Less than a month ago we answered you in an entry to the question "Water birth, yes or no?", Explaining that water births were recommended for being less painful and, consequently, making less use of epidural anesthesia and synthetic oxytocin.
In the studies we discussed, it was found that the risk for babies was not greater than in a delivery out of the water. However, a new review of studies conducted by the AAP (American Academy of Pediatrics) and ACOG (American College of Obstetricians and Gynecologists) concludes that water birth is discouraged because of the risk to the lives of newborns.
Dilation in water is safe
As we commented in his day and as they explain in the study that we commented, immersion in water during dilation has been beneficial when it is done after 5 cm dilation, since doing so before only delays the process and decreases the benefits of water (more epidural and more oxytocin).
For this reason there are more and more centers that offer the possibility of immersion in the water to dilate, to the point that the Royal College of Midwives and the Royal College of Obstetricians and Gynecologists (both of the US) made a statement supporting water birth for healthy women with uncomplicated pregnancies.
Dilate yes, give birth no
As they explain, when reviewing studies related to water births, they saw that not all differentiate labor from the same delivery and that, consequently, the positive results that occurred during dilation could not and should not be extrapolated at birth.
In addition, in the different studies water immersion is not always the same, since there are variations in the duration of the dive, the depth of the bath or pool, the temperature of the water and even in the use or not of jet jets.
To this they add that the majority of studies carried out had small samples of subjects (few mothers) and that the chances of bias were high.
Even so, they consider that in the absence of more evidence water dilation can be considered positive, for the decrease in pain and for the best experience on the part of the mothers.
However, when giving birth in the water, at the time of the expulsion, they recommend the outside because, although it is usually thought that it can be positive for babies, because it is a softer birth, a less traumatic transition from the inside liquid to the outside liquid, there are risks that should not be ignored.
These two associations have analyzed reports of individual and group cases where complications have been seen for the mother and the baby. They speak of a higher risk of maternal and neonatal infection, especially if there has been rupture of membranes, difficulties in neonatal thermoregulation, avulsion and cord rupture when removing the baby from under water or maneuvering from above, inside the pool, producing hemorrhage and shock, respiratory distress, water aspiration hyponatremia, seizures and neonatal asphyxiation.
How can a baby drown, if at birth he does not breathe?
I was wondering the same when reading the study. Babies at birth do not breathe, do not gasp and do not yet have the immersion reflex. They are receiving oxygen through the placenta through the umbilical cord and therefore cannot drown.
However, animal studies show that when we talk about compromised babies or fetuses (who may have some difficulty) the immersion reflex may be present, occurring some panting or aspiration of what surrounds the baby. Proof of this is that some babies are born with meconium aspiration syndrome.
This could explain the described cases of babies who have suffered severe respiratory distress after being born in water, or cases of drowning or near drowning.
We talk about few cases, very few cases, but about potentially serious cases, with obvious risks to life (with a case even of multiorgan failure due to sepsis after aspirating water during labor), which could be avoided, they suggest, promoting birth out of water.
In fact, they claim that no benefit has yet been demonstrated for the baby or mother to perform the expulsion in the water, so they suggest reviewing the recommendations so that having the baby in the water does not become a norm, neither in the cases in which the women want to give birth at home or when the deliveries happen in the hospitals.
