Waterbirthing in China

Regarding birthing, here is a very descriptive article in China.org.cn:

Mother to Give Birth in Water

Just over a week after China’s first waterbirth, another Shanghai woman is preparing to deliver her baby underwater, perhaps as early as Tuesday.The delivery will once again take place at Shanghai Changning District Maternity and Child Health Hospital.

Ma Nan, a 27-year-old local teacher, was the first to try waterbirth at the hospital on March 1.

Now her 24-year-old friend, a woman surnamed Zhang, wants to follow in Ma’s footsteps.

“I got to know Ma at a training class for pregnant women and we became friends. Since she chose waterbirth and delivered the baby so successfully, I also want to follow her.”

The birth will take place in a semicircular tub with the woman lying in about one meter of water. According to doctors, the tub is filled with hot, disinfected water, in which the mother to be sit during labor.

“Being in water during labor can be very soothing,” said the hospital’s head nurse, who would only giver her surname, Lin.

“Once the woman settles into the warm water, her contractions hurt less and she finds little need for medication. With decreased pain experienced, she will feel less anxious and her adrenalin levels also decrease,” said Lin. “Because muscles are supported in the water, a woman becomes less tense and can cope with the contractions easier.”

Medical staff also says women who deliver their babies in water lose less blood and deliver the baby quicker than normal.

The warm water is also helpful for the baby to adapt to the outside world, as it grows in the fluid-filled environment of the womb, doctors said.

Waterbirths have been around for decades in the West, but have never gained large popularity.

Other maternity hospitals in Shanghai question whether their is enough demand for the service to set up a waterbirth delivery room and also fear that it can cause infections if the water and tub are not properly disinfected.

“Delivering a baby in water requires strict disinfection of the water and the facility. Since the woman is so vulnerable when delivering, the water can result in serious consequence if it is not clean enough. In addition, we don’t think many Chinese women and their families will choose waterbirth,” said a spokes-woman for Shanghai International Peace Maternity and Child Health Hospital.  (source = eastday.com March 11, 2003)

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The conjecture = we don’t think many Chinese women and their families will choose waterbirth–was absolutely wrong.  In the last 20 years, more and more women have deliberately chosen waterbirth in China.
Here is a segment from a research paper:

Women who are seeking water birth and undisturbed birth have usually considered the consequences of interference with the birth process. They may have read about the impact of early childhood trauma, including birth trauma, on the developmental neurobiology, endocrinology, immunology, and epigenetics of this new human being (Karr-Morse, 2010). Many women are not just looking for pain relief but a way to remain drug-free, relaxed, and with some control over the process of letting the baby out. Over the past three decades, I have assisted hundreds of women in the birth pool. I have observed closely, listened carefully, and recorded many actions and characteristics in mothers and their caregivers. I have heard many caregivers and mothers retell their stories to friends, to families, and to their babies. More than 2,500 women have completed surveys about their water-birth experience through Waterbirth International, often using the same words to describe how their babies responded after birth and in the months and years that followed (Harper, 2008). Is it just the water that caused these babies to be alert, calm, responsive, connected, present, and aware? The use of warm water immersion aids and assists the mother in feeling calm, relaxed, nurtured, protected, and in control, with the ability to easily move as her body and her baby dictate. From the mother’s perspective, using water becomes the best way to enhance the natural process without any evidence of increased risk. A calm, relaxed mother is more likely to experience a calm, relaxed baby after birth. (source)

Delayed-breathing and delayed clamping of the placenta as a strong benefit

Immediately after birth, the cardiac output to the lungs must increase from the 8% level in fetal life to a 45% level necessary for neonatal life and adult circulation. Therefore, some of the blood from the fetal “lung,” the placenta, is needed by the neonatal lungs for draining of the fetal lung fluids and adequate expansion and recruitment of lung tissue. Immediate cord clamping eliminates the many benefits of placental transfusion and compromises lung expansion and function. The infant is left with only the blood that was in the body at the time of cord clamping, which is not adequate to create an increase in the circulatory bed at the same time that the infant’s organs (lung, liver, kidney, skin, gut, and brain) begin to assume the functions that had been sustained by the placenta during fetal life (). In other words, the more blood that flows from the placenta into the newborn, the higher the blood volume. The more blood volume and the thicker the blood, the more fluids are able to leave the lung tissue.
The many mechanisms that function to switch the newborn from fetal circulation to newborn status take place over the course of hours and sometimes days. Not all the fluids that were in the lungs prenatally are drawn out into the vascular circulation. The fluids that remain are drawn out of the lung tissue through the lymphatic system, which is stimulated over the following 72 hr by skin-to-skin placement, self-attachment, and breastfeeding.
One of the many benefits of water birth is immediate and uninterrupted skin-to-skin contact. Water-birth providers have learned so much from observing what normal full-term healthy newborns do in the habitat between the breasts. The neonate who is placed skin-to-skin regulates all his systems very quickly but is usually extremely quiet. The absence of vigorous crying is not indicative of the absence of newborn breathing. Quiet stable newborn breathing happens often without a single peep out of the baby who is immediately placed in the habitat (; ). This is frequently observed of babies who are born in water. (source)

