It is the video posted on Instagram by Josy Peukert, a 27-year-old girl, has been seen millions of times and shows the incredible moment in which she gave birth to her baby by giving birth alone in the water, by the sea, with only her partner next to it. A choice that has sparked a lot of controversy between those in favor of the practice of freebirth (free birth) which proclaims a holistic birth outside the medical system and those against which underline its danger. But beyond these extreme cases, giving birth in water (as long as you do it in a medical environment) actually provides benefits to both mothers and newborns: it reduces the risk of post-partum complications and makes everything more pleasant especially for the parturient. . This is what emerges from a study just published on BMJ Open.
Being born in water is good for mom and baby
Water birth is done using a tub that helps the parturient to relax and find pain relief. In fact, the mother can take the positions she prefers most to deal with the annoying uterine contractions. Water birth can be carried out either by entering the tub only to relax the parturient who then comes out to give birth to the baby as usually happens so that she breathes air, or by remaining in the water also to give birth by bringing the newborn to the surface to make it breathe.
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Research
The researchers wanted to compare the extent of health interventions needed during and after labor between the two different types of water births. Therefore they looked at approximately 36 studies involving 157,546 women who required various types of interventions including induced delivery, artificial water rupture (amniotomy), stimulation of labor, continuous fetal monitoring, opioid use. , epidural, Caesarean section, manual removal of the placenta, neonatal resuscitation or treatment of an infection in the mother or newborn.
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Less pain and invasive procedures
Data analysis showed that a water birth, regardless of whether women give birth in or out of the pool, has clear benefits and is just as safe as traditional births. In particular, it significantly reduces the use of epidurals and opioids. “Immersion in water – the researchers explain – decreases the risk of having to perform an episiotomy, that is a surgery aimed at facilitating the passage of the fetus during vaginal birth. It is an operation that does not actually offer any perineal benefit. or fetal, it can increase postnatal pain, anxiety and negatively impact a woman’s experience of giving birth. ” With water birth, pain and heavy bleeding also decrease, while mothers’ satisfaction levels and chances of an intact perineum increase. Finally, the researchers found no difference in the rate of caesarean sections performed.
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The rupture of the umbilical cord
However, the researchers noted that there were more cases of umbilical cord rupture among those born in water, but the rate was still low: 4.3 per 1000 water births compared to 1.3 per 1000 ‘standard’ births. . According to the researchers, this could be linked to the traction of the umbilical cord when the newborn is lifted out of the water. But the study states that “immersion in water offers benefits for the mother and the newborn if used in obstetrics because it is a low-tech intervention that can improve the quality and satisfaction of care”.
It is not suitable for all pregnant women
In many hospitals, even in Italy, women are given the opportunity to choose to give birth in water and not only in the north of the country. Last April, for example, Brando was born, the first born in water at the Umberto I hospital in Syracuse which has, in fact, inaugurated the new water delivery room of the Gynecology and Obstetrics department. However, this modality is not suitable for all pregnant women and in any case it is not without risks because even if rare there can be serious associated neonatal complications. In particular, water birth is possible only if it is a single pregnancy, with the fetus in the cephalic position, the absence of medical / obstetric complications and a physiological course of pregnancy.
What the Guidelines say
One of the problems is that there is not enough data available and for this reason the American College of Obstetricians and Gynaecologists recommends that birth take place ‘on land’, i.e. not in water. Both the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives support water labor for healthy women with uncomplicated pregnancies. The Nice guidelines recommend informing women about the lack of scientific evidence to support or conversely discourage water birth. Maternal risks concern the possibility of reducing the safety globe in post partum (ie the last contraction that serves to expel the placenta and make the uterus retract). However, no adverse events related to immersion in water emerge from the literature. As for infants, pediatricians have expressed concerns about the potential risks of water aspiration, hypothermia, cord rupture, and infection. But even in this case, adverse events reported in the literature are very rare.