Tag Archive for: labor

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.

A support person offers comfort to a birthing person in labor.

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.

A birthing person holds their baby in a birth pool after their waterbirth.

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.

Am I actually going into labor?

One of the most searched topics during pregnancy? “Am I actually going into labor?”

Although the conventional knowledge says that pregnancy lasts nine months (which would be 36 weeks), most babies are actually born between 38 and 42 weeks. This means that you can think of your due date as more of a “due month” rather than a specific date. In fact, less than 5% of babies are born on their due date. This date range can present a problem, though: how do you know if you are actually ready to meet your baby? Here are four surefire ways to know if you are going into labor.

You’re experiencing certain physical and emotional changes. 

There are specific physical and emotional changes we hear from clients that make your doula double check her birth bag and put her running shoes by the door! We often see a change in emotions and becoming more sensitive. Bursts of nesting energy and new or unusual cravings can also signal your body is getting ready to give birth. Physical changes may also occur.

These may include:

  • feeling “crampy” or having backaches
  • increased vaginal discharge
  • loss of mucus plug (especially blood-tinged mucus)
  • softer, more frequent bowel movements.

Be in tune with your body and emotions, and communicate those changes with your care providers as you get closer to your due month.  

You’re having uterine contractions. 

Uterine contractions are the first sign of going into labor for most people. But how do you know the difference between uterine contractions and Braxton Hicks or false labor contractions? Uterine contractions are regular and consistent; they get steadily closer, stronger, longer and do not lessen with rest, movement, eating or drinking. You may have contractions before you are in labor. But if they are not causing your cervix to change, you are not in labor. See our blog post on latent labor for more on those contractions.

Your water breaks. 

You’ve seen it in movies and on tv shows: water spills on the floor and the character suddenly knows their baby is coming. In reality, only occasionally does your water break ahead of contractions. Typically the other signs we’ve outlined will happen for hours or even days prior to your water breaking. Ir this is your first sign, the vast majority of people will experience contractions that follow within 12-24 hours. 

Your cervix is not a crystal ball and it can’t tell you if labor is imminent.

Cervical exams are not necessarily an indication of when labor will begin. There are a number of cervical changes that have to take place ahead of dilation, the number measured in centimeters that we all associate with how close the baby is to being born.

Your cervix will go through these changes:

  • shift forward to align with the birth canal
  • soften or ripen
  • thin (or efface)
  • The final step is dilation.

These changes may be evaluated by your care provider during a cervical exam once you head to the hospital in order to determine if you are in labor.

To learn more about childbirth and the stages of labor, sign up for our Complete Childbirth Education class or Birth Basics.