One option is the use of water during labor and birth.  I personally chose to have a waterbirth with my first child.

It was the most exhilarating experience I have ever had in my life.

I felt so empowered and strong! I would have had a waterbirth with my second child, but alas she came out so fast that I didn’t have time to make it to the tub, let alone a bed!  Several of the nurse-midwives in our practice have also chosen waterbirth for the birth of their babies.

What is waterbirth?  Water birth is the birth of a newborn under water.

What is hydrotherapy (also called water immersion)? Hydrotherapy in labor is the immersion of the laboring mother in water, often used in an effort to delay or prevent use of pain medicine either through an IV or with an epidural. Hydrotherapy can be accomplished in a tub or a shower to help the woman relax and cope with labor pains.

How long have women been delivering their babies in water?   Waterbirth has been around for centuries. The first documented waterbirth was in France in 1805. From the years of 1985 to 1999 over 150,000 waterbirths occurred around the world.  More research is underway across the nation to help better understand how many women have waterbirths in the US.

Are there benefits to using the tub for labor and birth?  Studies have shown that women feel more buoyant, better able to relax or feel calm, and some women feel less fear and stress. Other studies have compared the use of pain medicine between water and land births, and have found water birth moms use less pain medicine. More research is being done to better understand the benefits of hydrotherapy and waterbirth. 

Is waterbirth safe?  Thousands of waterbirths have been studied over the years, and researchers found waterbirth to be as safe as land birth. The studies compared waterbirth to land birth and concluded, “There is no evidence of increased adverse effects to the fetus/neonate or woman from laboring in water or water birth” (Cluett & Burns, p.2, 2009).  Pain medication use, length of labor, vaginal tears, infections of the mom and baby, and patient satisfaction were some of the areas studied.  

What are the reasons I would not be able to use the tub for labor and delivery?  In our delivering facility, we have a policy on hydrotherapy and waterbirth.  Use of the tub is for women with healthy, normal, and full term pregnancies with normal labor patterns. Contraindications (reasons you would not be able to use the tub) include: suspected infection, maternal fever, active genital herpes, untreated skin infection or open wound, abnormal tracing of the baby’s heart rate, too much vaginal bleeding, recent pain medicine use, any positive Hepatitis or HIV results, morbid obesity (BMI >40), less than 37 weeks gestational age, and having less than 4 prenatal visits.

How warm is the water?  The water temperature in the tub is warm and is similar to your own body temperature. Women can get warm in the tub, which is why staying hydrated during your labor is important.

Are the tubs clean? Our tubs are cleaned following strict recommendations from the tub manufacturer, and have been approved by the Indiana State Board of Health. Hospital personnel responsible for cleaning the tubs follow these strict guidelines, receive initial training, and complete competency check offs.

What if I have a bowel movement while I am in the tub? Many women have bowel movements during labor and especially during the pushing stage of birth whether or not they are in the tub or on land. Women who use hydrotherapy and waterbirth are mobile, and can get out of the tub to use the restroom.  If you have a bowel movement in the tub, the stool is removed from the water. If the water is very messy you can get out of the tub, and it can be drained and refilled.

Where can I go to have a waterbirth? The Indiana University Maternity Center at Methodist Hospital offers both hydrotherapy and waterbirth. All of our nurse-midwives practice at Methodist Hospital, and are well trained in helping you safely give birth in water.  We have been safely offering waterbirth at Methodist Hospital for nearly 15 years. At this time, we are the only hospital offering hydrotherapy and waterbirth in Indianapolis.

For more information about HealthNet’s Midwifery Services, please click here.

Post by Carrie Bonsack, CNM, MS

As a certified nurse midwife and a mom of two, I can attest to the misery of morning sickness. I was lucky or shall I say, very unlucky to have it with both of my pregnancies.  I still have a strong sensory aversion to the scent of cucumber melon! I had a car deodorizer in this scent and every time I would drive to work I would throw up. I even had to keep gallon size Ziploc bags in my car for emergencies!

You may be feeling like you are hugging the toilet more than your loved ones, but don’t worry it will eventually go away so that you may experience the joy of pregnancy! Let’s go over a few facts about morning sickness.

What is it?

Nausea and vomiting is a common condition in pregnancy also known as “morning sickness”.   This condition is so common that is has been shown to affect 70-85% of pregnant women[1].  Morning sickness can occur at any time during the day. Some women may have nausea only, while others have both nausea and vomiting.

In most cases, morning sickness will not harm you or your baby.  A severe form of morning sickness, Hyperemesis, is where the woman can’t stop vomiting, lose at least 5% of pre-pregnancy weight, and presence of ketones in the urine. Women with hyperemesis need medical attention.

Why am I sick and how long will this last?

Hormones are thought to be a cause of morning sickness, although the true reason is unknown. Women, who are pregnant with twins, have had it with a previous pregnancy, or who have a history of migraines or motion sickness are more likely to have nausea and vomiting.

Symptoms usually start between the 4^th and 9^th week of pregnancy, and typically last until between the 12^th and 16^th week of pregnancy[2] .  There is no magic cure, but here are some helpful hints.

What can I do that helps me feel better?

Taking a multivitamin before getting pregnant can reduce the severity of morning sickness symptoms.

• Rest as much as possible
• Powdered Ginger capsules (250mg) one capsule during the day and one at bedtime may help[3].
• Eat small, frequent meals (5-6 times/day rather than 3 big meals)
• Eat high protein snacks (milk, yogurt, peanut butter)
• Eating crackers or dry cereal before getting out of bed in the morning may help
• Taking folic acid and a multivitamin vitamin or chewable/gummy children’s vitamin without iron for the first trimester may help.
•  Acupressure wrist bands (Sea Bands) may help[4]
•   “Preggy Pops” are lolly pops made of brown rice syrup, sugar and essential oils, that come in several different flavors created to help relieve morning sickness.
• Slices of lemon with salt are used by some women
• Your medical provider may decide to place you on a medication such as Vitamin B6 (Pyridoxine) and/or Doxylamine (an antihistamine), or other antiemetics such as Phenergan or Zofran if these measures don’t help.

What should I avoid doing?

• Certain smells can trigger nausea or vomiting, so try avoid bad smells.
• Avoiding fatty and spicy foods may help

When should I seek help from a medical provider?

If you have tried the above recommendations for nausea and vomiting and are still feeling sick you may need to seek medical treatment from your HealthNet midwife, nurse-practitioner, or physician. At the health center, your provider will find out if you are having morning sickness or if something else is causing your nausea and vomiting.  Your provider will work with you to determine if you need medications to help relieve the sickness. If you are dehydrated, you may need to have fluids placed in your body through an intravenous line (IV).

Call for these symptoms of dehydration (not enough fluids in your body):

• You cannot keep down food or fluids for 24 hours
• Your urine is dark and you are not urinating very much
• You are dizzy or feel like you might faint
• You are vomiting blood