To water birth or not to water birth?

The Malaysian Ministry of Health has recently banned the use of water birth for expecting mothers in Malaysia, citing that there are no known benefits to the practice and there are also no guidelines or specialised training for midwives or obstetricians and gynecologists. Therefore it has directed all hospitals to stop the use of birth pools for labour and birth until guidelines have been finalised.

A water birth means that at least part of your labour, delivery, or both happen while you are in a birth pool filled with warm water. It can take place in a hospital, a birthing center, or at home. A doctor, nurse-midwife, or midwife helps you through it.

While it’s an established option in advanced countries, there are still skeptics. A major fear is the risk of the baby drowning in the water. Another is that water may cause mother and baby to be more susceptible to infection.

Other worries that the baby is not being constantly monitored. Therefore, if something were to go wrong, caregivers would be unable to help until it is too late.

However, Dr Choong from Pantai Hospital, which has offered this birthing option since 2009, states that the health of pregnant women would be vetted beforehand and only those with normal, low risk pregnancies would be allowed to use this method.

He also stated that women who are using medications like the epidural would not be allowed to give birth in water.

On the risk of a baby drowning during a water birth, Dr Choong said that the percentage of babies drowning during such birth in countries using the method such as the United States, Italy, Australia, New Zealand and United was small — at below one per cent.

In the event a mother should change her mind, she could request to give birth on a bed on standby at the labour room. She can also get out of the tub to use the bathroom or even have a drink of water.

Based on current research and reported experiences the benefits of water birth include:

• Pain relief.
• Relaxation of aching muscles.
• Buoyancy helps women to feel lighter, reduces pressure.
• Freedom of movement so women can change positions as they see fit.
• Helps reduce stress hormones that increase pain.
• Immersion in water can help reduce anxiety related hypertension.
• Reduced risk of episiotomy and tearing.
• Encourages relaxation of the pelvic floor.
• Reduces inhibition and anxiety by creating a feeling of privacy allowing a mother to better listen to her natural birthing instincts and work with her body.
• Encourages a gentler arrival and transition for baby.
• By facilitating movement, privacy, and emotional and physical relaxation. it can reduce the length of labor.
• Reduces the risk of interventions such as synthetic oxytocin. Both experts and mothers claim that this is an alternative method for pregnant women to deliver their babies in a way that is most comfortable for them.

Regardless of where you decide to deliver, having a water birth means you should ask questions about how the labor and delivery are done. Things to look for:

• You have experienced health care professionals to help you through the labor and delivery.
• High standards are kept to ensure the tub is clean and well maintained.
• Proper infection control measures are in place.
• You and your baby are being properly monitored while in the tub.
• There’s a plan to get you out of the tub as soon your doctor, nurse, or midwife says it’s time.
• The water temperature is well regulated, usually at 37 degrees Celsius.
• You drink water during the birth to avoid dehydration.

Due to an uproar over the ban, the Health Ministry is currently in talks to create guidelines over the safety and training requirements needed for water birthing.

News source: The Malaysian Times