Wednesday, April 29, 2009

Water birth arrives in Columbus

Beginning in December of last year, a select group of Columbus mothers-to-be began delivering in the water after Doctors Hospital acquired an inflatable birth pool. I wrote a story for the May issue of her magazine about the water birth experience in Columbus – as seen through the eyes of the certified nurse-midwives at Obstetric & Gynecologic Associates of Columbus who began offering the option and one mother who highly recommends water birth after delivering her third daughter in the Doctors Hospital birth pool.

For more information on water birth, go to

Waterbirth.org and American Pregnancy.org

Thanks to her editor Jennifer Sillitto for allowing me to run the text of the story in this post. Please pick up the May issue of her to view the photos that accompany the story and to read other stories about mothering – the focus of this month’s issue.

Water Birth Arrives in Columbus
By Annie Addington
Photos by Seth Grant

On December 18, 2008, Rachel Rach of Phenix City brought her now 4-month-old daughter, Erin, into the world in the 101-degree warmth of a birth pool.

Erin’s birth marked the first in-water delivery at Doctors Hospital since the hospital acquired an inflatable birth pool in November 2008.

The opportunity to have a water birth in a hospital gives local mothers like Rachel, who are interested in having a natural but gentle birth, a powerful option for pain management.

After an increasing number of patients began expressing an interest in water birth, certified nurse-midwives Melissa Terry Flynn and Courtney Heynen, and obstetrician and gynecologist Dr. Joseph Eikelberry – all of Obstetric & Gynecologic Associates of Columbus – attended a water birth credentialing course in Atlanta. Five nurses from Doctors Hospital also attended the course. They worked with the staff at Doctors Hospital to get water birth protocol established and to acquire a hospital grade Birth Pool in a Box, which holds water at a depth of 23 inches and can easily be stored between uses.

When Rachel, a 25-year-old former Air Force airborne operations technician who swam competitively throughout high school, learned water birthing was being offered at Doctors Hospital, she was immediately interested. Rachel had a friend who experienced four water births at home and recommended it highly, and Rachel herself has always enjoyed being in water.

“It’s a comfortable element for me,” she says.

Courtney was Rachel’s primary midwife and recalls even in transition – the most intense stage of labor – Rachel seemed remarkably relaxed.

“When she was about 7 to 8 centimeters dilated, she just had a smile on her face,” Courtney remarks. “She did so well that no one could really believe she was in the transition part of labor. She said the water was just helping her so much. She definitely handled the pain very well. She was laughing and cracking jokes, and you could hardly even tell that she was in labor.”

Rachel admits she was in no laughing mood during her four final contractions, but she was able to move around in the water to help her newborn daughter emerge relatively quickly. She says she felt much more mentally present than when she was enduring that last bit of pushing with her first two children; in fact, Rachel was able to reach down to help welcome Erin to the world.

“I basically helped deliver my own baby,” Rachel remembers. “I grabbed her and helped pull her out to the surface.”

Rachel was the first of several women who have already enjoyed water births at Doctors Hospital. Between December 2008 and early-April 2009, six women delivered in the hospital’s birth pool and four women used the pool during a portion of their labor but then got out of the water to deliver their babies.

Melissa, who also attended Rachel’s birth and has been present for most of the water births at Doctors Hospital since the program was implemented, notes women laboring in water tend to know instinctively how to change position and make their bodies work for them.

And labor and delivery nurses, who have been watching births for years, are struck by how peaceful a water birth can be. Melissa recounts one particularly gentle birth in which the patient largely guided herself through the delivery of a 10-pound baby with some quiet coaching from her midwives. Three veteran labor and delivery nurses looked on with tears in their eyes, she recalls.

“They said they’d never seen anything like it,” Melissa says. “It’s just a really interesting take on the whole birth process because nobody’s really messing with anything. The baby’s just coming out on its own time and we just reach in and pull it up out of the water.”

But water births are not an option for everyone. The midwives and doctors at Obstetric & Gynecologic Associates of Columbus are only willing to provide the service to women who meet some fairly stringent criteria, including a history of uncomplicated prior deliveries and an uncomplicated current pregnancy. Even if a woman meets the criteria and plans a water birth, she may be removed from the water if complications arise.

Water birth candidates have to fill out extra paperwork, buy a disposable pool liner for $35 and meet with both midwives to discuss the risks and benefits of water birth along with potential reasons why the client may not be able to have a water birth. The midwives emphasize to their clients that the birth pool is just another tool for labor. In the end, the goal is not to have a water birth but to keep mom and baby healthy.

One of the primary fears surrounding water birth is the notion that the baby might inhale water, but Melissa and Courtney say the instinct to breathe is not triggered until an infant is exposed to air, so water aspiration is almost never a problem, especially if the baby is brought up out of the water quickly.

