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Water Birth Delivery: The Next In Thing

Dr. Ranjit Chakraborti

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Nothing in the world is as soft and yielding as water, yet in dissolving the hard and inflexible, nothing can surpass it. The soft overcomes the hard, the gentle overcomes the rigid.

Water Birth has finally made its way into India. The first baby was born end April in Delhi.

According to eminent gynaecologist Dr. Ranjit Chakraborti, this form of delivering a baby is very safe and results in less labour pain. During a water birth, a mother gives birth to her child in a pool or tub full of water. Water improves the chances of a normal delivery without the use of any painkillers or drugs, which may be required in the conventional method. Dr. Chakraborti says, Water helps to provide relief from pain and offers great benefits to the woman in labour. Parents who are considering this option need not worry. There is no chance of the baby’s death due to asphyxiation or drowning.

Dr. Chakraborti explains,  Immersion in warm water raises the body temperature and causes the blood vessels to dilate, resulting in increased blood circulation. Thus, larger quantities of blood and oxygen are able to reach the uterine muscles.

A water birth also allows a mother to manoeuvre her body during the labour process with the water offsetting the pressure experienced during childbirth. The hydrostatic pressure of the water relieves the discomforts of contractions and relaxes the body, which in turn stimulates the release of Endorphins-body’s natural painkillers.

Dr. Chakraborti emphasizes, Precautions are very much necessary. The water has to be pure and clean. It should also match the mother’s body temperature and it should be conducted under medical supervision only. In UK we have seen water birth deliveries taking place at home. But I would not advise the water birth for expectant mothers who are suffering severe infectious diseases. Because in that case the chances of the infection being passed onto the child cannot be ruled out. The patient has to be well selected for safety of water birth by their gynaecologists.

While explaining safety, he went on to add that the bay comes out of one water environment into another. The baby is still attached to the mother by the umbilical cord when it is born and so it does not breathe. Dr. Chakraborti adds, Once considered an option only in birth centers, warm water immersion during labor and delivery is now becoming a viable choice for birth plans at many facilities. It promotes relaxation and provides an environment where mothers can have more control over the birthing process. made by individuals who have labored and/or delivered in the water. I receive a good many enquiries from patients who have had such a delivery abroad or are aware of this through internet. These ladies sound very much interested. Given the interest, two leading city hospitals have already approached me to set up such a unit since I have the experience while in UK. Water immersion for labor and delivery is a safe option for healthy women with low risk pregnancies. Research has shown that there is no statistical difference in the outcome of mothers and babies who have used water immersion as opposed to traditional deliveries. There was no increase in infection for either the mother or baby, no increase in bleeding for the mother, and no increase in aspiration of fluid by the baby. Many mothers are concerned about the monitoring of the baby during labor. The babies are monitored with a Doppler every 15-30 minutes during the dilating stage of labor. During the pushing stage of labor, the baby’s heart rate is monitored every 5 minutes. Waterproof Dopplers are available so the mother does not have to get out of the water to hear the baby’s heart beat. There is research that shows that periodic monitoring of the fetal heart rate in low risk pregnancies is as effective in evaluating the baby as continuous electronic fetal monitoring. The mother’s temperature, blood pressure, and progress in labor will be monitored throughout labor. The birthing pool will be set up and filled while the mother is in early labor. There are protocols for setting up and cleaning the pool to prevent any problems with infection. The pool is filled with warm water to nipple level. This seems to be the secret to decreasing the pressure of labor. The mother assumes any position that is comfortable in the water. The water must be between 96 and 100 degrees Fahrenheit. If the water is warmer, it causes the baby’s heart to beat faster and also causes dehydration in the mother. If the water is cooler, the mother is uncomfortable. The baby who is delivered in cool water is more at risk for taking a breath before his or her head is brought above the water. The mother is encouraged to drink fluid while in the birthing pool. Mothers should get into the birthing pool when they are in the active stage of labor. This phase is characterized by contractions that are strong and close together. At this point, mothers find the birthing pool very relaxing and at the same time most mothers experience some pain relief. Getting into the water too soon will cause the labor to slow or stop. Other comfort measures such as showering, walking, and massages can be used to help the mother cope with labor until she is ready for the birthing pool. When the baby is born, she is lifted from the pool so that her head is above the water. The nose and mouth can be suctioned out and the remainder of the baby kept under the water to remain warm. Babies do not always start crying immediately. They start breathing and looking around as they make a gentle transition to their new world. Women who use the birthing pool for the delivery of their babies do not usually receive episiotomies (a cut at the perineal opening to make room for the baby to come out). Instead, the baby’s head is allowed to deliver slowly. This helps the stretching of the perineum and eases the risk of perineal lacerations. If there are lacerations, they are repaired after the mother gets out of the birthing pool. Water birth is a gentle delivery with the mother having more control over her experience. The water seems to give sufficient pain relief to make it possible for mothers to have a very satisfying, unmedicated birth experience. The mother and her support person are able to participate fully in their birth experience with watchful observation by the obstetrical staff and care provider. Dr. Chakraborti mentions that both The Royal College of Obstetricians and The Royal College of Midwives support labouring in water for healthy women with uncomplicated pregnancies.

Known benefits of water labour and water birth " Facilitates mobility and enables the mother to assume any position which is comfortable for labour and birth. " Speeds up labour " Reduces blood pressure " Gives mother the feeling of more control " Provide significant pain relief " Promotes relaxation " Reduces the need for drugs and interventions " Reduces C-Section rates " Reduces perineal trauma and eliminates episiotomies.



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