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Parenting: Growing in Good Health

Parting the Waters

By Naomi Mendelsohn

For a small percentage of women, it removes all the pain. 100 percent. For a larger group of women, pain is reduced anywhere from 20 percent to 80 percent.

A week before her first baby was due, Lakshmi Bertram and her husband traveled to a cattle feed store.

Their mission: to buy a horse’s feeding trough.

"People thought I was crazy," says Bertram. "They were there buying stuff for their horses and cows. And here we were getting in and out of the troughs."

This wasn’t some form of prenatal calisthenics or a gigantic baby’s cradle. No, this trough was for Bertram herself.

"A week before the baby was due I saw a video about waterbirth," explains Bertram. "I fell in love with it."

The decision to have a waterbirth was easy; finding a tub was not.

That’s where the trough came in.

All of Bertram’s five children were born in the original "tub." In fact, Bertram found the experience so pleasurable that she penned a book about it, Choosing Waterbirth: Reclaiming the Sacred Power of Birth, which is due out in August 2000.

Why get wet?

"The buoyancy and warmth of the water makes a woman comfortable," says Barbara Harper, R.N., midwife, founder and director of Waterbirth International. "For a small percentage of women, it removes all the pain. 100 percent. For a larger group of women, pain is reduced anywhere from 20 percent to 80 percent."

Barbara refers to simple mathematics for proof.

"Let’s say you’re 200 pounds at the time of birth. The water will reduce the weight to 50 pounds. All of a sudden you can move. On a bed, you’re a beached whale. In the water, you’re a slippery dolphin."

After five births in water Bertram is inclined to agree.

"I think a lot of women like the idea of having a natural birth but are put off by the rumors of how painful it can be. Waterbirth, while not making birth entirely painless, reduces the pain enough that women feel able to go through labor."

And while there hasn’t been extensive research into the field, Bertram does cite studies showing that hydrotherapy, which is commonly used to treat disorders such as arthritis, increases blood circulation and allows the body to use oxygen more efficiently. For waterbirth purposes, this means that both the baby’s and the mother’s blood are circulating well during labor and that the mother has more usable oxygen.

It's not the water, it's the power

Although many women attest to the ameliorating properties of water, there are few statistics on the issue. In fact, many physicians and midwives are inclined to believe that the power of waterbirth lies in the setting itself.

"The phenomenon of using warm water in labor as far as pain is concerned is almost impossible to quantify," explains Michael Rosenthal, M.D. "Just about 100 percent of women who had the experience with water loved it. But the real question is, what part of the experience did they love."

Dr. Rosenthal has seen enough waterbirths to ask these questions. A recently retired physician, Dr. Rosenthal was the director of a birthing center in Upland, California where 2000 women labored in water and 941 gave birth to water-babies.

"They were in an environment which used fewer controls," explains Dr. Rosenthal. "They could walk around. They could have nobody there or have their whole families there."

And, according to Dr. Rosenthal, this control makes all the difference.

"The more they controlled the experience, the better they felt. They could do whatever they wanted. If they wanted to do it on a toilet, fine. Squatting on a bedside or in a bathtub, fine. Whatever they wanted."

If these techniques don’t sound like they came from a medical textbook, they didn’t. Dr. Rosenthal learned all this from watching women in labor.

"The biggest lesson I learned was that the less you fiddle with normal women, the better your results."

Dr. Rosenthal has statistics to prove it. At his birthing center, the c-section rate was consistently less than 10 percent, which is significantly lower than the national average of 25-30 percent.

"It’s never been shown that a birth is at all benefitted by a physician," says Dr. Rosenthal. "80-85 percent of women are going to have an uneventful pregnancy. It’s nothing magical that we do, but we have trained women to become dependent on us."

Come again? In this modern age, a physician who still believes that women can give birth without obstetricians, monitors and epidurals?

"When you put women in a hospital, you subject women to the behavior of a surgical patient," says Dr. Rosenthal. "You take off their clothes. Give them an IV. Shave them. Then you take them to an operating room with surgical lights and scare the hell out of them. You’re expected to be passive. The more you feel that you’re in control, the easier it is to deal with."

And baby makes three

With all this talk about the mother’s experience during birth, it is important to remember the other parties involved, namely, the child. Some people believe the transition between womb and world is more gentle if a child floats into a tub of warm water.

Others, however, focus on the dangers.

"I have seen two disastrous water births," explains Patricia Robertson, M.D., perinatologist and associate professor of obstetrics and gynecology at University of California at San Francisco. "Babies born in above ground swimming pools at home. The first baby came in dead on arrival, having drowned in the water. The second baby had meconium[feces] aspiration, where the child had ingested meconium into the trachea and developed a bad pneumonia."

Dr. Robertson’s experience, however, is different than both Harper’s and Dr. Rosenthal’s.

There were no drownings in the nine years Dr. Rosenthal ran the birth clinic. And Harper thinks there are few, if any, extra dangers involved in waterbirth. Physicians are typically on call in case of emergencies.

"The dangers of waterbirth are associated with the dangers of normal childbirth," says Harper. "The practitioners who provide this option for women need to know how to anticipate and deal with problems. All but one of 12 studies say that there’s no difference between waterbirth and non-waterbirth. And the one study says that waterbirth is better."

And while many waterbirth practitioners believe that waterbirth should only be considered by women who have reached the end of a pregnancy without complications, the tides are starting to change on that issue as well.

"There are a few physicians advocating the use of water for things that in the past we would have considered emergencies or complications like breech birth and twins," explains Harper.

And she adds some words of advice for women interested in waterbirth.

"The key is growing a healthy placenta," says Harper. "So feed yourself well."

To learn more, www.waterbirth.org is chock-full of resources and information about all things waterbirth.

Naomi Mendelsohn is a content editor at savvyHEALTH.com.

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