When looking to escape the frenzy and stress of the day or searching for a way to soothe sore muscles, a warm bath offers comfort and restoration. Visualizing this calm retreat, it is easy to understand why for centuries women have naturally been drawn to water to ease the strain of labor and birth. Laboring and birthing in water not only provide greater comfort and control for the mother, but also ease the newborn from the womb to water and to the mother's embrace.

Around the world, cultures have recognized the therapeutic benefits of waterbirth. The ancient Egyptians birthed royal babies, destined to become priests and priestesses, underwater. Sacred Minoan temples on the Island of Crete contain frescoes depicting waterbirths that took place there. History tells us that for eons tribal women in the Americas, New Zealand, the Pacific and Hawaii have entered the warm ocean waters to facilitate labor and birth.

Beginning in the 1970s, French physicians Dr. Frederick Leboyer and Dr. Michael Odent began to explore and document the therapeutic effects of warm water on labor and birth. Since then the practice has become recognized the world over for its benefits to both mother and baby. For the mother, laboring and birthing in water reduce pain, provide comfort, conserve energy and decrease length of labor. The buoyancy inherent in a waterbirth eases the baby's stress as it leaves its mother's body.

Colleen Brezine is a certified nurse – midwife with her own practice in Westlake, Ohio called “All About Women.” For four years she has assisted women with water immersion for birth and labor, and has birthed in water herself. She has assisted 77 women in water immersion for labor and has delivered 57 babies during a water immersion birth. She explained, “A woman experiences a sense of relief and control once she enters the water. Her pain perception decreases and she becomes comfortable enough to concentrate on herself without much interference. During my own experience with water immersion, my pain level decreased by 75% the moment I entered the water, making my labor much easier to focus on and manage.”

If the mother and fetus's vital signs are normal and there are no medical reasons to the contrary, the water labor and birth may proceed. The fetal heart rate is observed through the use of waterproof monitors. Some indications that waterbirth is not medically advisable would be improper position of the baby
in the birth canal, premature labor, multiple births (twins), infection or other medical concerns. An expectant mother hoping to experience a waterbirth must be flexible as the conditions for a waterbirth must be optimal in order to proceed. Brezine stresses, “Any laboring mother must surrender to her experience, regardless of her birth plan. It is important for her to be prepared for unforeseen circumstances. If she is inflexible, she will have a less satisfying birth experience.”

The laboring mother may enter the tub during the last hour or two before delivering the baby. Many women who deliver via waterbirth report experiencing a surge of energy as they enter the water and often deliver very soon thereafter. The water temperature, which is maintained at the mother's body temperature (about 98°F or 37°C), increases local blood flow, decreases muscle spasms, relaxes small muscles and lowers blood pressure. The encompassing warmth also decreases sensory stimuli to reduce pain levels.

During a waterbirth the mother's body is immersed in warm water up to her shoulders. The buoyancy relaxes the mother's abdominal muscles which allows for more efficient contractions and increases blood circulation which delivers more oxygen to mother and fetus. The buoyancy also offers more freedom of movement for the mother so that she may find the most comfortable positions. Mother and child, still intricately linked, experience shared hormone responses as the mother's body releases fewer stress-related hormones that could otherwise stall labor. Mothers experiencing waterbirth are more likely to release pain-inhibitors, such as endorphins, that complement labor. Without the distraction of pain and anxiety, she is better able to focus inward on the birthing process and often decrease the duration of her labor.

Some women choose to leave the water to actually deliver the baby. But those who choose to deliver their baby in the weightless, warm, wet and soft environment ease the shock of the baby's transition from womb to world. The water mutes the sights and sounds of the delivery room, and once the baby is delivered, the mother and newborn may then cradle in the familiar warm water. Still connected to its mother by the umbilical cord, the newborn also benefits from all that the mother experiences – increased blood circulation, decreased reactions to pain and adrenaline, and less trauma. Midwife Brezine has noted that babies born into water are generally quieter, calmer and more alert.

If the mother chooses to reenter a warm bath following the birth, she will benefit much the same as she did during labor. The warm water cleans damaged tissues and increases circulation to enhance healing and relieve pain.

Giving birth is an experience a woman will carry with her for life. Every expectant mother deserves the opportunity to experience the birth of her child in a manner fully encompassing mind, body and spirit. With all the birthing options available today, more and more women are investigating the benefits of a waterbirth delivery. Expectant mothers should be prepared to employ the services of an educated and experienced birth attendant such as Collen Brezine, and make arrangements for the use of special equipment such as the waterbirthing tub. It is advisable for expectant parents to check out all available resources on the subject.

Colleen Brezine, CNM, MSN, has six years experience as a certified nurse-midwife and four years experience with water immersion for labor and birthing. She has her own practice called All About Women in Westlake, Ohio and can be reached by calling (440) 827-5390. Other information on waterbirth can be found at www.waterbirth.org, www.birthbalance.com or www.aquadoula.com.