All about water birth: benefits, risks and contraindications

The water birth is used since the sixties as an alternative less painful and more natural childbirth. It was Dr. Igor Charkovsky who proposed it, realizing its benefits, for mother and child. Today it is also possible to use them in public hospitals.

How water birth works

Water birth can be performed in two different ways : with water labor and dry birth or water birth with immersion in the tub in advanced labor.

In the second case, it is necessary to enter the water when it is in full expansion. In fact, if you dive too early, the contractions may stop. In any case, the temperature is constantly monitored, so as not to exceed 36 ° during labor and to touch 37 ° during expulsion .

Through the benefits of buoyancy, gentle birth offers full freedom of movement to the mother , who can stand up, float, crouch and kneel, but also get out of the tub.

In fact, operators often advise, during labor, to go for a drink and pee. It also allows full participation by the father, who can enter the pool together with his partner.

Before and after the birth, the doctor and midwife also monitor the heartbeat of the fetus and the mother, and may request that you leave the pool if the following conditions / complications arise:

  • Dirty water (birth remnants can cause infections)
  • Significant and / or abnormal loss of blood or amniotic fluid
  • Excessive tiredness or stress during labor
  • Labor too slow
  • For normal checks

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Water birth guidelines

To access this possibility, it is necessary to meet some fundamental requirements:

  • It doesn’t have to be a risky pregnancy
  • It doesn’t have to be a twin birth
  • It must be full term and not premature (i.e. between 37/41 weeks)
  • The child must present himself correctly (for example, not breech)
  • Be negative in serological tests (hepatitis B, HIV) for the safety of medical personnel
  • Do not have skin infections
  • Don’t have a fever
  • Have a clear cardiographic trace
  • Don’t be affected by preeclampsia
  • Doctor and midwife must agree with the choice
  • Physiological labor is already well under way (with a dilation of 3/5 cm)
  • Basin at least 70 cm high
  • Water temperature no more than 37 ° (in the expulsion phase)

Water birth negative experiences

The data in the possession of medical personnel are not sufficient to develop a scientific case study on the risks and benefits.

In general, water is able to increase the risk of infections, both for the mother and for the baby, and is for example able to carry herpes more easily .

It is also not recommended in case of:

  • Severe fetal malformation
  • Baby too big for gestational age
  • Placenta previa
  • Irregularity in the baby’s heart rhythm
  • Signs of fetal distress

The choice of how to give birth must always be evaluated together with your gynecologist and obstetrician.

Is water birth safe?

The American College of Obstetricians and Gynecologists points out the possibility of some risks to the newborn:

  • Contraction of legionella , caused by inhalation of water particles
  • Possible damage to the umbilical cord
  • Possibility of respiratory distress
  • Possibility of asphyxiation and convulsions

These negative consequences in Italy are resolved rather easily, given that the hospitals used for water births advise against staying in the tub even for the expulsion phase. This is in fact the most critical for the formation of infections.

Could the baby drown?

When the child enters the water, his diving reflex remains active. The baby, in fact, does not breathe in amniotic fluid, it will begin to do so as soon as it comes into contact with the air.

There is therefore no danger of him drowning or drinking . In addition, the dive lasts only a few seconds, as the medical staff will be immediately ready to bring it to the surface. This is why it is very important to rely on a hospital or specialized personnel.

Can it be done with an epidural?

Several studies have shown that immersion in warm water reduces the demand for epidural analgesia.

Consider that those who rely on induced labor and analgesia cannot give birth in the tub.

Water birth costs

The birth performed in water is free at the facilities of the National Health Service.  Some are equipped with chromotherapy, aromatherapy and music therapy .

Remember that in private and affiliated structures the costs can fluctuate even a lot.

It is also possible to give birth in water at home; some ASLs are able to provide reimbursement for expenses and the assistance of professional midwives. In this case, it will be necessary to rent a swimming pool for the birth , costing around 400 euros.

The midwife, if specializing in this type of birth, may bring an inflatable pool with her; there are also several associations that offer them at reasonable prices.

The bathtub has a water filtering system, to purify it from biological materials and bacterial agents, and to avoid the risk of infections during labor and delivery. Furthermore, before and after each use, it is sanitized.

The tank has a height between 70 and 90 cm and a length not exceeding 2 m, to facilitate movement and change of position. It is also mandatory to rent, for reasons of hygiene and safety, also the disposable bath cover, which remains in contact with your body.

Where it is possible to have water births

There are more than 100 hospitals and private clinics equipped in Italy that are equipped for this type of birth, but not uniformly throughout the national territory. For example, they are not present in Basilicata, Molise and Valle d’Aosta.

However, it is necessary to inquire in advance, since it is not certain that the tank, even if present, is also operational or free.

Water birth in Rome

In Rome there are only two reference structures:

  • Fabia Mater Nursing Home (private facility)
  • Villa Pia Clinic (accredited private multi-specialty)

Inaugurated in 2015, the water birth room of the Villa Pia Clinic also offers a round bed with 75 positions, the neonatologist, a resuscitator, pediatrician and anesthetist, 24 hours a day.

Water birth in Milan

There are 6 public facilities in Milan that offer this type of birth, some only in labor and not expulsion. While there are 28 distributed in the other Lombard provinces.

  • Vittore Buzzi Children’s Hospital (labor only)
  • San Carlo Hospital
  • Niguarda Hospital
  • San Paolo Hospital
  • Macedonio Melloni Hospital
  • Casa di Maternità la Via Lattea (private clinic that also offers home birth service)

Know that in Tradate and Varese only labor is allowed; others have only a bathtub.

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Water birth: opinions

This method of giving birth to a child has spread since the 60s and then ended up forgotten and has returned in vogue since the 90s.

The Committee on Fetus and Newborn  of the American Academy of Pediatric does not guarantee its safety or efficacy , but it appears that hot water helps to ease the pain of contractions and stress.

By improving blood circulation, it also makes the tissues of the perineum more elastic: preventing episiotomy . Water birth also benefits the fetus, which is brought into the world in a less traumatic way .

Finally, with this mode, skin-to-skin contact is facilitated, which would make breastfeeding easier.

The afterbirth phase takes place within 30 minutes: after the cord has been cut, the baby is quickly checked by the neonatologist, placed on the mother’s breast and dried.

Why choose it

Among the advantages of water birth , we remember:

  • Lower adrenaline levels (less tension, emotional and muscular)
  • Acceleration of dilation
  • Increased levels of endorphins and oxytocin (fewer uterine contractions)
  • Reduction of labor times (up to 30 minutes)
  • Lower risk of vulvo-vaginal lacerations
  • Less painful childbirth

By choosing the position in the pool you have the opportunity to better cope with contractions and to keep stress at acceptable levels. In addition, the hydrostatic thrust helps to support the weight of the fetus, with a relative lower load on the lumbar area of ​​the woman.

Greater relaxation for the parturient means better oxygenation for the baby. In fact, the same environmental conditions that characterize the uterus occur in the passage from the amniotic fluid to the water of the tub: the same temperature, attenuated lights and noises .

In addition, in the absence of gravity, the baby’s respiratory system will also undergo a gentler adaptation.

We can recommend some readings to understand if this mode of delivery will do for you:

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