Hydrolabour is defined as the use of water during the active phase of first stage of labour. Hydrobirth entails the actual delivery of the baby that is the second and third stage of labour in the pool of warm water.
The equipment used is a disposable inflatable tub about 5 and ½ feet in diameter and two feet tall. The water is maintained at a constant 37* Celsius i.e body temperature which is warm to hot. Monitoring of labour for both patient & baby is just as we do in routine labours.
Patients are admitted early in labour and essentially the entire process of labour remains the same. Due consent is taken for the use of water in labour and delivery. The patient enters the pool of water in the active phase and labours and delivers there.
The baby is born active and calm as the mother holds and brings it out of water after a few seconds of adaptation. The cord is now cut and respiration is established. Placenta delivery may take place in the pool or after shifting the patient out. Episiotomy can be given underwater with local anaesthesia.
The average duration of second stage is shorter and the incidence of instrumentation is lower in patients undergoing Hydrobirth. None of our patients has had any significant 3rd stage complications.
There is absolutely no difference in the neonatal condition at birth or the incidence of neonates requiring resuscitation or other assistance.
Facts Vs Myths
|The baby will aspirate water or drown .||There is no attempt to breathe till the cord is cut or exposure to air occurs.|
|Infection risk to the mother.||Theoretical- never reported in the last 50 yrs.|
|Infection risk to the baby .||Almost all babies are bathed in most hospitals after birth. We use the same water for our Hydrobirths.|
|Hygiene?||Disposable equipment available for each patient.|
|What about Episiotomy & the placenta.||Episiotomy under local anaesthesia can be given underwater. Delivery of the placenta may be done underwater or on the delivery table nearby|
So why water?
- 60% of our body is water!!!
- Water is the essence of life – natural & pure.
- Water is a muscle relaxant it rejuvenates and refreshes.
- Water increases blood supply to the uterus – takes away toxic local hormones.
- Water makes labour more efficient … more progress with lesser number of contractions.
- Gives buoyancy and makes you weightless.
- Results in shorter and less painful labours –without increasing the risk to mother and baby in any way.
In water stress hormones are reduced and pain relieving chemicals or endorphins are released in excess. Also the shock of sudden lights sound and other sensory stimuli to the baby is reduced if the baby goes from water to water to air rather than from water to air directly and these babies are reported to be more balanced and stable individuals who have better adaptive capabilities as adults later on in life.
The subjective reporting of pain relief has us completely stunned and very enthused about what we have seen.
We did not use any drugs or medication to hasten or accelerate these labours which is an important concept of natural birthing.
Benefits of Water Birthing?
- Water is a muscle relaxant – it aids the passage of the baby through the birth canal.
- Relives pain.
- Refreshes & rejuvenates the mother – making her more co-operative
- Shortens the duration of labour & reduces incidence of artificial instrumentation at delivery (Forceps/Vacuum)
- Causes weightlessness- overcomes gravity- allows the mother relief and comfort.
- Gives the baby a smoother medium of transition from the womb to the out side world…..And many, many
Cochrane Review : Of more than 40,000 Waterbirths worldwide. No directly attributable fatality and No specific risk above Normal deliveries.
British Medical Journal 1999 : Dr. Gilbert et al. 4032 Waterbirths – Perinatal Mortality 1.2 / 1000 live births. Lower than normal Deliveries.
Choosing Waterbirth : Lakshmi Bertram
Gentle Birth Choices : Barbara Harper
Waterbirth Unplugged : Beverly A Lawrence Beech
Waterbirth Handbook : Eileen Herzberg
About the Author:
Dr. Rajeev Punjabi: Dr. Rajeev V Punjabi started his Practice in 2000, and spent 4 years performing Sonography in Obst. & Gynaecology, besides working as a Gynaecologist in Mumbai. In July 2003, he joined hands with his colleague from LTMMC, Sion Hospital, Mumbai and long time friend Dr.Sheetal J Sabharwal to start Tulip Women’s Healthcare Centre in Khar(W), Mumbai, India. In October 2003, he performed Mumbai’s First and one of India’s first documented and reported Underwater Deliveries – Hydrobirth successfully. He continues to promote the use of Water in labour and delivery ( Waterbirth ) with great enthusiasm.
You can also email him at: firstname.lastname@example.org