Recommend, 2018

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Share Childbirth in the water, yes or no?

Armando @armando_bastida

When you stop to watch videos of births at home you realize that most women end up dilateing or giving birth in the water, in a large bathtub in the middle of the dining room . If midwives use this system for women to be there better than out of water, why is it not used in hospitals?

Well, in some hospitals, bathtubs are used, but they are the least and perhaps for logical reasons, lack of space. Or maybe it's just that dilate in the water is not so much? Next we are going to talk about the scientific evidence that is behind the dilation or the childbirth in the water: the childbirth in the water, yes or no?

What scientific studies say

Luckily for us, the Cochrane made a review of studies about the dilation in baths of childbirth in the year 2004 achieving a total sample of 2, 939 women. In this review they wanted to know if a woman's immersion in the water helps to relax and reduce the use of analgesia or if it is not for so much and also poses a risk of infection for the baby or the mother or even a risk for the baby, that could suck water at birth.

They analyzed eight trials and concluded that the use of bathtubs during labor helps significantly reduce the use of epidural anesthesia . There were no differences in instrumentalized deliveries nor were there differences in the cesarean section rate.

It was observed that women who used a birth bath reported significantly less pain in the process of dilation . There were no differences in the Apgar of the babies at five minutes of birth, in the income of the babies in the neonatal unit or in the rates of neonatal infection.

That is to say, that using the bathtub to give birth is not worse in any sense than not making use of it and, nevertheless, it improves the pain of the women and makes it less necessary the use of anesthesia to give birth.

A more recent study, conducted in 2007, analyzed 200 women who used bathtub, one before reaching a 5 cm dilation and others after having dilated those 5 cm. With this they wanted to see if there was any difference between them in order to know when it was better for a woman to do the dive in the water, whether sooner or later when she had been dilating for a while.

They saw that women who entered the water earlier had a longer period of labor (9.8 hours) compared to those who entered later (8.5 hours). They also saw that the former ended up making more use of synthetic oxytocin (57%) than those who later entered the bathtub (30%) and also saw that women who used water earlier made more use of epidural anesthesia. (27%) than those who used it later (9%).

After all this they concluded that the use of the delivery bathtub was preferable during the dilatation once a minimum expansion of 5 cm had been produced.

What the Ministry of Health recommends

In light of the evidence shown, the Ministry of Health in its Guide to Clinical Practice on Normal Birth Care says the following:

Immersion in hot water is recommended as an effective method of pain relief during the late phase of the first stage of labor.

That is to say, that childbirth in the water is recommended whenever possible, but making use of immersion in a delayed manner, when the dilation is already somewhat advanced, so as not to stop it and thus avoid other interventions.

So now tell us a little, is there a possibility of giving birth in the water in your hospitals? Have you ever used a birthing tub ? How was the experience?

More information | Cochrane Review in Pubmed, Pubmed Study, Clinical Practice Guideline on Normal Birth Care Photo | Rabble on Flickr in Babies and more | And Transi Álvarez gave birth to her little Ana, Beautiful video of a birth in the water, Dilation in the water and vertical delivery at the Costa del Sol Hospital (video)