Firstly, you need to prepare your mind. Examine your own motivations, incentives and expectations for wanting a water birth. Ask yourself what made you decide to have a water birth and why – is it something you are doing for yourself or are you doing it because someone else expects you to? Remain flexible and let go of the expectation that you must birth your baby in any certain way. Examine how you might feel if your baby is not born in water. We cannot plan birth and there is always a good chance it will go differently than planned. So hold on to your wishes lightly, inform yourself well of the options and alternative scenarios. The more you know and open yourself up for other possibilities, the less surprises you will have along the way and that will result in less stress and a better birthing experience, water birth or not!
The water temperature ought to be within 35C – 38C, depending on your preference. Adjust the temperature to your comfort. This can be done with a hose or by removing and then replacing some water with a bucket. If the water is too cold, you will use your energy trying to keep warm and become tense. If the water is too hot you’ll feel drowsy, overheated and may become dehydrated. Your blood pressure will drop which can make you feel faint and you’ll have a greater tendency to bleed after the birth. If you just want localized heat, for example on your back, wet hot wash cloths can be used. Cold wash cloths are great for cooling your face. It is normal for women during labour to one minute be too hot and the other too cold, your body is working very hard to birth your baby, so expect a little of that.
A woman should be encouraged to use the labor pool whenever she wants. However, if she chooses to get into the water in early labor, before her contractions are strong and close together, the water may relax her enough to slow or stop labour altogether. It’s best to wait until you have a strong desire to be in the water or your contractions are strongly established and you are in active labour. Some recommend waiting until you’re at least 5 cms dilated, that way you save the pain relieving effect for the time you need it most. If labour slows down when you are outside the water, try getting into the tub as this might stimulate labour. If your progress slows down whilst you are in the tub, get out, empty your bladder and move around to stimulate labour. Often it is the CHANGE of environment that gets labour moving again. Women’s bodies are all different. The first hour of relaxation in the pool is usually the best and can often help a woman dilate quicker.
Drink to thirst. Ask your partner to remind you to drink to avoid dehydration, which can result in fatigue and a poorly functioning uterus. Eating and drinking during labour has been shown to reduce the total length of labour by as much as 90 minutes. Eat light, easily digested food.
Experiment with a variety of different positions while in the tub. Try kneeling, squatting, leaning, sitting or lying outstretched (body facing up or down.) Your body will typically move til it finds a position that feels more comfortable. Some women prefer their partner to be in the pool with them to hold onto and act as an anchor, others prefer to be in the bath alone.
The baby doesn’t breathe until after its face leaves the water and its skin comes into contact with the air or it is stimulated when out of the water.
Until then, the baby receives oxygen through its umbilical cord, as it has done during the 9 months of pregnancy. Discuss the actual birth moment with your midwife ahead of time. Many midwives feel comfortable with the time that it takes the mother to reach down and pick the baby up herself, others (often less experienced in water birth) feel the need to have the baby come straight out of the water.
Often a mother will have an automatic response and bring the baby straight out of the water to her chest. If she has thought about it before hand she may take the time to just pause for a moment while the baby is immersed under water and look at her little one before bringing it up out of the water. As long as no part of the baby has come out of the water this is fine and safe to do. Remember that the great benefits of water have already been achieved as soon as the infant is born into the warm water. Sometimes babies born in water are so calm at birth it can appear that they aren’t breathing. Gently rub their back or blow on their face and they will gasp. Being born from water into water is a gentle start for a baby and these water babies sometimes need a little more time to literally land on earth.
Some women like to stay in the pool after the birth to enjoy the moment and bond with the baby. Many women want to get out quite soon after and get into a nice warm bed. Birthing the placenta in the water is usually fine. Some midwives prefer the placenta to be born out of the water due to the difficulty to judge accurate blood loss. When it is time for the placenta to come, your midwife may ask you to get out of the pool. Discuss what you both feel comfortable with beforehand and what the scenarios may be that would change this stage of the process.
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