An increasing number of hospitals now offer water birth, but it's still a small number. As a result, "water births happen mostly at home or at a stand-alone birthing center," explains Marra Francis, M.D., a gynecologist practicing in San Antonio, and the former chair of the ob-gyn department at Memorial Hermann Hospital. But the hospitals that do offer water birth "have an adjoining birthing center staffed by midwives [and] are offering that option on hospital grounds," Dr. Francis says. The main reason most hospitals still do not offer water birth is that there is still "increased risk without proven benefit," says Patrick Weix, M.D., Ph.D., an ob-gyn practicing in Irving, Texas, and contributor to the medical website healthtap.com.
Although data is limited and conflicted on the topic of water birth, there are some serious risks to the fetus that include drowning, pneumonia, infection, and the tearing of the umbilical cord. It is not always easy to assess what is happening underwater, and, Dr. Weix says, "umbilical cords can tether the fetus underwater or tear, leading to fetal blood loss. Maternal tears can be difficult to assess, and patients may bleed excessively." Even though these cases are rare, a 1999 study published in the British Journal of Medicine found that the risk for babies delivered in water is similar for babies born by standard vaginal delivery to low-risk women. A 2010 study of neonatal mortality rates published in the American Journal of Obstetrics & Gynecology also found that "less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate." Because the majority of water births take place at home, without access to immediate medical intervention, water births are included as a cause for increased risk of neonatal mortality rates. Despite the limited data on water birth, studies show that the lack of medical services available in a home birth is more harmful to the baby than the actual water. More hospitals are now looking into and offering water birth to reduce these risks by being on hand to help the infant immediately if anything goes wrong.
The American Academy of Pediatrics has expressed concern over the safety of water births, owing to insufficient numbers of studies on the subject. But the positive data supporting water birth as a significant alleviator of labor pain and as a reducer of the time spent in labor is enough for some hospitals to incorporate water birth into their practices. Although there is data to support hospital-based water births, it is still very limited. Water birth in a hospital is not widespread yet, as obstetricians and hospitals are still sifting through data and demand. Doctors, midwives, doulas, and the Department of Health and Human Services agree that rates of water birth are rising, and the fact that some hospitals are offering water birth brings the option to more mothers and helps make the choice much safer.
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