 

In 1960, Dr. Siegel published a study in the Journal of Obstetrics and Gynecology entitled, “Does Bath Water Enter the Vagina?” Pregnant women were put into bathtubs that contained iodine-stained water. Before entering the bath, a sterile, starched white tampon, without a string, was inserted into the vagina. After 15 min of soaking, the women left the bath, the tampons were removed, and not a single one was stained with iodine. Common advice from physicians at that time was to avoid bathing in the third trimester and definitely to not bathe while in labor or after membranes have ruptured. Dr. Siegel concluded,

Thus, the fear that bath water may infect a pregnant or puerperal woman is not founded on fact, since normally no water enters the vagina. Therefore, restrictions on bathing during and after pregnancy are not warranted on this basis alone. Moreover, this teaching represents another classic example of error. (source)

Need for Pain Relief

The Nutter et al. (2014a) review looked at eight studies that included this outcome and found that people who give birth in water use less pain medication than people who give birth on land. This agrees with the findings of the Shaw-Battista (2017) review, which also found that people who labor in water report less pain and anxiety. Four research teams found that fewer people who gave birth in water required any pain relief at all (Otigbah et al. 2000; Geissbuehler et al. 2004; Chaichian et al. 2009; Torkamani et al. 2010), and two research teams mentioned that people who had waterbirths had a 0% epidural rate (Thoeni et al. 2005; Zanetti-Daellenbach et al. 2007a).

Potential benefits of waterbirth

  • Less pain and higher satisfaction with the birth experience
  • Less medication use for pain relief—this may be important for people who want or need to avoid epidurals or narcotic medications during labor
  • Less use of artificial oxytocin and possibly shorter labors
  • Higher rates of normal vaginal birth
  • Lower rates of episiotomy
  • Higher rates of intact perineum, especially in high-episiotomy settings
  • Possibly lower rates of severe tears (3rd or 4th degree), especially in high-episiotomy settings
  • Possibly lower rates of postpartum hemorrhage

It is not clear if waterbirth provides any health benefits to newborns. The studies we have are complicated by the fact that care providers help some mothers out of the pool for medical reasons—leaving the more straightforward births to take place in the water.

Potential risks of waterbirth

  • We need more research evidence on waterbirth, so this makes it more difficult to make a truly informed choice.
  • There may be a higher rate of mild labial tears from waterbirth in low-episiotomy environments such as homes and birth centers
  • Umbilical cord snap is a rare but possible occurrence. Care providers need to take care not to place too much traction on the cord when guiding the infant out of the water.
  • There have been several case reports of water aspiration. These cases have not been observed in prospective research since 1999, and almost all of the infants in the case reports made a complete recovery.  (source)

Watch the video of Kaylee and Jordan

I’d be lying if I said I wasn’t nervous about posting this video.  It was the hardest thing I’ve ever done, the most intense experience, and the most emotional day of our lives. Some people question how we could share such an intimate moment with the world. Leading up to this day, I watched hundreds of birth vlogs on YouTube, and the ones that truly helped empower and prepare me for this moment were the ones that were the most raw, real and vulnerable. That is why we chose to share our story in this way.  [Aaron: This is why I have chosen this raw, real, and vulnerable video for your viewing.]

Click here to begin the Video.

Should husbands be permitted to take part in the birthing process?

And how about the men?  There has been a movement to keep them out of the birthing room.  One doctor said, “The first person to faint are the husbands.”  Is that true?   Or is it the sentiment of an OB who didn’t want any men in the birthing room (save himself)?

Preparing fathers to assist their wives in the birthing proces

Many first-time fathers do not know what to expect when preparing for the birth of their child. It may seem very overwhelming, intense and complicated when thinking about the birth process. You may have your own worries and concerns outside that of the mother and new baby. Here are some steps on how to prepare for the birth of your child:

1. Join in on a childbirth class. Lovelace Labor of Love offers classes on what to expect before, during and after your baby is born. Mothers love for their partners to join them in these classes because you both can experience this amazing process together. There is much for the both of you to learn. We offer Baby Care Basics, Breastfeeding Basics (Yes dad, this one is for you too!), and Prepared Childbirth. Two free classes for both mom and dad/partner to consider are Loving Families and New Parent Group.

