1) How do you keep the water warm?
The thick air walls of all our inflatable pools keep the water warm for hours. La Bassine will hold its water temperature for over five hours within one degree. Adding one to two soup pots or tea pots of boiling water, carefully to not touch the pool or mom, while bring the temperature of the water up several degrees without adding too much water to the pool.
2) What keeps the baby from breathing underwater?
There are four main factors that prevent the baby from inhaling water at the time of birth:
- Prostaglandin E2 levels from the placenta which cause a slowing down or stopping of the fetal breathing movements. When the baby is born and the Prostaglandin level is still high, the baby's muscles for breathing simply don't work, thus engaging the first inhibitory response.
- Babies are born experiencing mild hypoxia or lack of oxygen. Hypoxia causes apnea and swallowing, not breathing or gasping.
- Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. So, even if water were to travel in past the larynx, they could not pass into the lungs based on the fact that hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence.
- The last important inhibitory factor is the Dive Reflex and revolves around the larynx. The larynx is covered all over with chemoreceptors or taste buds. The larynx has five times as many as taste buds as the whole surface of the tongue. So, when a solution hits the back of the throat, passing the larynx, the taste buds interprets what substance it is and the glottis automatically closes and the solution is then swallowed, not inhaled.
3) How long can the baby be left underwater?
Here in the US, practitioners usually bring the baby out of the water within the first ten seconds after birth. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth videos that depict leaving the baby under the water for several moments after birth and the babies are just fine.
Physiologically, the placenta is supporting the baby with oxygen during this time though it can never be predicted when the placenta will begin to separate causing the flow of oxygen to baby to stop. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him into his mother's arms.
4) How is the baby monitored during waterbirth?
The manufacturers of monitoring equipment and hand held dopplers have developed water proof varieties of monitoring equipment. In typical waterbirths the baby’s heart tones are listened to every 30 minutes during first stage and after every pushing contraction during second stage.
5) Is waterbirth safe?
The safety of water birth needs to be judged in looking back at the number of cases that have been reported world wide and the number of problems that have occurred as a result of birth in water.
To date, over 100,000 documented cases of water births gives us a good look at the statistics. The opinion of practitioners is that water birth poses no threat to mother or baby if all the normal parameters are met during labor and birth. If complications arise they are evaluated and sometimes the mother is asked to leave the water before the birth takes place.
Everyone’s goal is to keep mother and baby safe and to facilitate a satisfying birth experience. The British government stated in a published health report that any woman who wants a waterbirth should be able to have one and that it is up to the practitioner to become familiar with the technique if they are not already educated.
6) When should you enter the water?
You can use the labor pool whenever you want. Some women have found that if they get into the water in very early labor, before contractions are strong and close together, the water may relax her enough to slow or stop labor altogether. This is is why some care providers want you to wait until the cervix is dilated to at least 5 centimeters. There is some physiological data that supports this rule, but each and every situation must be evaluated on its own.
Some mothers find a bath in early labor useful for its calming effect and to determine if labor has actually started. If contractions are strong and regular, no matter how dilated the cervix is, a bath might be in order to help the mother to relax enough to facilitate dilation.
7) Can I be in water if my amniotic sac has ruptured?
When the amniotic sac ruptures, or the water breaks, a woman can labor in the water. Studies show that the risk of infection does not increase from laboring in the water, whether the amniotic sac breaks while the mother is in the tub, or whether it was already ruptured before she got in the water.
Therefore, it has been suggested that the bath be used in a "trial of water" for at least one hour and allow the mother to judge its effectiveness. Midwives report that some women can go from 1 cm to complete dilation within the first hour or two of immersion. The first hour of relaxation in the pool is usually the best and can often help a woman achieve complete dilation quickly.
8) How warm should the water be?
Water should be monitored at a temperature that is comfortable for the mother, usually between 95-100 degrees Fahrenheit. Water temperature should not exceed 101 degrees Fahrenheit as it could lead to an increase in the mother's body temperature which could cause the baby's heart rate to increase. It is a good idea to have plenty of water to drink and cold cloths for the mother's face and neck. A cool facial mist from a spray bottle is a welcome relief for some mothers as well.
Generally speaking, the water temperature can be what the mother desires as long as it is not too hot.