Waterbirth Basics – Water Birth in  Hospitals

Waterbirth

By Barbara Harper, Founder and President of Waterbirth International and Global Maternal-Child Health (www.waterbirth.org)

Waterbirth is simple.

Within the simplicity of water labor and birth lies a complexity of questions, choices, opinions, research data, women’s experience and practitioner observations.

Over the past five years as more hospitals within the United States examine waterbirth and create programs to support the use of water for labor and birth, newspaper reporters latch onto the sensationalism of this simple option and publish stories of successful waterbirths in local publications.

Each reporter does their best to simplify waterbirth and at the same time answer the most common questions. Each story shows a happy beaming mother, a quiet peaceful baby and a proud father, who usually successfully set up a portable birth pool. The surprise headlines like, “watery birth” or “baby’s birth goes swimmingly” or “junior makes a splashy entrance,” are countered with the simple stories of couples who have made this decision for themselves and are proud of it.

It is hard to think of another “method” of childbirth that receives such praise from women and practitioners alike. Dr. Lisa Stolper is an obstetrician practicing in the quaint New England town of Keene, New Hampshire. She began offering waterbirth to her clients at Cheshire Medical Center in October of 1998. One year later she reported an overall waterbirth rate of 37% for all vaginal births and 33% for all births, including cesarean sections. Her hospital has purchased just one portable jetted birth pool but they use it to labor almost 50% of their clients. They are now considering installing permanent pools to make it available for more women. Her comment about her job as an obstetrician was, “Waterbirth just makes my job so much easier.”

One of the final questions that newspaper reporters pose and birthing couples ask is: Why aren’t more hospitals in the US offering waterbirth?

Hospitals in the United States have made incredible advances in the waterbirth movement in the past five years. Monodnock Community Hospital in Peterborough, New Hampshire, was the first hospital in the country to embrace waterbirth and install a permanent birth pool, imported from England. They still offer this option to women and can now look back on almost ten years of great outcomes and lots of satisfied families. The rest of the country has taken some time and there are certain areas of the country that are making greater strides than others.

In almost all cases where there are successful waterbirth programs going, they have been started by Certified Nurse Midwives. Midwives are more open to exploring the issue with their clients and doing the research necessary to get protocols accepted in hospitals. Some midwives have even purchased portable birth pool equipment with their own funds in hopes that it would pay for itself by generating more business. In most instances that investment has paid off.

The whole US movement is at least five years behind the European movement in acceptance in hospital environments, but home birth midwives in the US have been offering waterbirth longer than most of their European counterparts. The UK has had the benefit of government-sponsored research and data reporting as well as the Cumberlege Report. The House of Commons Health Committee recommended that all hospitals should provide women with the option of a birthing pool. The underlying philosophy of the “Changing Childbirth” report recognized that women have the right to choose how and where they wish to give birth. In a 1994 statement, the UKCC stated, “…waterbirth is preferred by some women as their chosen method for delivery of babies. Waterbirth should therefore be viewed as an alternate method of care and management in labour and one which falls within the midwife’s sphere of practice.”

The states that have made the most progress for hospital waterbirth are New York, Maine, New Hampshire, Illinois, Ohio, North Carolina and Massachusetts. Obviously, the East Coast is changing faster than the West Coast. It is surprising to some people when they find out that the whole state of California only has a handful of hospitals that provide waterbirth services. More than two thirds of the birth centers in the US offer waterbirth as an available option.

Mothers who call Waterbirth International wanting advise on how to get their particular hospital to allow them to have a waterbirth are advised that it takes three ingredients to make policy changes within a hospital setting.

• A motivated mother
• An open and supportive practitioner
• A compassionate nurse manager or perinatal coordinator who is willing to take on the training of staff and the creation of new policy.

Note: Waterbirth International will supply the necessary research studies, the sample protocols, the pool kits, the videos and the experience to help couples get policy changed, but without these first three components some hospitals will continue to deny the request. Time is the other factor. The more advance notice a hospital is given the better chances there are for change.

The final key to change is education. Waterbirth 2000: A Vision for the Future, an international waterbirth conference held in Portland, Oregon, September 21-24, 2000, provided a forum for evaluating current waterbirth practice and discussing the needs of the both practitioners and the families they serve.

There are so many areas of waterbirth yet to explore. Waterbirth is more a philosophy of non-intervention than a method or way to give birth. Waterbirth combines psychology, physiology, technology, humanity and science. Waterbirth is ancient and yet new at the same time. Waterbirth embodies a spiritual aspect of birth that is hard to express. Cynthia, who gave birth in water, said it better, “The water made me so completely connected to my body and my baby. The water held me and cradled me so that I could surrender more completely to this amazing and wonderful grace that was happening to me. This is the way that God intended childbirth to be.”