Childbirth Education Archives | Doulas of Baltimore

Hydrotherapy in Labor: Can Water Make Birth Less Painful?

Imagine sinking into warm water as intense contractions peak, like a warm and comforting hug. Many birthing individuals are curious about Hydrotherapy in labor for their birthing experience. Hydrotherapy (or the use of water in a therapeutic manner) is as simple as using a tub of water for immersion or a shower for pain relief. This safe, simple, and readily accessible tool is a great one to ensure you have in your toolbox.

Walk with us as we explore the benefits of using water for pain relief, how it can offer support before and during birth, and some tips and tricks from our experts at Doulas of Baltimore.

What Exactly Is Hydrotherapy in Labor?

Hydrotherapy put simply is using water as a therapeutic tool. This isn’t relegated to labor alone, as water is used in healing modalities for all sorts of situations from everyday people taking a shower during a migraine to professional athletes using cold water to limit swelling after injuries. During labor the most common uses are showers, birth pools, and baths.

Using water during labor is not just relaxing, it’s non-medical pain management. With roots in ancient civilizations for both health and spiritual reasons, using water as a treatment goes back centuries. Science has now caught up with the extensive use and offers us explanations for why historically this worked.

Why Water Works Wonders: Science-Backed Benefits

Physical Benefits

When discussing a birth pool or tub, the phyiscal benefits are measurable! By submerging in water, our bodies experience buoyancy which eases movement and reduces the stress on our muscles and joints. Even outside of labor, harnessing this power by floating in a pool can increase comfort during pregnancy.

The warmth of the water used during labor helps to increase blood flow and relax the muscles. This can ease the discomfort of contractions as muscles that are already tight become tighter as contractions increase. The relaxation can help allow your body to do what it needs to do to move baby down.

The pressure of the water (called Hydrostatic pressure) also can help to reduce swelling and support the peineum.

Emotional Benefits

Beyond physical comfort, emotional comfort can also emerge from the use of Hydrotherapy. Water creates a physical barrier, offering comfort whether in the shower or tub. Especially when giving birth in a less familiar setting (such as a hospital room), this can give a huge amount of security to the birthing person.

Water has been shown to help aid in the release of endorphins and lowering of stress hormones. During labor this can directly translate to pain reduction. Using Hydrotherapy also offers the birthing person a sense of control during active labor. Handing this control back to them can be the difference betwween stress and safety in their birthing experience.

Labor Progress

While the evidence is limited, there is data out there that suggests that immersion in water during labor can help shorten the duration of that labor. There is also evidence to suggest that use of Hydrotherapy as a tool during labor can potentially decrease the usage of epidurals or other medical pain management tools. This might be of particular interest for pregnant individuals who do not wish to or cannot use medical pain interventions for any reason.

When & How to Use Hydrotherapy in Labor

Timing

Early Labor – great for using showers as a distraction and pain relief

Active Labor – great time for using warm water in a birth pool or bath

Transition – this is when you’d want to exit the water if you’re not planning a waterbirth

Tip: water is also a great tool to use for both stalled labor and back labor. Submerge into warm water and allow your muscles to relax!

Techniques

Showers are great for leaning against the wall with the warm water running over your back. If the shower is equipped with a handheld shower head, you could also hold the warm water running over your back or belly, depending on where you’re feeling the tightness of your contractions.
When setting up the birthing pool, the ideal water level is at least 18 inches of water to ensure the birthing person experiences the benefits of buoyancy and to ensure the baby is fully submerged if they emerge in the water. Ideally, the water would be over the birthing person’s abdomen, just under their chest. Any higher can limit movement and cause instability.
The ideal water temperature is between 97°F–100°F. It’s important not to go too far above or below that range for the safety of baby.
In your birthing pool there are many positions you might try. Consider squatting, leaning over the side while on your knees, or floating on your back.
Partner Pro Tip: help with your partner’s relaxation by performing temperature checks, pouring warm water over their back or belly, keeping their cool water fresh, and offering or switching cool washcloths for their head or neck.

