Afloat on water births
Labour and delivery while submerged in a pool gaining popularity as a safe, more comfortable option
For “island girl” Taimi Koskela, a water birth, delivering her baby while immersed in a tub, just seemed natural, not new or gimmicky. Raised in Sointula by commercial fisher-folk parents, with the sound and movement of the ocean always nearby, Koskela said she feels a nice connection with things aquatic.
“Growing up in a community like Sointula, being an island girl, I’ve always been very connected to the water,” she said in an interview from her Brentwood Bay home. “I like the water, I like being fully immersed in it, I like baths and find them very relaxing.”
So two years ago, when she was expecting her son, her first child, she heard giving birth while submerged in water can help with the pain of labour. Since she and her husband, Andrew Beischer, were planning a home birth with midwives, the options for medical pain relief were otherwise limited.
So, a water birth, in a special, inflatable tub erected and filled at their house seemed like a beautiful fit. And the experience, she said, was perfect, with no unpleasant surprises. As documented many times, her infant didn’t open his mouth to breathe until it was clear of the water.
“There were no issues,” Koskela said. “My son was perfect and healthy, and he opened his mouth and cried as soon as they put him in my arms.”
But even now she encounters mild shock and disbelief when she tells people of the birth of her son, named Beckett, and her similar plans for the next birth in five months.
“I still have people saying: ‘Aren’t you worried that it’s not safe?’ ” Koskela said.
Water births, undergoing labour and bringing a baby into the world while immersed in a small pool, appears to be gaining more support.
Testimonials say the warmth and buoyant support of the water make birth more comfortable. Meanwhile, medical research is increasingly declaring it safe for those mothers who qualify.
This month, a study from Oregon State University was published in the Journal of Midwifery and Women’s Health in which researchers found no evidence that water births pose any risk to the child.
The study examined outcomes from 6,500 midwife-attended water births and is believed to have been the largest study of water births to date.
The research revealed that in comparison to regular births, water-born babies are no more likely have to low Apgar scores, the mark out of 10 in which heart rate, respiration, muscle tone, colour and reflex response are tabulated for an indication of newborn health. Nor are water-born babies any more likely to require hospital medical care in the first six weeks of life.
Direct official opinion in Canada from obstetricians and gynecologists is hard to find. Doctors haven’t come out in favour, but neither are they ready to officially support the practice.
An inquiry to the Society of Obstetricians and Gynecologists of Canada was answered by a midwife, not an MD.
Lisa Morgan, the midwifery representative on the board of directors to the Ob/gyn Society, said in a telephone interview from Cambridge, Ont., obsetricians/ gynecologists have yet to take any official stand on water births.
Morgan said since obstetricians and gynecologist usually work in hospitals where few water births occur, an official position hasn’t been needed.
But if asked, she said they are supportive enough of midwifery and evidence-based practices that the society would not be opposed to water births.
In British Columbia, the B.C. Women’s Hospital and Health Centre in Vancouver has been performing water deliveries in a few cases since 1998. Also, the College of Midwives of British Columbia has had formal guidelines on the use of water immersion during labour and birth since 2001 and updated them in 2010 and 2014.
Those guidelines include criteria for eligibility for water births, for example:
• An uncomplicated pregnancy of at least 37 weeks gestation;
• Normal fetal heart rate.
The guidelines also include medical circumstances that rule out the use of water, for example:
• Pre-term labour, less than 37-week gestation;
• Maternal infection with a bloodborne pathogen, such as hepatitis B or C or HIV;
• Abnormal fetal heart rate;
• Mobility problems that might make it difficult for the delivering mother to leave the water, if necessary.
Louise Aerts, registrar of the College of Midwives of B.C., said water births are now well within the knowledge and skillset of midwives. Most water deliveries are handled at the home of the mother. But many midwifery clinics are setting up special tubs.
Aerts said drug-free pain relief and comfort are the most common reasons women choose a water birth.
“Women are looking for a way to deal with the pain, and the warm water and the comfort of the water seems to help,” she said.
One question Aerts was unable to answer is whether water births are growing in popularity. Government health officials do not collect that information.
“It’s a gap on the forms that are used to record a birth and delivery,” said Aerts. “There isn’t a box for nurses, doctors or midwives to check for ‘water births.’ ”
“We have highlighted to government that it would be valuable information, but it’s not there yet,” she said.
But from an anecdotal point of view, water birth appears to be more widely accepted.
Ashley Brilhante, owner of the Victoria-based Tranquil Birth Solutions, rents, delivers and picks up inflatable tubs for couples to have a home water birth.
Three years ago, Brilhante started with one tub. She now rents out six in two sizes. She said other firms have started in Victoria, and most midwives in town are offering water births to women who qualify.
Brilhante, 33, is also a trained doula, so she is qualified to support and offer some assistance during a delivery. She has two children, Sofia, five, and Miguel, two, both of them delivered in water.
Her eldest was born in Edmonton. She was, however, mostly raised in Victoria. So maybe it’s that Island/water connection, but she opted for water delivery, even while she and her husband, Rob, were living on the Prairies.
Three years ago, after the couple had returned to Victoria and she was pregnant with her second child, she wanted a water birth again. Brilhante, however, could find nobody renting the tubs. So the first tub she purchased was used to deliver Miguel and the business was born.
Brilhante now brings tubs to the homes and empties them and removes them after. She has seen mothers arrange the furnishings, set up music players, even adjust the lighting for the birth.
“It just depends on the particular labour and the woman,” Brilhante said. “Every pregnancy and labour are different.”
But the result is the same: a more comfortable birth experience.
“A woman in labour gets into a pool and it helps take the weight off, and she can move around a little easier,” she said. “And when you are in labour it just provides some relaxation.”
“Think about getting into a nice warm bath. ‘Ah, that is so nice,’ ” Brilhante said. “It’s the same with a woman in labour and she gets into the birth pool and it is so nice.”