Water birthing was introduced to Dubai in July 2015 by Al Zahra Hospital (www.azhd.ae), and has rocketed in popularity ever since, with Mediclinic City Hospital also opening up a water birthing facility at the end of 2017. We spoke to two senior members of the Al Zahra hospital staff – Sally Hunter-Madubuko the senior women’s health manager and midwife; and Anne Willoughby, the senior charge midwife and water birth lead midwife – about the advantages of a water birth and what to expect.
Who is a water birth suitable for?
Generally, if you are healthy and between 37 and 42 weeks pregnant; have experienced a normal pregnancy with no serious medical conditions or complications; and any previous labours have been completely normal, you are suitable to use water for labour and/or birth, say the Al Zahra midwives. They add that labour should also start spontaneously (ie. you cannot have a water birth if you have to be induced).
What are the advantages?
According to Sally and Anne, the many benefits include less painful contractions; shorter labour; less need for pain relief and for drugs that accelerate labour such as oxytocin; and a more gentle birth for the baby. The relaxing effect of warm water helps produce endorphins – promoting the body’s natural pain-relief mechanism. In addition, a birthing pool supports 75 per cent of a labouring woman’s weight, allowing her to feel buoyant and comfortable. Mobility is easier, thus conserving a woman’s energy for labour. Water also helps to relax the pelvic floor muscles and soften the perineum, thus reducing the risk of tearing.
Sally adds that women are more likely to achieve a natural birth; have the feeling of being in control; and have a more enjoyable labour experience.
What are the risks?
According to the Al Zahra midwives, for a healthy woman with an uncomplicated term pregnancy, complications are seemingly rare. “A concern for some people is that the baby will breathe while still under the water – this is highly unlikely as there are many mechanisms that prevent this from happening, one of which is ensuring the baby’s head is totally submerged during delivery to prevent the breathing reflex from starting until the head is clear of the water,” explains Sally. She points out that research suggests that for healthy women with straightforward pregnancies and in full-term labour (after 37 weeks gestation) using water for labour and birth is as safe as for a land birth.
Sally and Anne say a woman should continue to see her doctors as a routine course of antenatal care, and that classes providing breathing and relaxation techniques are advisable, but otherwise, nothing additional is required as this is a normal labour and birth.
Sally explains the process: “As the birth approaches, you will know whether you wish to birth in the pool; some women prefer to birth their baby out of the water. Your baby will be allowed to birth with no one touching you, and you will be supported with verbal guidance from your midwife or doctor. You, your midwife or your doctor will raise your baby gently to the surface, head first. Your baby will then start to breathe. Once the baby has been born, his or her head must not go back into the water.” She adds,“Babies born in water tend to have their eyes open and be very calm. Sometimes the baby may take a short time to become pink. This is because the birth has been very gentle and is normal.”
As for when the best time is to enter the pool, the Al Zahra midwives say there is not enough evidence about this, but they believe it is when the labour is established.
Al Zahra does a short admission trace of the baby’s heart rate before entering the pool. Midwives will also regulate the water temperature so that the mother is comfortable. They will check the mother’s temperature, the water and the room temperature every hour in labour, and the water temperature every 30 minutes before the birth.
“If you require gas and air (Entonox) this can be used in the pool. However, if you need a pain-relieving injection or an epidural you will need to leave the pool. If you have already had a pain-relieving injection, four hours should lapse before getting into the pool.
“To maintain the benefits of labouring in water, we will try to create a calm, unhurried and relaxed atmosphere.” says Sally. “We will encourage you verbally when necessary and disturb you as little as possible at other times.”
But they will need to listen to the baby’s heart rate and regularly check the mother’s temperature, pulse and blood pressure.
The mother will be supported in labour by a midwife, her birth partner and her doctor. Your OBGYN must be present at the birth of your baby.
You may also like: 'What it's like to have a baby at Al Zahra Hospital Dubai'
What should I wear?
“It is important that you feel relaxed and in control during labour so the choice of what you wear is entirely up to you,” explains Anne.
“Some women like to be naked when they give birth and find clothing gets in the way, being naked also allows skin-to-skin contact to take place straight away. Others feel more comfortable if they are wearing a T-shirt or bikini top which covers their body.
“You may want to bring a dressing gown or large towel from home because you can become cold very quickly if you need to leave the pool for any reason.” (You can choose to leave the pool at any time during labour – for example, to use the toilet – except when the baby’s head is about to deliver.)
How much does it cost?
There is minimal additional financial outlay; if you are labouring in the portable pools the charge of Dh360 for the pool liner. If you are delivering in the water birth/hypnobirthing room there is an additional Dh1,000 charge.
Read about Dubai mum Victoria Browne's water birth experience in Dubai
You may also like:
'Doulas, Hypnobirthing and Waterbirth: Your guide to alternative birth options in the UAE'
'My Dubai-based hypnobirth wasn't all Mother Earth serenity!'
'Why I ditched pain relief to have child number three'