Water Birthing Written by Maria Barrios Water babies Why moms are turning to the tub to labor and deliver By Maria Barrios Raina Zelinski-Wahnsiedler wasn’t committed to laboring in the water. The only commitment she did make to herself was to have a flexible and malleable birth plan. “My whole idea with labor was whatever works at the time—the more possibilities for natural pain relief, the better,” says Raina. “When I was laboring, it just sounded like a good idea to get in the tub. It was the first thing I wanted to do. I thought that the heat would be relaxing, which it was.” According to her midwife, Esther deJong, Certified Nurse Midwife (CNM), Raina had the right idea. “Women should treat the tub as an additional tool but not get too attached to a certain plan,” says deJong, who offers water births at West Jefferson Medical Center and Touro Infirmary. “It is a good idea to be open and flexible when it comes to birth plans. I often quote the Buddhist saying ‘no expectations, no aversions’ to my clients.” Laboring in the water can have a dramatic impact on the duration of a woman’s labor. “We have found that getting in the tub too early, or staying too long of a time in the tub, can slow labor,” says deJong. “We encourage women to move and change position, get in and out of the tub, walk around, or sit on a birthing ball.” That said, women will be happy to learn that according to Cathy Badeaux (CNM), deJong’s partner at Uptown’s Woman to Woman Midwifery, the tub can also accelerate the labor process. “The majority of time I will see labor stop temporarily or the contractions will get much milder,” Badeaux says. “The woman becomes really relaxed. After a while—as soon as 15 minutes—the woman will start having contractions again. I think that labor is accelerated because of relaxation. When the woman is relaxed, the uterus produces more efficient contractions.” Even if being in the tub slows labor temporarily, that isn’t always a bad thing. It can allow a laboring woman to regain energy. “While it did slow my labor a little, at five centimeters it was the perfect time to take a break and kind of regain strength for the really intense part,” says Raina. One aspect of the tub that many women find appealing is that it creates a private realm for a woman to labor and deliver. “I recently attended a lovely birth of a young couple having their first baby,” says deJong. “The woman had had a stressful pregnancy and so I was not sure how she would cope with her labor. She said later that she went into an altered state in the tub. She went from transition into pushing in a nice, fluid way. I was behind her supporting her perineum when the head delivered. The husband lifted the baby out of the water into his partner’s arms. What struck me was how private the experience was. This couple had their baby and I had very little to do with it.” Elena Reeves-Walker of Uptown, who labored at home, also found laboring in the tub to be a private experience. “I felt that the pool created a semi private area—a room within a room—that was my own space, a little buffer for modesty but also for meditation,” says Elena. There are medical scenarios that may preclude the option of the tub. If pre-term labor (before 37 weeks) is expected: if the mother has Herpes; if the baby is breech; if maternal infection exists; twins or multiples are to be delivered; and in the event of severe meconium, toxemia or preeclampsia. However, it is important to note that in at least some of the afore mentioned scenarios, safe water births have still occurred, making it critical that a woman first discuss all of her options with her health care provider. “If there is meconium-stained fluid or any signs of fetal distress, then we would not do a water birth,” says deJong. “All of the hospitals that offer waterbirths have guidelines for using the tub which are based on those of Waterbirth International (www.waterbirth.org).” It is important to note that while many women feel soothed by the heat of the tub, it does not eliminate labor pain—but rather offers women a useful coping mechanism. “For me, it helped more in the earlier stages of labor than later,” says Raina. “In my experience, once the heavy stuff hits there really isn’t anything you can do. It is not an epidural.” Elena agrees that the tub does not rid a woman of labor pains. “I believe pain relief is a mental state,” she says. “It comes from total relaxation, learning how to not fight and fear the contractions. It doesn’t come inherently from being in the water. Of course being in the water can aid a woman in relaxing. But don’t expect the water to make you relax enough to have a pain-free labor.” Built-in tubs available at Ochsner—Kenner The only built-in labor and birthing tubs available in the New Orleans metro area are those at Ochsner Medical Center–Kenner. One benefit of having a built-in-tub is that the water is continuously refreshed, keeping it clean. Additionally, the temperature is closely monitored for safety. Sandy Pitre, a labor and delivery nurse at the facility, has seen great benefits of utilizing the tub in a hospital setting. “The primary goal is for the woman to have her birth in the fashion that she desires,” says Pitre. “If she wants medication, it is available, while if she wants no medication she can do that as well. There is no pressure—we just want to offer her all of the options available.” There are distinct advantages to having a waterbirth in a hospital. “The staff is behind the scenes watching for the safety of the mother and the baby,” explains Pitre, “which is the primary concern, while being able to handle any emergency that may arise. You get the best of both worlds—a peaceful labor process with medical assistance if needed.” The nurse adds that she hopes to see even more moms-to-be take advantage of the built-in tubs at Ochsner-Kenner. Through the use of the tub, explains Pitre, labor and delivery are treated as natural occurrences as opposed to a medical experience. “[Water labor and delivery] transform labor and birth to… a spiritual experience where the family maintains control.” Additional resources: Waterbirth-Friendly Hospitals: Ochsner Medical Center – Kenner, 180 W Esplanade Ave, Kenner, 504.468.8600 West Jefferson Medical Center, 1101 Medical Center Blvd, Marrero, 504.347.5511 Touro Infirmary, 3525 Prytania St, New Orleans, 504.897.7000 Waterbirth Midwifes: Esther deJong, CNM, 504.272.0681 Cathy Badeaux, CNM, 504.272.0681 Rebecca Hageman, CPM, LM, 985.789.8956 Emmy Trammell, CPM, LM, 985.974.2724 Waterbirthing Tubs Typical tub rental fees are $250, with a $50 deposit required. Note: The $50 non-refundable deposit is required up front and the remaining $200 is due after the birth—only if the tub has been unpacked and set up.