ask to mother for placenta from the tub, as gravity can be beneficial in the third stage.
• This also encourages their welfare after birth or during the third step or research
• When mother suddenly felt lightheaded, it might be difficult to quickly and safely ger her out of the water.
• Many clinics, birth centers and home birth teams have a protocol on how to supply placenta, many of them for health reasons on beds, toilets birth stubs or floor mat.
• The transmission of the placenta in the pool can be accelerated by injection oxytocin
• Slightly lifted out of the water would be required for this to occur.
• Mother will then have to leave the pool in matter of minutes to deliver the placenta.9
When might mother need to get out of the pool
• When midwifes see meconium
• If patients having bleed from the vagina
• When the baby’s heart rhythm increases, for example when heart rate shifts, increases in the temperature and blood pressure.
• If the labour shows down when mother go for the toilet (mother can leave and return),
• If her contractions get weaker
• To deliver the placenta.9
Discussion : Water birth is a process by which mother gives birth to a baby in a hot tub. In our paper we find that mother and baby have some advantages and risks. This working method is not popular in the world, although in some countries it is used. We need a suitable sagefriend and we need permission for birth in water from a hospital or birth center.
Conclusion : The birth of water is a worldwide choice for conception. However , in India it is less popular. Water birth is a choice for low- risk patients in renowned hospital as well as in small hospital and birth centres. In water conception, analgesic requirements have been reduced relative to other delivery positions. Water birth seems secure for both the mother and neonate when people are properly chosen.
References :
1. Liu Y, Liu Y, Huang X, Du C, Peng J, Huang P, Zhang J. A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery. BMC pregnancy and childbirth. 2014 Dec;14(1):1-7.
2. Maude RM, Foureur MJ. It's beyond water: stories of women's experience of using water for labour and birth. Women and birth. 2007 Mar 1;20(1):17-
3. Mackey MM. Use of water in labor and birth. Clinical obstetrics and gynecology. 2001 Dec 1;44(4):733-49.
4. Pinette MG, Wax J, Wilson E. The risks of underwater birth. American journal of obstetrics and gynecology. 2004 May 1;190(5):1211-5.
5. Woodward J, Kelly SM. A pilot study for a randomised controlled trial of waterbirth versus land birth. BJOG: an international journal of obstetrics & gynaecology. 2004 Jun;111(6):537-45.
6. Swain D. Water Birth is an alternative to air birth-A Comprehensive Review article. Asian Journal of Nursing Education and Research. 2013;3(2):69-78.
7. Otigbah CM, Dhanjal MK, Harmsworth G, Chard T. A retrospective comparison of water births and conventional vaginal deliveries. European Journal of Obstetrics &Gynecology and Reproductive Biology. 2000 Jul 1;91(1):15-20.
8. Rawal J, Shah A, Stirk F, Mehtar S. Water birth and infection in babies. BMJ. 1994 Aug 20;309(6953):511.
9. Schroeter K. Water births: a naked emperor. Pediatrics. 2004 Sep 1;114(3):855-8.