22 Apr The Safety of Waterbirth

You may have noticed that there is a bit of a buzz going around about waterbirth. A few weeks ago, ACOG released an opinion based statement about waterbirth. This statement has caused Allina Health Systems to change their policy and suspend all waterbirths at their hospitals. Allina hospitals include The Mother Baby Center at Abbott Northwestern, United, Unity, Mercy, and St. Francis, among others. Waterbirth is still an option for families planning to birth with waterbirth supportive providers at HCMC, Methodist, Hudson Hospital, Woodwinds, St. Joe’s, St. John’s, Fairview Riverside, Regions, Minnesota Birth Center, Morning Star Birth Center, Health Foundations Birth Center, and all home births.

Shortly after the ACOG statement was released, ACNM (American College of Nurse-Midwives), AABC (American Association of Birth Centers), and The Royal College of Midwives released statements reflecting the current evidence available regarding waterbirth.

The ACNM statement concludes:

“In summary, labor and birth in water can be safely offered to women with uncomplicated pregnancies and should be made available by qualified maternity care providers. Labor and birth in water may be particularly useful for women who prefer physiological childbirth and wish to avoid use of pharmacological pain relief methods.”

The AABC statement reviews the safety of waterbirth, looking at outcomes of almost 4,000 waterbirths occurring between 2007 and 2010 in freestanding birth centers in the US. “These data demonstrate that water birth, with careful selection criteria and experienced providers, does not negatively affect mothers or newborns.”

A Twin Cities Midwifery mama receiving her baby in the water

The Royal College of Midwives state “there is no reliable available evidence to indicate that waterbirth presents an increased risk factor compared with land birth for women who experience a straightforward pregnancy. There is therefore no reason to deny them the choice of using a birthing pool during the first or second stage of their labour in their planned place of birth. Maternal choice in childbirth is a human right.”

Looking for more research still? Here is a great review of the current waterbirth research by Barbara Harper of Waterbirth International. She says, “Waterbirth is an option for birth all over the world. World-renowned hospitals, as well as small hospitals and birthing centers, offer waterbirth as an option to low risk patients. Though some members of the American Academy of Pediatrics and American College of Obstetricians and Gynecologists feel otherwise, the Cochrane Review and many other studies find no data that supports safety concerns over waterbirth.”

A TCM mama meeting her baby in the tub

Here in the Twin Cities, mamas are speaking up about their right to have options in the way they birth. Yesterday there was a peaceful protest at St Francis Medical Center in Shakopee where Allina leadership was meeting to discuss this policy change. Watch the KSTP video here, or the CBS video here. Midwives working at Allina hospitals are working hard to overturn the policy so that they can continue to offer waterbirth. In the meantime, laboring in water (hydrotherapy) is still an available option for supportive providers at Allina hospitals.

A local waterbirth baby at Monday’s protest

Here at Twin Cities Midwifery, I attend home waterbirths all the time, and have not had any poor outcomes related to waterbirth. Actually, I’ve had a ton of positive outcomes related to it, the most common being a more comfortable birthing time for a laboring mama!

A TCM dad receiving his little girl in the water

*Update: Evidence based birth released a very thorough article on Waterbirth Safety if you’d like more information on this topic!