Maternal request to abandoning water birth

It is true that maternal request is one of the most common reasons for abandoning a planned water birth. In most cases, this happens because the experience does not live up to her expectations. She may find the pain unbearable and the relaxing effect of the water insufficient to overcome this.

As for maternal distress, it is upon the attending midwife to assess and if need be, suggest leaving the pool if it becomes obvious that the mother is not coping. This will allow for a more effective method of pain control to be adopted.

Preparing for a water birth

If a woman is planning a water birth, a midwife or other qualified birth assistant will have an exhaustive discussion of this method of labor and delivery with the parents-to-be. All questions should be asked and answered.

Importantly, the pregnant mother should be encouraged to spend prolonged periods in warm water before labor, to form her own opinion of the experience. She should remember that, on the day, it will be significantly different, as there will be pain. Also, the process could last six hours, probably longer.

As Term approaches, the usual obstetric assessment will be made to ensure there are none of the factors which will contraindicate labor in water as explained earlier.

At the onset of labor, before entering the pool, a shower is taken and the midwife ensures the rectum is empty. This is done by administering a gentle enema if necessary.

Electronic fetal monitoring (CTG) will be done for at least thirty minutes prior to entering the pool, to ensure that the baby is fine.

Type of water used in the birthing pool

Ordinary tap water is used. Some practitioners advocate salinizing the water, for example by adding sea-water. This is claimed to make the tissues of the birth canal even suppler. This claim is not backed up by any scientific evidence.

Ideal temperature for a water birth

Water should be kept as close to the normal body temperature as possible. For the thermostatically controlled pools, this temperature is set to fluctuate in a narrow range of about 35-38°C.

The ambient temperature should also be warm but not stuffy.

If the water is very hot, it may bring about quick exhaustion to the laboring woman. It is important to remember that, for the majority of women, labor lasts several hours. Early exhaustion may lead to her having to leave pool.

There is evidence also that very hot water may diminish the strength of the contractions. In early labor, it could potentially stop the contractions altogether.

When water is merely lukewarm, it will be uncomfortable and the relaxing effect will be lost. Cold water is out of the question for obvious reasons.

Continues next page