Water birth is a widespread modality in recent years. It has proven beneficial to better cope with labor contractions and promote dilation when it has already begun, but its benefit is not proven at the time of expulsion of the baby.
The American College of Obstetricians and Gynecologists (ACOG) has released on Monday some recommendations regarding this way of giving birth. In fact, they are not new, but rather ratify the recommendations given in 2014 based on a review of studies that advised against water birth as a possible risk for some newborns.
Dilation in water: yes
The dilation phase It begins at the moment when labor begins and in turn is divided into two subphases. The early or latent phase, characterized by more or less variable contractions in intensity and duration and are accompanied by cervical erasure and slow progression until reaching 4 cm dilatation. And the active phase, faster than the previous one, in which the regularity, intensity and frequency of contractions increases until reaching 10 cm of dilatation or complete dilatation.
More and more maternity hospitals, centers and hospitals that incorporate dilation bathtubs due to the good reception they have had among the parturients. The use of hot water during dilation induces women to relax, reduces anxiety by stimulating the production of endorphins, improves uterine perfusion and shortens the period of dilation, increasing the feeling of pain control and satisfaction.
Also, the immersion in warm water causes the perineal muscles to relax, so the pain decreases and the expulsion of the baby is easier. This relaxation also reduces the production of adrenaline, which hardens the cervix. This favors that the time that lasts The active dilation process is shortened.
According to ACOG, immersion in water during the first stage of labor is associated with a reduction in labor and a decrease in the use of epidural analgesia, which is why it is considered a good way to give birth in healthy women with uncomplicated pregnancies between weeks 37 and 41 of gestation.
Risks of water birth
However, there are insufficient data on the benefits and risks of immersion in water relative to the second stage of labor and delivery. Several serious neonatal complications have been reported, therefore, as a precaution and in the absence of more evidence, The universal recommendation is that the birth occurs outside the water.
What complications could be associated with water birth? Although the cases analyzed have been scarce, there is talk of an increased risk of maternal and neonatal infection, especially if there has been rupture of membranes, difficulties in neonatal thermoregulation, avulsion and cord rupture when removing the baby from under water or maneuvering from above, inside the pool, producing hemorrhage and shock, respiratory distress, water aspiration hyponatremia, seizures and neonatal asphyxiation.
Despite these recommendations, this year, in August, a study based on more than 15,000 births analyzed and published in the scientific journal Journal of Midwifery & Women's Health, concludes that water birth is not only not more dangerous than other births, but also has some benefits that are not discussed in other studies. Among them, less income for babies at birth and lower risk of hospitalizations in the first six weeks.
The College points out that the woman who requests to give birth in the water must be informed that the maternal and perinatal benefits and risks of this election they haven't studied enough as to support or discourage your request.
