Thursday, January 14, 2010

Notes on Waterbirth

Waterbirths are touted as gentler than 'land births' because the baby emerges from a warm liquid to a warm liquid (rather than cold air). Water is also called 'the natural epidural' because it is so effective at relaxing and comforting the laboring woman. I have come to believe that the lubricative properties of the water help mother to stretch rather than tear, adding yet another aspect of gentleness.

"Waterbirth" by Cary York

Waterbirths have been practiced for years by tribes who routinely birthed in streams or lakes or even the ocean, however much of the western world has been scared to try them, fearing that the baby might drown, or, more especially, that it would be very inconvenient for the provider to try to assist a woman in a tub.
Let me begin by clearing up the 'drowning' myth. The baby has spent 9 months completely surrounded by fluid. He gets all his oxygen through the umbilical cord. So long as that cord is intact, he has no need to breathe air or use his lungs. Most midwives do bring the baby right to the surface of the water, but unless the cord has broken (which is rare), they don't really need to. Eagle's head emerged (underwater), and it was at least a full minute before the rest of him came out. During that time his head remained under water but he was fine because his cord did not break until the last moment, and the midwife brought him promptly to the surface and put him in my arms. He did not cough or sputter or anything. He just took a breath of air and stuck out his tongue at me. ☺
I very much hope to have all future babies in water as well. It was that awesome.

So, with that introduction, I thought I would share a few tips about waterbirthing.

First of all, you'll need a pool. Some women birth in their bathtub--this is ok, but tubs are narrow, and all the tub-birthing moms I've talked to have said that it was not very comfortable because it was just too crowded. Some women have a large jetted tub, or a hot tub to birth in. This works well, although the temperature of the hot tub should be lowered to something close to body temperature. It should be comfortably warm, but not hot. (Think about the temperature you use for a baby's bath, and go with that). The third--and most common--option is to rent or buy a birth pool. Some midwives bring the pool with them (and use disposable liners for each woman), some midwives require the mother to purchase her own pool. In my case, I needed to buy a pool.
There are a number of online stores that cater to waterbirth, and sell pools and accessories. There are several companies that manufacture pools specifically designed for birthing--they are large and have high sides. Some even have handles for the mother to hold on to, or a raised seat at one end (see below left). These official birth pools cost anywhere from $125-$450. Alternately, many mothers buy "fishy pools" which are regular inflatable wading pools that are relatively deep (though not quite as deep as the birth pools). The waterbirth stores carry these as well, and they usually cost $25-40. One downside is that pools are heavy, so in my case I picked out a $30 pool but then found that shipping was going to be another $25! A lot of people buy fishy pools from a local store, but that option was not available to me (especially in November!). I mentioned the dilemma to Hubby and he suggested I try amazon and their free shipping. Sure enough, I found the pool on the right for $38 and free shipping (photo is linked to the listing). I actually really liked the star shape, as it provided both flat spaces and 'corners' that I could lean into. It also has a padded floor, which most of the fishy pools do not. I highly recommend it as a birth pool!

One thing to keep in mind--many women want a larger pool so that daddy can get in the pool too, however if you get a pool that holds more than about 100 gallons, you may run out your hot water heater while filling it. So plan ahead and order something that will work with your space, your budget, and your water heater! (My pool held about 90 gallons and fit us both just fine, though it would have been nice to have about 4 more inches of water, Hubby used a pan to pour water over my back during contractions and it was fine.)


  • You will need a hose for filling your pool, and an adapter for attaching the hose to your sink faucet or shower head. The adapters cost just a few dollars, but the hose will be a little more. Some women are comfortable using a regular garden hose, but many prefer to buy a medical-grade (lead-free) hose from one of the waterbirth sites.
  • It's worth investing in a good size pump for inflating the pool--a manual one is fine (if it's big) or an electric one might be nice if you have an especially big pool. You do not want to try to fill it by mouth!
  • I strongly recommend a debris net. It is very common for things besides the baby to be pushed out during birth *ahem* and having a little net to clear them away is very nice. The net only costs a couple of dollars, so if you don't use it it wasn't a huge investment...but if you do need it you'll be glad you had it!
  • A draining pump can be attached to the hose to siphon all the water back out of the pool (and down your tub or toilet) after the birth. I did not buy one of these because it was $50 and I had been told that it was easy to set up a manual siphon either into the tub or out the window...however we tried both those things and neither one worked so Hubby ended up having to empty the pool bucket-by-bucket, and got a very sore back in the process. He said next time we need to spring for the pump.
Some sites that offer waterbirthing supplies:

