Summary: For the first time ACOG and AAP are weighing in on water births. Both doctor groups give the okay for moms-to-be to labor in a tub, but say that water delivery should be off the table, citing danger to the baby and lack of evidence that water births are advantageous to mom or baby.
Water births have been gaining popularity among mamas-to-be — they're thought to help ease pain of laboring moms while providing newborns with a gentler transition from uterus to the world. And now, both the AAP and ACOG have weighed in for the first time on their thoughts on the practice.
Do they endorse water births? In a way, yes. The doctors find that it's perfectly safe — and even beneficial — for expectant moms with uncomplicated pregnancies to spend labor in a tub. That's because immersion in water during labor has been shown to increase cardiovascular efficiency and blood flow. Coupled with the sense of relaxation and stress relief many moms feel while being immersed in water, soaking in a tub could help decrease the sensation of pain during labor (which isn't a walk in the park). In fact, a review of studies on water births found that immersion during labor decreases the use of epidurals or other analgesia.
AAP and ACOG doctors note that existing research also shows there is no difference between moms who labor in the water compared to those who don't when it comes to perineal tears, the need for forceps, or the need for c-sections. Nor is there any evidence that the newborn's health benefits from mom spending her labor in the water.
The potential problems arise — with no obvious benefits — when moms actually deliver their babies in water...and that's why ACOG and AAP recommend moms come out of the tub when it's time for delivery. Previous reports have shown an increase in infections for both moms and babies following water deliveries. There have also been reports of more serious, even life-threatening complications (umbilical cord rupture when baby is lifted from the water, seizures, breathing problems from water aspiration, drowning or near-drowning) among babies born under water. Studies also show that babies under stress do breathe in water, despite claims that newborns delivered in water don't breathe or gasp because of a protective "diving reflex" — and that, obviously, can lead to problems.
Since delivering in water provides no health benefits for the baby or mom and can potentially be dangerous, ACOG and AAP say that labor in the water is OK but giving birth in the water is not. Yes, it's unlikely something will go terribly wrong, but experts say it's not worth your baby's safety to chance it.
If you have your heart set on a water birth, speak to your prenatal practitioner (and your chosen pediatrician) for their advice. Remember, you can still labor in the water even if your delivery ends up being on a bed — just make sure that whether you're doing so at a hospital, birthing center, or at home, the tub you're using has undergone rigorous cleaning and infection control procedures. And keep your eye on the prize: A healthy baby is what's most important, no matter how your cutie comes into this world.
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