Here are some common water birth myths. Which have you come across?
You can’t birth the placenta in the pool
Why not? Most places it is the norm. You still get a few midwives who say you should get out – they need to get educated. If you want to get out, get out; if you want to stay in, stay in. It is your choice. If you want to have the injection to help the placenta out, you’ll need to be out of the pool but why not wait and see. If it doesn’t come after a while, and a little push from you doesn’t move it, then get out. Sometimes the action of gravity and lifting your leg over the pool can help.
You have to wait till you are 6cm dilated.
My favourite! If you ring a midwife when you go into labour the first thing they suggest is to have a bath. What’s the difference?! It denies the relaxing and pain relieving benefits of water for those early stages. If you’re at home get in the pool when you want. The main reason for suggesting waiting is that it might slow labour down if you are in too early and you’ll have to get out (see below). If you are having a water birth at a hospital or midwife led unit hopefully you will have stayed at home and had a bath. This myth also implies that an internal/vaginal examination (VE) is required to gain entry to a birth pool. You do not ever need to consent to a VE. They cannot deny access to the pool if you decline VE. (VEs carry risks and are not accurate predictors of labour progression.) However, if you want a VE have one. It is your choice.
If you get in too early you might have to get out.
Ok, so this is true – but the myth is that getting out should be avoided. Let me tell you: getting out of the pool is not a bad thing. It is good to get out, go to the loo, walk around a bit, and then get back in. Getting in the pool before around about 6cm (can’t talk during contractions, and staying internally focused in between) has been shown to slow labour down. But labour is not a sprint. If it slows down just get out for a bit. Research has shown that getting in a pool after about 6cm speeds labour up, as your body releases a wave of oxytocin. This lasts about two hours. Staying in one position for too long in labour is not a good thing anyway. And you need to empty your bladder (which you can do in the pool as it will be diluted by the water). Sometimes that change of scene, the privacy that we feel in the loo, the action of turning and sitting on the loo with our legs wide, can be really useful to labour progress. And then you can get back in – and have another wave of oxytocin. Result!
You can’t have a water birth if ...
You are induced
If you’ve just had pessaries, or your waters broken, and are then in established labour, then you should be able to use the pool. Find out what the policy is in your area. Some areas do this so yours should. Remember water releases oxytocin. Often a supervisor of midwives, or a consultant midwife would be the best person to talk to. Obstetricians know very little about water births – that’s the midwives’ domain. If you are on a drip of artificial oxytocin then it’s not a good idea to be in the pool.
If you are overweight
Being a bigger woman is the latest scare story of obstetrics. Yes, bigger women may have bigger babies – so let’s do everything to increase the space the baby has to get out – like have a water birth. Bigger women are more likely to have complications with a caesarean so let’s do everything to reduce the need for one – like have a pool birth. Also, the pool is great for helping with changing position in labour – a challenge for any heavily pregnant woman. There is the worry that should you collapse then it would be harder to get you out, but that’s a bit of a red herring. Hospitals deal with overweight men having heart attacks all the time. You might like to ask your midwife how often women have collapsed and had to be lifted out of the pool. I don’t think it will be many, if any. If it’s a real worry then have an inflatable pool as the top ring is really quick to deflate to reduce the height. Besides your partner can get in the pool and hold you up. I think midwives and doctors worry that women won’t get out if their care givers suggest it. But women are the ones most concerned about their baby’s wellbeing. And also the ultimate responsibility is with the woman, if she is making the decisions. It is all about weighing up the risks and benefits. It is your decision.
If you have had a previous caesarean
I think this one is disappearing fast. Water birth for vbac women (vaginal birth after caesarean) is so common now. Many women are using pools in midwife led units, and of course you can have a home birth. Many units, including midwife led units, have wireless telemetry so you can still be continually monitored (if you agree to it). Some hospital trusts now automatically put women having vbacs under midwife led care, not consultant led care, and research out in early 2016 showed better outcomes and higher success rate for vbacs under midwife led care. I have been at a wonderful home water birth vbac (or hwbac!). I also know women who’ve had water births after 2, 3 and even 4 caesareans. It is possible.
There are more myths about water births, including that the floor might break or your partner can't get in the pool with you. So look out for part two. What myths would you add?
I am a doula and antenatal teacher with over 14 years of experience supporting women and couples prepare for birth. I have used water in labour with all five of my babies' births and one was born in a birth pool. Another was meant to, but I got out to go to the loo and didn't have time to get back in!
I run water birth workshops and a 'pass the pool' scheme. For more details of all my services check out my website and facebook page. If you are a doula who'd like to run water birth workshops in your area please send me an email.