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Doctors, midwives and aquatic birth, part 2: research evidence

In the first part of this post, we began discussing the debate between doctors and midwives about women going through labor and perhaps even giving birth while immersed in warm water.

One level, the debate is about safety. After all, terrible birth injuries or even death could occur if a baby were to take its first breath underwater.

But at its core, the debate may actually be more about jurisdictional jousting between doctors and midwives over who is in charge of how the labor and delivery process unfolds.

The doctors’ group that recently cautioned against giving birth in warm water said there is not yet enough evidence of its safety.

Nurse-midwives, however, contend that there is mounting evidence supporting the position that water birth is indeed safe.

A prominent spokesperson for nurse-midwives is Jenna Shaw-Battista of the University of California. She directs an education program there for nurse-midwives.

Shaw-Battista has been conducting a study of 1,200 women who went through warm-water immersion for either labor or birth. Her preliminary findings are that these women’s outcomes were as good as or better than those of women who used traditional (nonaquatic) techniques.

Even strong advocates for aquatic birth concede, however, that the procedure must be handled with care. A trained professional should be present and clear guidelines should be followed.

These guidelines include such steps as immediately bringing the baby up to the surface. It is also important to make sure the umbilical cord extends far enough to do that without damaging the cord.

In short, territorial tensions between doctors and midwives are unlikely to evaporate any time soon. But the focus should be on professionalism during the birth process – making it as joyful, but also as safe, as reasonably possible.

Source: NPR, "Doctors Say Don't Give Birth To Baby In A Tub, But Midwives Disagree," Nancy Shute, March 23, 2014

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