Friday, September 11, 2015

Questioning Water Birth -- My Most Unpopular Post Ever

It's been months since I've published anything here. I've written plenty, just not published them. At 44, I've finally learned when to keep my mouth shut. The birth community has really changed in the last couple of years, too, so there's that. I'm not overly excited about arguing with other birth workers when good will not come of it. Negativity breeds negativity and I really don't want to be a part of it. How about an actual blog post about birth, not business or the birth community?! Let's do it!

There is something that has weighed on my mind since the viewing of Microbirth back in February. I spoke up at the discussion afterwards about several thoughts I had during the movie, but they were not well received by the majority of the room, well, except for the longest working midwife in Dallas-Ft. Worth, Helen Jolly, who wholeheartedly agreed with me.

If you haven't seen the movie, here's a sneak peak:

I've hesitated to talk about the thoughts I had as I watched this movie because they won't be popular in the natural birth world. I own a company, Birth Boot Camp, that promotes natural birth and midwifery care, and the last thing I want to do is make people upset. The purpose of this post is a discussion. I'm not saying I'm right whatsoever, but I do want to bring up some points that I feel might be ignored or overlooked in the natural birth community. People are free to make their own decisions, as always.

A fascinating statement was made in Microbirth that a baby passes through over 400 beneficial bacteria in the vagina when they are born. They did a great job of addressing the complications that cesarean birth may be causing for these babies who are not receiving these bacteria. They proposed swabbing the vagina and rubbing it all over the the baby's face and in its mouth, etc. after it is born. If you are anything like me, you find this awkward to do after the birth. I'm curious how often this will actually be done. I have yet to hear of it.

As I'm watching this movie, and getting all this information about beneficial bacteria in the vagina, and then witnessing water birth after water birth, I can't help but think about the bacteria being washed off the babies immediately after the birth. When I mentioned this after the screening, one woman immediately started talking about how much she loved her water birth. That's not the issue! There are chemicals in the water and some babies are spending a lot of time in the water after the birth. Moms, or midwives, will keep washing water over the babies to keep them warm or wash off "goo" and inadvertantly, the beneficial bacteria. Even if they are taken immediately out of the water, doesn't it make sense the water likely washed some away?

What if this is part of the problem? What if we are doing damage - or at least not helping -  the baby to receive the benefits of vaginal birth because s/he is born in water? What if?

The mom is also submerged and anything that came off the baby that would have been on her, is also washed off. I wrote a post several years ago called The Sense of Smell Connects Babies and Mothers. When a baby is born in water, they do not have these same benefits of smell. The smells of amniotic fluid and "goo" are good for mom and baby to keep for a while! And while I'm not writing an entire post about it, I'll just add that mom wearing a bunch of essential oils when her baby is born may also be a distraction in this important smelling and bonding process.

As with so many of the things we do during labor and birth, I feel an important question to ask is, is this part of the natural process? Are we altering how God intended birth to go? Are babies intended to be born into water? I don't know. I had a water birth over 14 years ago, before it was trendy or popular. In fact, I'd never known anyone to have one before. Ironically - or maybe not - that child is my only one who has asthma and skin issues. I'm sure it's a coincidence, but what if it's not? Asthma was one of the main issues addressed in the movie.

I'm just putting this out there to think about. I could be totally wrong, but I think it's irresponsible to not at least explore the possibility of the harm water birth might be doing to our babies. We are so quick to "judge" cesareans and blame them for so many health problems, but perhaps we are doing damage by doing something so "natural."

Again, people love their water births. I don't want to take that away from anyone and I'm certainly not anti-water birth. I think it's super important that it is an option for women. I've said for years that water is a "midwife's epidural" and I believe that. Labor feels different in the water. It does good things for a laboring woman, but I am having serious questions about the actual births taking place in the water.

Since we are here, talking about water... Let's just touch on herbal baths. It's been explained to me that it is beneficial for the mom's perineum. OK. But does it have to be done so soon after the birth, with the baby submerged in the water again? It just seems like this is a photo opportunity and people like it, but again, is it possibly doing harm? Just putting it out there.

Bottom line - are we doing things because they are trendy, and are they really benefitting moms and babies?


Supermomof3 said...

As a Doula I had a emergency c-section happen and mom asked for the vaginal swabs and the midwife said "Of course" You are the third I have had do this! She then explained the process to her. So, it does happen but it's new. As far as the water birth may be right. It may wash off "some." I dont think it will make or break the outcome of bonding between a mother and a child. I think the bigger problem is the hats placed on the babies by medical staff who apparently know "more than me" about birthing babies ::sarcasm:: I have an issue with the word "trendy" 14 years ago we didn't have social media nor did we have anything other than AOL dial up chat rooms so research and access to information was limited to card catalogs in a library. When people say "trendy" I think feathered hair, leggings, and shaved eyebrows...not where birth is concerned. We only now have the options to share our stories making them more known and also allowing women to have choices. People think home birth is trendy...I say we are more aware of options. I had no idea that home birth was an option when I started having kids 15 years ago. My great grandmother had all 14 kids at home in the early 1920's before hospitals came into play. So, I don't think trendy is a good word, I think its just the birth community is as you said changing and women are being made aware of more options.

