Water Bath: Yay or Nay? What does the science say?

The idea of a water birth to me sounds somewhat luxurious… the idea of being immersed in warm water and a comfortable entry of the baby into this world… The only thing missing would be the warm sun shining down and a mojito at my side for when it’s all over.  :) 

But for some reason a water birth doesn’t quite sit well with me (yet?). Excluding the fact that I worry about my shoulders being cold or somehow getting chilled if I was in there too long, there are other factors that raise concern for me. The first of which, is that it just doesn’t seem natural to me. I haven’t heard of many women of the past intuitively running to the stream to give birth, but do correct me if I’m wrong! I seriously just haven’t heard of it (except for the first documented case of a woman in France in 1803 who, after a long exhausting birth, got into a tub of warm water (http://www.babycentre.co.uk/a542003/the-history-of-water-birth). 

At first I thought it was because I was worried about how the baby would react to being under water. A Doula teacher of mine said that in fact, the baby is protected as long as he/she always stays immersed because the umbilical cord will continue to provide oxygen. What’s NOT recommended is for the birthing mom to move in and out of the water or for the baby to be exposed to air only to then be re-immersed in the water bath. Once exposed to air, I was taught, the baby would open it’s airways and begin it’s life breathing for itself. At that point, immersion in the water would be dangerous.

Logical enough, I thought, but the concept still didn’t feel absolutely right. I then began to wonder about the good bacteria that naturally covers the baby as it passes through the birth canal through the mom’s vagina. “Won’t that all get washed away in the water?” I’ve asked. I have yet to find and answer to that. 

I also just began to wonder if water births really serves the entire team of mom and baby in a way that I feel comfortable with. There is some evidence that women fair better in terms of analgesic needs when giving birth in a water bath (http://www.ncbi.nlm.nih.gov/pubmed/24627674)**, require fewer episiotomies, and have shorter first-stage labour (http://www.ncbi.nlm.nih.gov/pubmed/17440268). There is mostly evidence for this with some scattered pieces suggesting there is no benefit. But there is little-to-no evidence that 1) water births are advantageous to the baby (http://www.ncbi.nlm.nih.gov/pubmed/24004064) or 2) that is water births are actually safe for the baby. In fact, there may even be some considerable suggestions that it is NOT safe for the baby. For example, there are hints at water births possibly being related to pneumonia, increased infections,  increased respiratory problems (http://www.ncbi.nlm.nih.gov/pubmed/22085259), water aspiration syndrome (http://www.ncbi.nlm.nih.gov/pubmed/19089769). Some researcher-practitioners are claiming there is not enough evidence for or against and therefore deeming it an “experimental procedure” to date (http://www.ncbi.nlm.nih.gov/pubmed/24652300). 

The question then becomes, Do I want my baby to be part of this experiment? Sure, there are many things that I would do at an experimental stage but in order for me to go there, I need some other kind of evidence, and it doesn’t have to be scientific. I would settle for a lengthy history of practice, deep intuitive sense, or shared womanly wisdom could suffice in some circumstances, but this just doesn’t cut it for me, at least in terms of the safety for the baby.

This lack of evidence concerns me and not because I am a die-hard-need-science-to-believe something person. In fact, I consider myself a “Holistic Scientist” because I consider many converging pieces of evidence, science being one. But because this lack of science combined with a sense that this practice just feels unnatural to me makes me really makes me want to ensure that this procedure is actually safe for the baby before I indulge in the luxury. Same goes for any analgesics I might have at my disposal, not the least of which include morphine or an epidural. Morphine and epidural themselves come with potential risks, and water baths might too… that being said, in the right circumstance they all make things more manageable for the mom, which in turn helps baby. 

But for me, for now, the water bath is a no-go. Not enough scientific evidence. Not enough intuitive sense. Not enough history. I could change my mind but that’s where I sit right now. 

** I included the link to the abstracts instead of the actual journal articles because I recognize that many people do not have access to the actual scientific papers, a sad but real truth about science... if you want the actual article you may have to pay for it unless you are affiliated with a university or research centre. Sorry...