2. Recognizing when your partner is in labor. You will know your partner is going into labor when she starts feeling the onset of contractions. Usually, a woman will start feeling contractions before her water (amniotic sac) breaks. If the bag of waters breaks, she may go into labor shortly after. She may feel lower back pain; this is normal. One thing to remember is your partner might experience false labor, also known as Braxton Hicks contractions. These contractions are not as intense and may come and go. This is why it is very important to keep time of her contractions. Once her contractions start lasting longer and occurring closer together, it is time to head to the hospital. Be sure to ask your midwife or doctor who and where to call if you think you are in labor.

3. What can you expect during labor? It is important to know all the stages of labor so you can try to understand what your partner is going through in that moment. Consider preparing by watching videos or reading about labor and delivery, as well as, attending classes.

Labor has three stages:

  • The first stage of labor has three phases. In the first phase, also known as the early phase, your partner may start to feel her contractions getting stronger than before. This phase can last from hours to days. In the second phase, which is the active phase, contractions for your partner are a lot more intense. This is the phase where you may want to ask your partner if she will be wanting to receive any pain medications, if she can. In the last phase, transition, your partner is having intense contractions and it is almost time to push! She may be cranky, so don’t get offended if she says anything hurtful to you.  She is in pain, frustrated, and is ready for the baby to be born.
  • The second stage of labor is the actual pushing and birth of your baby. This can takes minutes to hours. Sometimes for first-time mothers, this can take a while, especially if she has had an epidural [pain-killer]. It is very important to support your partner in this stage because it may be when she needs you the most. After your baby is born and whenever possible, your baby will be placed on the mother’s chest for skin-to-skin contact. We call this the Loving hour. It is a time meant for bonding and for mom to help regulate baby’s vitals and to prepare for the first breast feeding. The father is also more than welcome to have skin-to-skin after the Loving Hour.
  • The third stage of labor is the delivery of the placenta. Your partner may have another push or two just so the doctor or midwife can deliver the placenta. The placenta provides oxygen and nutrients to your baby while he is in the womb. You may be able to take a look at it, some people actually take it with them. The decision is up to you and your partner.

4. How can you provide comfort for your partner? It is very important to comfort your partner before, during and after the birth of your child. Ask her before labor begins so you have a few options that may work depending on how she is feeling. You can help physically by actually giving your partner a massage or getting her something to eat. You can use comforting phrases such as “You’re amazing” or “I am here for you” or “You’ve got this.” She may just need quiet during this exhausting, yet breathtaking experience.

The birth experience is a wonderful process. We want you and your partner to enjoy this very special time. Attending classes together will allow you to be aware of what to expect and what to do when it is time to welcome your child into this world. Please do not be afraid to ask questions of the doctor, nurse, or midwife during your partner’s labor and delivery.  (source)

Story of an expectant mother in the 7th month

“Can you hear me, baby? Can you hear mommy?”
More soft movements as a response. I feel a limb slide against me from inside. The baby’s probably just feeling out its environment for the first time. I rub my belly very very sofly.
“It’s alright, baby. You’re inside me…you’re inside mommy. You’re safe…”
Thump. Another sharp kick. “Ohf! Alright, easy, baby-” But it starts kicking more and moving around a lot. A lot more than I’m used to right now. I just hold onto my belly and leave the bathroom. I’m not sure how to get it to stop, so I slowly pace myself to the living room and sit down on the couch for a bit, rubbing my belly back and forth. “Shhhh…stop…please”
Soon Aarene [her partner] comes in through the door and finds me sitting slumped into the couch. S/he gives me an odd look with an eyebrow raised. “Hey? What’s up?” s/he asks.
“C’mere…” I eagerly motion for him/her to come sit down. “Here, feel.” I place a hand on my belly for him/her to feel.” His/her eyes light up as s/he realizes that our baby is kicking me. Right there, I start feeling more and more connected with this creature growing inside me. Me and Aarene looked at each other and shared a mutual feeling of excitement in our smiles for the first time in a little while.

