Regarding the use of warm baths during labor, this is an effective tool for non-pharmacological pain management.
The benefits of immersion in warm water in order to relieve pain in the first stage of labor are well documented by several studies. The therapeutic effects of hydrotherapy have been known since ancient times. Immersion in water has been used as a pain reduction method, for muscle relaxation and mental tension reduction due to its hydrothermal (ability to absorb and release heat) and hydrokinetic (movement and interaction with objects/bodies) properties.
Using a warm bath to reduce discomfort and pain at the beginning of labor is often recommended by the midwife before presenting to the maternity ward.
The effects of water birth on the health of the mother and the newborn
Although the practice of immersion in warm water during early labor is a form of relaxation that dates back generations, studies on water birth are not numerous. The first reported water birth took place in France in 1803. Since then and until now, few centers have published results regarding the safety and effects of water birth. However, the existing ones suggest that this method is safe for the mother and the newborn.
A retrospective study known for analyzing the effects of water birth on the health of the mother and the newborn was carried out in Great Britain, at Rochford Hospital.
The purpose of the study was to evaluate the safety of birth in water, while also analyzing the possible benefits for both the mother and the newborn. Also, the medical complications that occurred during water birth were monitored, being compared with those that occurred in the case of traditional vaginal birth.
Over a period of 5 years, between 1989 and 1994, 2 groups were compared: 301 women who gave birth in water and another 301 women who had a normal vaginal birth.
The women of the two groups had similar characteristics - low-risk pregnancies, age, number of births.
In the study were analyzed:
- Duration of labor
- The amount of analgesics used
- Apgar score at birth
- Maternal complications during childbirth (including perineal tears), postpartum hemorrhages
- Fetal and neonatal complications (including shoulder dystocia, neonatal intensive care unit admissions, infections).
What were the results of the study?
- Women who gave birth for the first time had a shorter labor (first and second stage of labor), the time spent in labor being reduced by 90 minutes .
- All women who gave birth in water requested less painkillers for pain relief. In the case of 38% of them, it was not necessary to administer analgesics.
- Primiparous women (women at their first birth) had less perineal trauma and a lower episiotomy rate , but more perineal tears.
- The Apgar score of babies born in water did not register major differences compared to that of babies born through traditional vaginal delivery.
- There were no significant differences between the two groups, neither in terms of postpartum hemorrhages, nor in the number of hospitalizations in the neonatal intensive care unit.
- There were no neonatal infections or deaths of newborns in the two groups.
The conclusion of the study was that water birth for women with low-risk pregnancies, together with a team of experienced professionals, is safe.
Other studies that considered the benefits and risks of water birth mentioned in the advantages chapter:
- Less pain because water helps relax muscles, relieving pain.
- A positive birth experience
- Fewer medical interventions.
According to the American Pregnancy Association , water reduces body weight, allowing the mother to move more freely, which supports more effective uterine contractions and better blood circulation. Improving blood circulation means better oxygenation of the uterine muscles, but also more oxygen for the fetus.
In addition, immersion in water contributes to lowering blood pressure caused by anxiety, reducing stress hormones and can provide an increased feeling of intimacy, also reducing stress, anxiety and pain experienced during labor and birth.
The risks of water birth include:
- The risk of infections - the water must be kept clean, otherwise it can become a favorable environment for pathogens, increasing the risk of infections in mother and child.
- The risk of aspiration of water in the respiratory tract of the newborn (rare).
Specialists also expressed their concerns regarding the difficulties in monitoring the heart rate of the fetus and the difficulties in assessing the mother's blood loss.
Under what conditions can one opt for water birth?
The reasons why women choose this method of giving birth differ from person to person. Currently, there is an abundance of information and many of them are previously documented about the overmedicalization of birth and its consequences. Other women are looking for a way to give birth with less pain or with increased control over the process itself (freedom of movement, a more relaxing environment that helps them concentrate).
There are women who have been informed about the benefits that water birth has on labor and birth, who want to have a satisfactory birth experience.
Finally, we must not lose sight of the fact that despite all the advantages, sometimes water birth is contraindicated or there is a possibility that certain complications and unexpected events may occur during labor that do not allow this birth method.
- Existence of medical conditions - heart problems, high blood pressure, preeclampsia, maternal infections (herpes, HIV), gestational diabetes, diabetes, blood coagulation disorders such as hemophilia
- Placenta previa, placenta accreta, premature detachment of the placenta, premature rupture of membranes
- Presence of congenital malformations, genetic syndromes, abnormal heart rate
- Lack of labor progression, the need for emergency medical intervention
- Multiple pregnancy
- Premature births
- Previous cesarean delivery/births - requires evaluation and precautions.
Remember that every birth is unique, choosing the right option for you must be analyzed together with the doctor who monitors the pregnancy. Regardless of the method of birth, medical supervision is essential to control unforeseen events and possible complications.