Safety & Considerations

Safety First

Some hospitals have a policy of avoiding submerging in water if your water has been broken for longer than 24 hours. This varies by facility and the best practice here is to keep in touch with your provider and doula once your membranes have ruptured. The concern here is introducing any bacteria into the placenta, this is definitely one to defer to your doctor on.

It’s important to pay attention to how you’re feeling and exit the water immediately if you begin to feel dizzy, overheated, or if baby shows signs of distress. At home you doctor may suggest a kick count to keep track of how baby is handling labor.

Since there is an open site for epidurals and you won’t be able to feel anything below that site, Hydrotherapy isn’t an option if you choose to recieve an epidural. It’s also often not an option for those who have recieved IV medication, though showers are often allowed! Make sure you touch base with your care providers on what is available to you.

FAQs

“Can the baby breathe underwater?” – Healthy babies have what is called a “Dive Reflex” where they do not breathe until exposed to cooler temperatures or air. For this reason, it’s important to monitor the temperature of the water and ensure it is kept warm. It’s also important to keep baby submerged if a water birth occurs until they’re fully emerged from the birth canal or that a birthing individual does not squat back down into the water once baby’s head has emerged. Immediate Surfacing, or bringing baby directly up for air and not submerging them again, is best practice for waterbirths. Follow the directions of your care provider in this instance.
“Does it increase infection risk?” – Studies have shown little to no evidence that Hydrotherapy in labor increases the risk of infection during labor. There was a slight increase in risk of infection after birth.
“What if I deliver in water?” – If you accidentally deliver in water your care team will guide you through the safest manner of getting you and your baby to safety. Sometimes this involves staying in the water, others this means you’ll exit the water. Waterbirth is also a viable birth option, though it’s rare to find in a hospital setting. If you desire a waterbirth, consider looking into a waterbirth-friendly birth center or a certified homebirth Midwife.

Planning for Hydrotherapy in Labor

Birth Setting Options

Remember that not all hospitals have access to birthing pools or baths. Most will have showers in the rooms. Birth centers are often equipped with birthing bathtubs designed for laboring. Homebirths will require a birth pool rental unless your provider clears the tub you’re birthing in as large enough. Check with your provider if your plan for Hydrotherapy is going to work for your birth space.

Prep Checklist

Discuss your desire for Hydrotherapy with your care provider early in your pregnancy. This is important to ensure that they’re both comfortable with your plan and that they have the capability to offer it to you in your birthing space.
Pack essentials for being in water in your birth bag. Make sure you bring a comfortable sports bra or bathing suit top, soft towels, and a water bottle to keep nearby. Consider also bringing extra washcloths.
If you’re renting a birth pool for your home, make sure you do a test run before labor begins! Ensure you have it inflated well before labor is imminent, know how you’ll fill it (will you be bringing a hose inside?), and know how you’ll empty it.

Conclusion

An incredible tool in any birthing person’s toolbox, Hydrotherapy is a perfect, non-medical comfort measure to try. Remember that not all birthing individuals like the same things and the tools you use can even shift during labor. Remember to chat with your care team and make arrangements ahead of time. Your comfort matters during your birth! Let water be a helpful friend that offers you comfort as you ride the waves of labor.

Birthing Parental Health Resources from Doulas of Baltimore

Childbirth Education, Postpartum

As birth professionals, birthing parental health is paramount to our roles in the birth and parenting space. We know that our advocacy is vital to improving outcomes. Around 3.7 million babies are born each year in the US, but we are the only developed country with a rising mortality rate for birthing individuals. Not to mention that rate is worse for marginalized groups.

Black women are three to four times as likely to die of pregnancy and birthing complications as white women. Disabled people have a significantly higher risk of dying from pregnancy and childbirth than their able-bodied counterparts.

