Water birth.pptx benefits, contraindications, procedure

water birth

1. Water birth

2. Water birth is the process of giving birth in a tub or pool of warm water. Theory behind this type of giving birth is that the baby has been in the amniotic sac for nine months and emerging in a water environment is gentler and less stressful for both the mother and the baby. It is also believed that is reduced stress during labor and birth which also reduces fetal and maternal complications.

3. Benefits of water birth Benefits for the mother Water is soothing, calming and relaxing Water seems to increases woman’s energy Buoyancy lessens body weight which allows free movement and new positioning Buoyance promotes more efficient uterine contractions and better oxygenation of the uterine muscles, less pain for the mother and more oxygen for the baby Immersion in water often helps lower high BP caused by anxiety

4. Water seems to alleviate stress-related hormones, allowing the mother’s body to produce endorphins, which are pain inhibitors. Water causes the perineum to become more elastic and relaxed, which reduces the incidence and severity of tearing and the need for an episiotomy and stitches As the laboring woman relaxes physically, she is able to relax mentally, concentrating her efforts inward on the birth process The water provides a sense of privacy, which releases inhibitions, anxiety and fears.

5. Benefits for the baby Provides a similar environment as the amniotic sac Eases the stress of birth, providing reassurance and security It is also believed that water babies cry less and are calmer and more alert

6. Contraindications Have had a history of CS or difficulties during previous childbirth, shoulder dystocia, PPH Age under 17 years or >35 years Had history of insulin-dependent DM, HIV + ve Mobility or skeletal problems that may prevent leaving the birthing pool when necessary Having pregnancy complications, such as preeclampsia, GDM and gestational hypertension

7. Multiple pregnancy Premature birth Big baby The baby is in a breech position; so, a CS is necessary Mother has an infectious disease like Herpes Mother has a fever of >39°C

8. Excessive vaginal bleeding Alcohol or drug misuse Baby passed meconium

9. Procedure of water birth

10. Procedure/ Care of women during Labor 1 st stage During the 1 st stage of labor, the water temperature should be comfortable for the women and not >37.5°C. the water temperature should be checked hourly and recorded in the maternal handheld records. Maternal temperature should be checked hourly and if the woman feels too hot, she should leave the pool until she cools down.

11. Women should be encouraged to drink adequate cool fluid while in the pool to prevent dehydration The depth of the water should be at least up to the woman’s axilla when she is in a sitting position. This aids buoyancy and promotes movement, which aids the progress of labor and increases maternal control. This will also give enough depth should the women choose to give birth in the water.

12. II stage During the second stage of labor, the water temperature should be maintained at 37°-37.5°C The water must be deep enough for the baby to be born completely submerged under water. During II stage, progress of the emerging head should be observed with a mirror. Slow crowning and birth of the head should be encouraged to minimize perineal trauma.

13. The hand-off method of birth should be practiced. This will minimize the stimulation to the emerging baby The cord should never be clamped or cut while baby is still under the water. The women or midwife reach down and support the baby as it emerges. The baby should be brought to the surface, and care taken to ensure the cord is long enough to allow this. Following this , rest the baby’s head above the water keeping the body in water, skin to skin with woman. This will keep the baby warm and promote skin to skin contact. Once the baby’s head has come out of the water, it must not be submerged again. Clearly document whether the baby was born under water and condition of birth.

14. III stage During the III stage , if the condition of the woman and baby is stable , there is no need to clamp the cord until the placenta is delivered Umbilical cord should be cut within 3-5 min The mother may remain in the pool for the III stage of labor and there is no evidence to contraindicate delivery of placenta in the water Blood loss should be carefully observed The estimated blood loss should be recorded as <500 ml or >500 ml Suturing should be delayed for 1 hr due to water saturation of the tissues unless bleeding is excessive and prompt suturing is required

15. Risk of water birth Theoretical risk of water embolism, if water enters the mother’s blood stream Water aspiration infections – if water is not clean Chance of umbilical cord damage or tear