Turkeybabe said...

I think it's a good idea to look at every aspect of birth and it's effect on our physiology. Considering water birth, I wonder just how much effect water has on successfully washing away bacteria, especially that bacteria that is inside the mouth. I also wonder due to the speed at which bacteria proliferates if it would even matter if some was washed away as long as enough was able to colonize. If a minimal amount was needed to colonize, it would be a factor in proving reasons to do the vaginal swabs on c-section babies. I think this is all fascinating, and hope people can consider the need for looking at these factors with an open and curious mind.

Natalie said...

I don't always agree with what you post but I have certainly missed reading your perspective. I have never thought about mater birth washing away the good bacteria. Thank you for your insight

Heather Midwife said...

The microbiome and vaginal seeding is still little understood. The theory is oversimplistic and in its infancy regarding what we know. For example, a mom who pushed for 6 hours with broken waters before having a cesarean vs. a mom who had a fast birth with very few pushes and whose water didn't break until the moment of birth but baby came out vaginally...which one is more "seeded"? Do we need to take mom's diet and general health into account? How do babies get sick from Group B strep when the water has never broken? Could the good bacteria also travel "vertically" before labor has even begun? What about all the bacteria that is undoubtedly in the birth pool? Mothers' skin? It's really too soon to say. I find this all very similar to Birth Boot Camp's policy that a mother who has not had a natural birth can't be a teacher for your childbirth classes. So the mom who labored for 72 hours and pushed for 7 hours and then needed a cesarean is less qualified to teach your classes than the mom who labored for 4 hours and pushed once.... lots of logical fallacies around here. love from a homebirth midwife in NM.

Heidi Marshall said...

Anyone who has attended a waterbirth knows that mom and baby are completely saturated in birth soup. This includes moms skin flora, vaginal flora, blood, fecal matter, often babies fecal matter and amniotic fluid. Some babies, whose care providers do not intervene in the process and artificially break the amniotic sac, are born in the caul. I have had several babies completely surrounded by their membranes as they were born and not exposed to all of the above birth juices. Are these babies at a disadvantage? I doubt it. Lets just support moms making healthy birth choices that work for them. If a baby missed some of these vital fluids and their microbiome was not fully seeded during the birth due to an intact amniotic sac or cesarean birth lets not spread fear! Let mom know that the baby will naturally be exposed to her flora over time and be "seeded" as she breastfeeds her newborn on her sweaty chest, skin to skin, with babies hands frequently touching her armpits, belly and other places she has hopefully not washed with antibacterial soap. Lets not give moms another thing to fear around birth. The microbiome and vaginal seeding is a process, not won or lost at the moment of birth.
Heidi Marshall Licensed Midwife

ShannonAksel said...

Donna, I was so pumped to see your name in my inbox. I miss your posts and perspectives. Haters gonna hate, and we need more strong women like you advocating for women's rights in childbirth. I hope you'll think about posting some of the other material you've written recently. Also, I'm sorry all the criticisms have gotten you down. You're doing great work!

Also, very interesting ideas you bring up on waterbirth and the vaginal flora. I agree with Heather that there is too little info at this point, but I like that you are thinking critically about how waterbirth might affect the flora.

Mike C said...

This discussion is needed as is more research on this cutting edge topic...I like the other issues that were brought up in the comments...en caul birth, the birth soup the baby is in in the water, the length of labour w/or without rupture prior to belly birth, breastfeeding seeding of baby...all great dialogue to have around this topic. It warrants more research as well as discussions in the birth community

A Byrd In the Hand said...

Such an interesting post. I had never thought about the possibility of washing off good bacteria in a water birth. Definitely something to explore and talk about.

Michelle said...

I think this is a great thing to think about! I had two water births and one non-water birth .
My 3rd was a water birth because I was GBS+ and declined antibiotics so the "solution to pollution is dilution" came into play.

I may reconsider my water birth the next time around.
Even in this, there seems to be differing research/ideas (that the baby is colonized in the womb and that passing through the canal they will get bacteria in their mouths as well, and that the vernix is oily so can't fully be washed off)

The chlorine in the water really stood out to me! I never thought of that point to it.

Rose Maria said...
This comment has been removed by the author.
Rose Maria said...

do men go to baby showers?

Samantha said...

Such a great perspective. I've often wondered about the true benefits of water birth, though I'm not saying they are bad; as a nurse, I see the benefits of having a birth outside of the water for airway purposes, but again, there really isn't any data showing that babies who are born in the water have lingering this is just my own ponderings, I suppose. I recently watched a video about how babies naturally find their own way to their mother's breast after they are placed on their mother's tummy after birth. All but their hands are dried with a towel so that the baby can taste their hands and then smell them and then find their way to mama's nipple. I watched these newborn babies do exactly as described and it was amazing! So, If there is no amniotic fluid/vaginal juices on baby's hands to taste/smell, does that affect their ability to find their mother's nipple on their own? Who knows. But, I do appreciate that someone is thinking about these things. Water is amazing in labor and I love it and will want it for any other children I have, but personally, I prefer to get out of the tub to have my baby, it just seems right.

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