Over the next few months Aarene and I just sit around feeling my belly and doing research on our baby’s movements. It becomes so much fun that we lose track of time and before we know it I’m seven months along. I’m really starting to waddle now, and my hips are widening a fair bit. I’m getting used to walking with this new shape of mine, which is difficult since the baby is able to shift positions inside me so much. My belly changes shape a lot. I’ve been wearing mostly dresses and baggy shirts I used to wear to hide myself. Now they’re the only thing that will fit.
“You look great in that dress!” Laura tells me one night while at our place for dinner. I blush slightly less than usual, as I’ve been getting more and more flattering comments about my appearance from Aarene as I’ve gotten bigger.
“No really,” Laura continues, “some women just end up with an uneven sagging belly. Yours is so round!”
“Yeah, you actually have a really good body for this,” Aarene adds.
Okay, so these comments make me laugh and blush a little bit. I’ve been having this strange juxtaposition of feeling thrilled and embarrassed about my body over the past couple months. I feel another firm kick from inside me and softly caress my belly from under the table. Over dinner Laura tells us stories from her pregnancy experience, many of which I can relate to.
“Walking became so embarrassing! Up to a few weeks before the birth I was waddling half the time wherever I went around the house. Sam loved it, though,” she laughed. “He thought it was adorable.”
“I remember that!” Aarene giggled, “I made fun of you so much!”
“You did! I was hoping I would be able to get back at you this time around!” Laura smiled. The three of us laugh together, me and Laura exchanging a look of mutual respect. Aarene looks over at me and smiles.
“You will eventually.”
I’ve usually been pretty quiet during social occasions, as conversation over the last seven months often turned to focus on me. I’ve become less shy about it it seems, but that may be because I’m with Aarene and Laura, two people whom I’m quite close with.
“How’s walking been for you?” Laura asks me.
“Uh, it’s usually not that bad when I’m carrying high up, but sometimes the baby descends downward and lays right in my pelvis. Those times are the worst because I always end up waddling to the bathroom in a hurry.”
“Oh man, that’s where mine rested all the time. There was so much pressure down there toward the end of it,” Laura says.
I smile and blush a little, once again happy that I know someone who can relate to what I’ve been going through.
“Have you guys thought about the birth yet?”
I freeze. No, I haven’t thought about the birth.
“You’re right!’ Aarene jumps in. S/he turns to me. “I think we should have a home birth! Maybe a water birth with that,” s/he says almost between gasps.
Suddenly all the embarrassment came straight back. I’ve learned to get used to waddling, throwing up every morning, and getting distracted by movements inside my belly, but this is too much now. My fantasies of pregnancy and childbirth haven’t been matching the real experience. I realize now that it was a very private and personal thing for me, and exposing it to the people I care about has been just too embarrassing. If I didn’t want this I wouldn’t have gone through with the coin toss. They know part of me wanted this.
She had to say birth. Not delivery or due date.
“I had mine in a pool,” Laura goes on. “It was incredibly comforting. I’d recommend it to anyone. I’m totally up to help you guys out if you need it. I am a midwife, after all.”
“Yes!” Aarene exclaimed. “It’ll be just the three of us, right here as well!”
Oh great. Now one of my best friends is going to see me go through this as well.
“What do you think?” Aarene suddenly turns to me.
“Uh…” I completely draw a blank. I think I wasn’t totally prepared for this.
“What’s wrong? You seem tense now. Are you scared?”
“No, I…”
“Don’t be scared! You’ll be great, trust me!” Aarene smiles.
“Yeah, somehow I think you’re going to do quite well at this,” Laura says.
Suddenly this conversation has turned into Aarene and Laura cheering me on. Do well at this? She said it as if giving birth were a sport or something. It’s not a sport, I tell her, trying to playfully hide my embarrassment.
“Meh,” she shrugs with a loose smile, “I like to think of it as one, now that you say that. Some girls do really well at it and stay calm the whole way through. Some girls panic and need a lot of extra help.”
Yup. Sounds like me. I can see it now.  (source)
Further Resouces
Mei X, Mei R, Liu Y, Wang X, Chen Q, Lei Y, Ye Z. Front Psychiatry. 2022 Dec 15;13:1091042. doi: 10.3389/fpsyt.2022.1091042. eCollection 2022. PMID: 36590638 Free PMC article.
  • Buddhism provides abundant healing resources for dealing with childbirth on the practical level. Overall I contend that Buddhist healing resources for childbirth served as an effective channel through which Buddhist teaching, worldview and concepts of gender and body were conveyed to its supplicants. Through this investigation, this dissertation contributes to the understanding of the association of Buddhism with medicine, the influence of Buddhist discourses and practices of reproduction on China, and the transmission of Buddhist views of gender, the body, and life to China through its healing activities related to childbirth.

Lin, Hsin-Yi, Dealing with Childbirth in Medieval Chinese Buddhism: Discourses and Practices.  2017 Doctoral Thesis, Columbia U.

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