And for women with no contraindications for water birth, the process can improve outcomes for both mother and baby.

A comparative study of nearly 6,000 spontaneous births at a clinic in Switzerland, more than 2,000 of which were water births, concluded that water births “do not demonstrate higher birth risks for the mother or child than bedbirths if the same medical criteria are used in the monitoring as well as in the management of the birth.” The study, published in a 2000 issue of Fetal Diagnosis and Therapy, also found that mothers’ blood loss was lower in water births; mothers had fewer episiotomies and fewer severe perineal tears; and the babies’ Apgar scores after birth were significantly higher.

According to Waterbirth International, water births also speed up labor, reduce blood pressure and reduce Caesarean section rates. If women enter the pool too early in labor, however, it can adversely slow their progress. Providers at Obstetric & Gynecologic Associates of Columbus encourage patients to wait until they are 5 to 7 centimeters dilated before getting in the birth pool.

In her book, Gentle Birth Choices, Barbara Harper notes that women have been using water for thousands of years to ease labor and assist in birth – especially in areas of the world located near slightly warm water. But it wasn’t until the 1980s that water births began to gain acceptance at some birthing centers in the U.S., following documentation of successful water births in Russia and France in the two prior decades. Now the movement toward water birth is growing, although most hospitals do not yet offer the option.

Melissa says she’s only aware of one other Georgia hospital offering water birth: North Fulton Regional Hospital in Roswell, Georgia. That hospital’s protocols for water birth became the model for Doctors Hospital.

Melissa says the warmth and buoyancy of a birthing pool are very logical aids for a woman in labor.

“It makes sense that when your muscles are sore and tired, getting in the water kind of revitalizes you,” she explains. “The lack of gravity when you’re buoyant in the water makes the body less likely to secrete stress-related hormones and that allows women to produce their own endorphins and be more comfortable. Also, being in the water with endorphin releases keeps blood pressure lower.”

Melissa adds she’s been struck by how comparatively gently a baby born via water birth emerges into the world.

“They seem to come out more quietly, and they come up onto mom’s chest and don’t immediately start screaming or anything,” she says. “It tends to be a much more gradual and quiet kind of birth – and absolutely beautiful to watch.”

Rachel says she did plenty of online research before settling on water birth as a safe option. Her husband, Michael, a U.S. Army Ranger, was soon persuaded by the research, too. He says the water birth experience was more relaxing for him, as well, largely because his wife was so much more visibly calm than she had been during her two prior deliveries.

Rachel says with the birth of each of her children, she has come closer to finding comfort in natural childbirth. She says by having a midwife, moving a lot and using a birthing ball and squatting bar during the labor and delivery of her second daughter, she felt much more comfortable than when she was lying in a hospital bed, as she had been during the birth, three years ago, of her first daughter. Her third labor was the most manageable, she says, due to the buoyancy and warmth of the water and the ability it gave her to change positions easily and alleviate muscle fatigue.

“My first experience, I basically stayed in the bed because I was with a doctor, and transition was so hard – the pain was so great that it was hard to concentrate,” Rachel recalls. “The second delivery was a lot easier because I had a midwife and was able to move around and stand and use the squatting bar. With this (third) delivery, I was able to move as my body dictated. For me, since I’m a swimmer, when I would go through a contraction I would immediately start doing flutter kicks. I felt like I was more in control; I was able to move in order to compensate for the pain.”

The Rachs don’t yet know if they will have another child, but if they do they’ll have their birth plan ready.

“If I had another, I would definitely do a water birth again,” Rachel says. “And, I highly, highly recommend a water birth, especially to first-time moms.”

5 comments:

Medical Information said...

It must have been great and different experience for you. Underwater birth means delivery occurs while the mother is submerged in water. In this method, mother and new born child are benefited. But sometimes child has threat of inhalation also. Good your delivery happened smoothly. To get more knowledge on underwater birth, refer Birthing technique

Proud mommy to be and army wife :) said...

Hello I was wondering who your doctor was that delivered your baby, I would love to have a water birth, but can't seem to find a doctor in the columbus area

Proud mommy to be and army wife :) said...

Hello I was wondering who your doctor was that delivered your baby, I would love to have a water birth, but can't seem to find a doctor in the columbus area

reshonda said...

I am wanting to have a natural delivery, this is my 4th pregnancy. i had a natural delivery with my second son and i was terrified, but i had very little knowledge back then. Now i am arming myself with info (lol). ho was the doctor that delivered your baby during your water birth? I think it sounds awesome and might want to have one! I am 3 months pregnant right now. Thanks!

psalm34 said...

I may be moving to Camp Hill, AL which isn't too far from Columbus and am searching for prenatal/birth care givers. I found your article and was excited about the possibility but can't find anything about midwives on the Doctors Hospital site. Could you by any chance give me some contact info for this group?
Dlphngold@gmail.com