Waterbirth Information
(From Wikipedia 2008) During the 1960s, Russian researcher Igor Charkovsky undertook considerable research into the safety and possible benefits of water birth in the Soviet Union. In the late 1960s, French obstetrician Frederick Leboyer developed the practice of immersing newly-born infants in warm water to help ease the transition from the womb to the outside world, and to mitigate the effects of any possible birth trauma. Another French obstetrician, Michel Odent, took Leboyer's work further, using the warm-water birth pool for pain relief for the mother, and as a way to normalize the birth process. When some women refused to get out of the water to finish giving birth, Odent started researching the possible benefits for the baby of being born under water, as well as the potential problems in such births. By the late 1990s, thousands of women had given birth at Odent's birthing center at Pithiviers, and the notion of water birth had spread to many other Western countries. Water birth first came to the United States through couples giving birth at home, but soon was introduced into the medical environment of hospitals and free-standing birth centers by midwives and obstetricians. In 1991, Monadnock Community Hospital[1] in Peterborough, New Hampshire became the first USA hospital to create a protocol for giving birth in water. By 2005, there were over 9000 hospitals in the US that had adopted such protocols. More than three-quarters of all National Health Service hospitals in the UK provide this option for laboring women.
(From King and Camacho Carr 2005) http://pediatrics.aappublications.org/cgi/content/full/115/4/1116) An accurate assessment of the risks and benefits of immersion in water during labor is the subject of a Cochrane meta-analysis3 published in February 2004 [Cluett et al) that included 8 randomized, controlled trials. The meta-analysis found no difference in Apgar scores, neonatal unit admissions, or neonatal infection rates in women who used water immersion during labor when compared with women who were offered "usual care." The water-immersion group had statistically significant improvements in pain and no significant difference in vaginal operative delivery or cesarean-section rates. Case reports of some adverse neonatal effects after water birth are being reported in the literature and should serve as a caution and a call for thorough investigation. This is the current state of the science that should be shared with women who are considering these options.
A Masters degree student at the Auckland University of Technology (Ashcroft 2007) has analysed media representations of waterbirth using a power and subject approach (Foucauldian analysis). She found three different ways that waterbirth is talked about. The scientific medical discourse contests waterbirth as an unsafe, unproven practice that puts babies' lives at risk. This discourse categorises women who choose waterbirth as unsafe, irrational, alternative, tree-hugging hippies who favour perceived benefits of waterbirth for themselves above the safety of their baby.The natural birth discourse contests that waterbirth is a safe practice that has encountered few problems since its emergence as a validated birthing practice in the late 1980s. It promotes waterbirth as having multiple benefits for both mother and baby and as a way of enhancing the physiological process of birth through non-intervention.The dive reflex discourse underpins the issue of babies drowning when born into water. This discourse details a reflex that suppresses the normal breathing mechanisms in neonates at birth. Literature debates its existence and troubles the overall trustworthiness of such a reflex to prevent a baby drowning when born into water. It is this discourse that sways people's views and positioning on the overall discourse of waterbirth.
No statistics are currently available for the number of births occurring in water in Australia or South Australia. The SA Government's policies on labour and birth in water have only been operational for a few years and not all midwives and obstetricians are yet experienced with facilitating waterbirth.Note however that the SA Govt policies are not restricting on independent midwives. All independent midwives in SA are experienced with waterbirth and most women birthing with them at home will use a birth pool for labour and/or birth. Our Birth Choices Guide for South Australia indicates where you may or may not be able to have a waterbirth in South Australia. For further information about waterbirth you will find the following useful.
Waterbirth Policies, SA GOVERNMENT DEPT OF HEALTH webpage gives the SA policies on "First Stage Labour in Water" and "Birth in Water". Note that women must leave the birth pool/bath in SA hospitals for the 3rd stage (birth of the placenta), but this does NOT apply to homebirths with an independent midwife. These policies are being currently under review (2008); the review committee has 2 consumer representatives from Birth Matters and the Homebirth Network SA.
Waterbirth International (USA) for everything you want to know about waterbirth!