  • Lay a tarp or a plastic shower curtain on the floor under the pool (unless you have it in your kitchen or something). Make sure the plastic extends at least a foot beyond the pool on every side--I left about 6inches and we ended up with damp carpet in several places.
  • Do a test run with your pool before your due date. Find out how long it takes to inflate the pool and make sure the space you have planned is large enough.
  • After the test run, if you have the space to do so, leave the pool 80% inflated. Then when you are in labor it will be much faster to get it fully inflated and then filled.
  • Usually very warm water feels best to the mother, but then there is potential for her to overheat. I did not encounter this myself, but my sister said she really recommends having an electric fan in the room in case mom is getting too hot, so that she doesn't have to get out of the water.
  • If mom does get out of the water for a while, lay another shower curtain or tarp over the top of the pool. That will contain the steam so that the water will stay warm. If she is out for a while, the water may cool down and then she won't want to get back in, which more or less defeats the purpose of having the pool in the first place.
  • Have a bunch of towels--ideally old ones that you don't mind leaving on the floor or getting dirty. Anytime mom (or anyone else) is in or out of the pool, water will get spread's nice for mom to have a little path of towels to take to the toilet or the bed.


Stacy said...

Loved, loved, loved being in the water for my last birth. I was in and out of the water a lot during labor and a lot of my best memories from labor come from the relaxation I was able to gain in the tub.

Here's a tip for water birthers in regards to water temperature- a few weeks before your due date, turn up your water heater as high as it will go. Then, when labor starts and you're thinking about filling the tub, just turn the water on as hot as it will go. Fill the tub until the hot runs out, then let it run cold until the water is the temperature you need it. If you need to add more hot water when it runs out, you can boil big pots of water on the stove and add them to the water in the tub. Alternately, if you're not ready to get in the tub, the water will stay nice and warm for a while.

And sum pumps work wonders draining birth tubs.

Mallory said...

Thank you so much for writing this! I have been very interested in having a water birth. But, I still have some worries. What if my pool breaks and dumps water all over? We live on a top floor apartment. I just feel like it could be disastrous. But, we also have a very private back deck. And when the baby comes, it will still be warm enough outside, I thought it would be kind of cool to put a pool on our deck and have the baby out there! It's still just a thought, but it seems like fun!

TopHat said...

We have a small water heater, so we boiled water. Very old-fashioned. "Go boil water!"

I liked our water birth, but still not sure if we'll do it again next time. Had Margaret's birth been less than 12 hours long and not all about the back labor, I never would have used it. Maybe we'll get a tub just in case.

Mommy Bee said...

Mallory, I've heard several stories (or seen pictures/movies) of outdoor births. If I had a private deck (and a summertime due date!) I might do that. It does seem very cool.
If you're on the top floor then no one would see you, the only issue that might arise is people hearing you (and that's only an issue if it bothers you). :)

Momza said...

We do water births all the time..and two things I wanted to add is that there are two different kinds of laboring pools:
1-Aqua Doula--largest, holds most water, heated. Used for first time moms because their labors generally last longer.
2-LaBasine: Smaller, fully inflatable sides and bottom, un-heated--but you put in warm water and cover it to hold the heat. Holds about half as much water.

Jessica said...

My last birth was in the water at a birth center and I've been toying with the idea of doing a homebirth next time (should we be so blessed). These tips are great for preparing for the home waterbirth I would want. Thank you!

Terresa said...

I never had a water birth, but always wanted one.

I labored in the tub for 2 of my labors, but my contractions always slowed, so my midwife & doula always urged me out of the warm water and into lunges, squats, etc.

Later, I found out that my midwife was not a fan of waterbirth. She told me she thought they were gimmicky. (Each to their own, although plenty of her clients did have fabulous water births, just never me.)

Great post!

knittingdragonflies said...

Thanks for this great post. I love the idea of this.

sara said...

All of the fishy pools I have seen and used also had inflatable bottoms. I would NOT recommend using a pool without them! Your bum would be numb!

I would LOVE to have an outdoor waterbirth. WOW! I have heard some awesome stories.

I also agree that you should turn up your water heater. We forgot with one of our babies and we had to boil water and it was NOT fun.

I kind of overheated with my last birth. Just add cold water! I also had a bowl of cool water nearby to soak a washcloth to cover my face and neck. ALSO - ice water. It's really important to stay extra hydrated if you are sweaty and a warm pool tends to do that. Be careful with any types of fans or coolers. It's fine in labor but once the birth is getting closer you really do want the air really warm for baby - especially if he's wet.

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