We love waterbirth! Whether you choose to actually give birth in water or not, water - showers, tubs, or birthing pools - can help tremendously during labor to keep you comfortable and relaxed. Laboring in water has often been referred to as an 'Aquadural'. We really encourage planning to use water at the very least while you are in labor.
Known benefits of water labor and waterbirth:
- Facilitates mobility and enables the mother to assume any position which is comfortable for labor and birth
- Speeds up labor
- Reduces blood pressure
- Gives mother more feelings of control
- Provides significant pain relief
- Promotes relaxation
- Conserves her energy
- Reduces the need for drugs and interventions
- Gives mother a private protected space
- Reduces perineal trauma and eliminates episiotomies
- Reduces cesarean section rates
- Is highly rated by experienced providers
- Encourages an easier birth for mother and a gentler welcome for baby
I am always in awe of the peace and gentleness of a waterbirth, and amazed at the baby's calm transition when born by this method. The baby has grown in water for nine months. The familiarity of water seems to soothe and calm the him. Many babies, in the few seconds they remain in the water during and after birth open their eyes and visibly relax and unfold. Mothers who have given birth in water almost always choose this method of birth for any subsequent babies.
Induction of Labor
Induction for non-medical reasons, such as for the convenience of either the mother or the doctor should be avoided. Risks of induction are numerous and should not be taken lightly. Induction of labor has become almost routine, and is often the first intervention used in an otherwise normal pregnancy and labor which leads to a long line of more interventions, each with their own set of risk factors.
For more information on Induction see "Birth American Style"
Vaginal Birth After Cesarean
The past few years have seen an almost nation wide ban by hospitals and physicians on vaginal birth after cesarean. Contrary to what you may have heard, the reason for this ban is not safety, but Increased costs and fear of lawsuits. The theory that outcomes for mothers and babies would improve with repeat cesarean vs. VBAC has proved to be wrong, and in fact, studies are showing that mothers and babies do significantly better with vaginal birth. 15 studies published in 2006 alone support the safety of VBAC and/or the risks of cesarean over vaginal birth.
Uterine rupture is frequently cited as the principle risk of VBAC, and yet most incidences of rupture do not occur spontaneously. Rupture, in the few instances that happen, almost always occurs when labor is induced or augmented with drugs, or forceps or vacuum extraction is used. That being said, no one can guarantee a risk free birth under any circumstances, and not all women are good candidates for a VBAC. If you are considering a VBAC I urge you to inform yourself on both benefits and risks. Only you can make the decision, and you alone are responsible for the consequences of that decision. For more information on VBAC please visit the International Cesarean Awareness Network website.
The Vaginal Birth After Cesarean Checklist
Issues and Procedures in Women's Health Vaginal Birth After Cesarean
A 10-Year Population-based Study on Uterine Rupture
The VBAC Fact Sheet
Umbilical Cord Clamping
Delayed or Immediate - Is This Really An Issue?
Most obstetricians believe immediate cord clamping is important and beneficial. Some even believe it is dangerous to not immediately clamp and cut the cord. Many refuse to even negotiate this issue with parents, although the issue is not usually safety, it is time. Is this really an issue though? An issue to make an issue of?
All of the blood in the placenta and cord belong to the baby. Immediate clamping of the umbilical cord deprives your baby of about 30% or more of his total blood volume. This deprivation of blood can become a significant issue if your baby is born following any compromise or distress at birth, when his entire blood volume is needed to protect his brain and other internal organs by assuring adequate perfusion and oxygenation. Immediate clamping can also lead to anemia, hypoglycemia, and more, including an increased incidence of cardiac murmurs.
Some of the benefits of delayed cord clamping include:
· 50 % larger red cell volume, enlarged blood volume, and higher hematocrit. The iron in these cells is stored by the body, which protect your baby from anemia.
· Increased amounts of white blood cells and antibodies which help the baby to fight off infections
· Increased platelets, important in normal blood clotting
· Increased plasma proteins and other nutrient benefits that come with adequate perfusion
· Better circulation in the first few hours after birth due to increased systemic vascular resistance
· Less trouble with maintaining a normal temperature
· The baby receives his or her own stem cells. These may contribute to health and well-being in ways we do not fully understand yet.
For more information on the risks of immediate cord clamping and how this became standard practice, and more information on the benefits of delayed cord clamping, including references:
Is this really an issue?
George Malcolm Morley, MB ChB FACOG
George Malcolm Morley, MB ChB FACOG
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