Here is the important statistic, though: 60% of birthing parent deaths are preventable. Understanding the disparities and providing equity in healthcare access can decrease maternal mortality. To help increase awareness for maternal health, the American College of Obstetricians and Gynecologists (ACOG) recognizes Maternal Health Awareness Day every January 23.

We’ve gathered some of our favorite resources for expectant parents to improve maternal health outcomes. Let’s walk through them!

Routine Prenatal Visits are Vital for Your Birthing Parental Health and Baby’s Health

ACOG recommends that you schedule a visit with a care provider as soon as you know you are pregnant. Then, go to all of your visits, even if you feel fine. A prenatal care provider can include an OB/GYN, a family care doctor, a nurse practitioner, or a midwife.

The March of Dimes has an extensive guide to prenatal care visits and what to expect.

Understanding Pregnancy Helps Support a Healthy Pregnancy

Our belief is that education, collaborative provider partnership, and unwavering nonjudgmental support can make pregnancy and childbirth one of the most fulfilling and transformative experiences of your life. Understanding pregnancy can help people know what to expect, what to look out for, and how to stay as healthy as possible. For example, preeclampsia is a leading cause of birthing parental mortality, but many people may not know their risk factors.

The American College of Obstetrics and Gynecology (ACOG) has an infographic with preeclampsia basics and an FAQ about staying healthy before and during pregnancy. At Doulas of Baltimore, our Childbirth Education Classes help you feel informed and make confident decisions.

Postpartum Care Should Be an Ongoing Process to Support Birthing Parental Health

While a lot of focus is placed on the time leading up to childbirth, ACOG has recognized that the postpartum period is important. For parents, this should mean planning and thinking about healthcare, feeding, care, and important decisions (link to last blog) before baby arrives. ACOG believes that postpartum care should be an ongoing process that is individualized for each birthing person. This is especially true for people who have other health conditions that may impact their postpartum health. March of Dimes has an overview of what to expect during postpartum healthcare visits.

Each pregnancy and birth is unique. By helping parents understand childbirth and the postpartum period, we can create change for healthier families and babies.

Install a Car Seat Safely: How To

Childbirth Education, Newborn care

Installing a car seat safely is one of the most important things to do before baby arrives. In fact, you can’t leave the hospital without a car seat. Choosing and installing a car seat that best fits your vehicle and lifestyle can seem daunting. That’s why our own Child Passenger Safety Technician (CPST) is here to help. Here are six steps to ensure your baby’s car seat is safely installed.

Be Prepared when Installing a Car Seat Safely

If you are a first-time parent, you’ve probably never installed a car seat before. And even if you have other children, you may not be familiar with your new car seat’s installation procedures. To install your car seat safely, read both the entirety of your car seat manual and the portions of your vehicle owner’s manual that pertains to child restraints. We recommend that you install your seat by your 36th week of pregnancy.

Accessories Can Be Dangerous

It might be tempting to use aftermarket accessories for your car seat or car. Don’t. Use only manufactured approved items that come in the box with your car seat (infant inserts, strap covers, etc.). This includes cozy winter inserts like the J.J. Cole Bundle Me, which are not approved for use in car seats.

Don’t Leave Baby in the Car Seat

Avoid keeping baby in the car seat more than absolutely necessary. A car seat is designed to keep baby snug and safe, but limits baby’s movement. Even if baby fell asleep in the car seat, consider babywearing or a stroller with a bassinet instead.

Ensure Proper Use of the Car Seat

Straps should come through the slot just below baby’s shoulders, be snug enough that you can not pinch any slack at the collarbone or hips and chest clip should be even with baby’s armpits. Never loosen car seat straps or unbuckle the chest clip or crotch buckle unless you are removing the baby from the seat.

Consult a Child Passenger Safety Technician to Install the Car Seat Safely

Before baby arrives, schedule an appointment with a certified Child Passenger Safety Technician (CPST). A CPST is qualified and trained to make sure that your car seat is installed correctly and can help you install a baby car seat safely.

As a Doulas of Baltimore client, you may schedule your Car Seat Concierge appointment for $100. What’s included in our car seat concierge service:

Initial consultation to discuss your feature and brand preferences, budget, and lifestyle factors
Assistance in selecting the best car seat for your child 90-minute personalized car seat installation appointment with up to 2 seat(s) in up to 2 vehicle(s)
12 months of industry professional phone/email support as your child grows to ensure your confident in your child’s car seat safety

Birth Classes | 3 Ways Independent Curriculums Stand Out

Childbirth Education

There are pros and cons for all the birth classes on the market. Depending on what you are looking for from a class, many of the mainstream birth classes can be unappealing.

You may feel like taking a childbirth series is one more thing to do before your baby arrives, but this is one thing that could make an incredible difference to your birth experience.

Childbirth education classes share information that is not just about the physiological birth process. They also dive into the myriad of options that could be present at the birth of your child. If you pick a quality class, it is about much more than that.

Most parents are asking their providers for recommendations of where to attend, and for many, that means signing up for the hospital’s class. Childbirth classes are all different!

We want to share why choosing an independent professional childbirth education class could be one of the best things you do for you and your baby.

1) All The Options for Birth Classes

Because our childbirth classes are taught outside of the hospital, our instructors are free to share all options and not only those that support hospital policy. As independent instructors we focus on sharing information, explaining the many options available during labor and birth, and the various scenarios that may arise. This way our students feel informed and prepared to enter their own experience.

Our goal is getting you the knowledge for the type of birth that you desire.

Are you looking for a low intervention birth?

Maybe you’re curious about epidurals?

Have you considered what to do before you get an epidural?

We give easy-to-understand knowledge, and tools to help you bring your plan to life, and, if necessary, help to navigate the unexpected.

2) Specialized Birth Educators

Once you decide to take a childbirth class , why not rest assured your instructor is someone connected and knowledgeable about birth in your area. To be a childbirth educator with Doulas of Baltimore, years of study, hundreds of hours teaching, and first-hand experience helping families in labor are what make the difference.

The nuance of birth is such that there is no pattern that everyone will follow. However, a new kind of skill develops which your teacher is happy to share with class attendees. It may be silly to say, but that ability is having trust and confidence in birth. When you know what is possible, and learn the necessary skills to discuss needs and wishes with your care providers, you increase the potential for an excellent birth experience.

3) Partners Enjoy Independent Birth Classes

There’s a stereotype that non-pregnant partners are uninterested in attending or participating in birth classes. We find birth partners engaged in our classes and happy to feel more confident when class has ended!

We do not shove you into a classroom with grainy videos of birth from the 1970s. A screen is never the focus of the class. We endeavor to make our time together result in you having more confidence about your child’s birth. And more confident about how to interact with one another during your baby’s birth.

Need more information? Read testimonials from former students and please to reach out with any questions. If you are ready to get started – head straight to our class registration page!

Top Positions to Try During Labor

Childbirth Education

Our top positions to try during labor? Childbirth is a process that can last a varied amount of time based on many factors. During labor, the birthing person might need to try a variety of different comfort measures. Even moving between each of these positions can help ease discomfort and be a welcome distraction. We’ve put together a guide on some of our top recommendations complete with variations and things for a support person to consider.

Positions for laboring in bed

This photo is property of Lamaze International.

Throne

Description: Throne position is a secret weapon of doulas everywhere! This position utilizes the movement of hospital beds to get the laboring person into a comfortable position for resting or waiting. This one is easy to remember, since the very idea of the position is in the name. We’ll be putting our birthing individual on a “throne”.

How to Get There (hospital bed): Have the birthing person sit in the bed. Using the controls on the hospital bed, raise the back up between 45 and 90 degrees. Have the birthing person lean forward for the initial adjustment and lean back to raise or lower the back to a comfortable position. Drop the lower part of the bed all the way to create a “throne”. The goal is a seated position.

Especially Helpful for: After an epidural or medication! This position is perfect for when you’re waiting for dilation but are comfortable enough with medication on board to rest. This is also helpful for getting baby to descend by letting gravity work its magic.

Variations: While this can be great for medicated births, this seated position is also excellent for non-medicated births in other spaces. One notable variation is sitting backwards on the toilet! Since our pelvic floors are trained to relax on the toilet to allow us to use the bathroom, often we’ll use this position to move dilation along. Note: this position can get intense very quickly as baby descends, make sure someone is nearby to help the birthing person off the toilet quickly if needed.

Side Lying

Description: As the name suggests, this position is very simply lying to the side for the birthing person. Another resting position, this helps take the pressure off of the pelvis and back for the birthing individual. We highly recommend a pillow or two between the legs. This one doubles as an excellent pushing position! The top leg can be held by the individual, their birthing partner, a nurse, or a doula to allow the pelvis to open in a more comfortable position.

How to Get There: Simply turn gently to one side or the other! To keep labor moving, a great idea is to move from one side to the other periodically.

Especially Helpful for: This is a great position for early labor, resting after an epidural, or while waiting for pushing urges to emerge.

Variations: Adding a peanut ball or a stack of pillows that brings the upper knee facing upwards is a surefire way to help with dilation and progression of labor. This position is well-loved by our clients who choose medication as it allows them to rest well while laboring down. This can also be used for an unmedicated birth but, just as with the throne position on the toilet, it can get intense very quickly. Ensure someone is nearby in case a shift needs to happen quickly.

Hands and Knees

Description: Put those arms and legs to work! Laboring on all fours is an excellent way to open the pelvis. This position also could be great for getting baby oxygen and some physicians recommend it for easier positioning of monitors.

How to Get There: Very simply put, this position is fairly simple to get into! In the bed, rotate a little bit at a time with some support on one or both sides. Have someone nearby to move pillows or blankets as needed until the birthing person is in position.

Especially Helpful for: Active laboring! This position is a very active one and gives the birthing person the sensation of doing something instead of being swept away by laboring. Note: this one can get tiring! This is a great position to prepare or “train” ahead of time by lifting light weights or doing movements that strengthen the arms.

Variations: Lean over something to give your arms a rest! Our best suggestions are a stack of pillows, a birthing ball, or the back of the hospital bed. This position could also translate well to water if choosing hydrotherapy with the birthing person leaning over the side of the pool or bath.

Positions for out of the bed

Partner Supported

Description: Lean on me! Standing can get tiring but letting gravity do its job can be very helpful. Enter: partner support! Whether you lean on someone standing in front of you, behind you, or use a bedsheet or rebozo, getting support from someone else can make standing or squatting much easier.

How to Get There: For partner-supported sitting, simply have the partner stand in front of or behind the birthing person to support. It may be helpful for the partner to have their back supported against the wall.

Especially Helpful for: Taking a break from walking or while a contraction is happening.

Variations: Use a bedsheet or rebozo under the birthing person’s arms to offer extra support that is easier to manage for the partner.

Hands and Knees Redux

Description: This position is a great one to do outside of the bed as well! Enjoy all the same benefits of hands and knees in the bed but with more freedom of movement.

How to Get There: Simply sit on the floor swinging legs around and using support to evenly distribute weight onto both hands and knees. Consider putting down a yoga mat or folded up blanket to support the knees and soften the surface.

Especially Helpful for: Active laboring and hip squeezes!

Variations: Lean over a birthing ball or chair to ease the strain on wrists.

Birth is not a one-size-fits-all and your comfort is a top priority. When practicing these positions, take note of what feels comfortable and what feels like too big of a stretch. Remind yourself and your birthing partner that what feels good outside of labor may change very quickly and vice versa. Stay in tune with your body as labor progresses and move naturally. Your body is wise!