You can use water in labor, even if you don't plan on a having a water birth!
Water is one of my favorite pain management tools in labor. Whether you give birth at home or in the hospital, at some point my clients end up in the tub or in the shower.
Here’s why hydrotherapy can be a wonderful option in labor:
You can relax!
Even for those who aren’t pregnant, a nice, warm bath after a long day of work can make you feel more relaxed and calm. Immersion in water can lessen anxiety and promote relaxation. These same benefits apply when you are in labor.
The calming effects of water can actually help with labor progression. When you are feeling relaxed and calm, your body releases endorphins, which promote the production of another hormone called oxytocin. Oxytocin plays an important role in labor, stimulating contractions. (Known as the "love hormone," oxytocin is also involved in attachment and breastfeeding).
When the oxytocin is flowing, your labor can progress. Conversely, when you are feeling stressed and anxious, adrenaline is produced, which can interfere with oxytocin production. So taking a warm bath, combined with other relaxation tools such as music, meditation, dim lighting, massage, and self-hypnosis, can help your labor keep a nice, active pattern.
Note: In early labor, taking a bath can slow down contractions. This is just fine-- early labor should be a time of rest, since it can take hours or even days to turn into active labor. If active labor is imminent, taking a bath won’t stop it!
It provides pain relief.
Water is sometimes referred to as a “liquid epidural.” While water doesn’t take away all sense of pain (although some clients report that at times it comes pretty close), it definitely helps to make the pain of labor more manageable.
The website Evidence Based Birth gives a review of the evidence behind water immersion as pain relief in labor. In a meta-analysis of several studies, it was reported that people who labored in water were less likely to use epidurals or spinal anesthesia for pain relief.
Submerging your body in water isn’t always necessary. Standing in the shower, with the hot water pointed at the part of your body where you are feeling the most pain or discomfort, is also very effective for pain relief.
You can move.
While submerged in water, it may be easier to move your body into positions that may be more difficult or uncomfortable "on land," like hands and knees, or in a squat. Being in water can help take pressure off of areas of your body that ache. You may feel more buoyant and lighter, contributing to feelings of relaxation.
If you are laboring at home, you can use your own bathtub or shower. (In early labor, I encourage my clients to take a bath and then try to sleep for a while, to reserve their energy for active labor.)
At the birth center, there are tubs and sometimes showers for your use. And more and more hospitals are offering tubs to labor in (although most hospitals still don’t allow pushing or giving birth in the water).
Fortunately for those in the Treasure Valley, both St. Lukes and St. Alphonsus offer labor tubs, either in each room or in a single-use shared space on the labor and floor. Some tubs sport jacuzzi-style vents for additional comfort.
For low-risk pregnancies, you can labor in the tub at just about any time, including after your bag of waters has broken, or if you have been induced. When laboring in the hospital tub, the nurses can monitor you intermittently without you having to get out of the water; if you consent to cervical exams, these can often be done in the water as well. (Note that with narcotic pain medications and epidurals, you won’t be allowed to labor in the tub for safety reasons.)
You can try it again.
At some point, if my clients aren’t planning a water birth, they decide to get out of the tub, either to push out their baby or to continue laboring on land. At this point, I can help them maneuver out of the water and wrap them up in a nice, warm towel so we can try some other comfort measures.
Sometimes, my clients decide to try the tub or shower again, and they easily can.
With some pain medications, you can have only a certain number of doses, and your mobility may be decreased for a while. With hydrotherapy, you can return to the tub or shower at just about any time during labor.
If you are worried about an accidental water birth, your doula and care providers can often get a sense of how close you may be to pushing based on your behavior and sensations you are reporting. We can recommend getting out of the tub to give you enough time to get to the place where you intend to birth your baby.
I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley.
Do you have questions about using water in your upcoming birth?
Whether you are looking at a return to work after maternity leave, or just need a sitter for an occasional date night, leaving your baby in someone else’s care for the first time can seem like a daunting task.
Will they be safe? Will they get the same level of attention as they get from you? What if they don’t take a bottle? Will they cry? Will you cry?
Here are five things to consider when finding a caregiver for your baby:
1. Determine the type of care you need and want. You will have different expectations of an occasional babysitter than that of a full time caregiver. It may not matter that an occasional sitter has a little trouble putting your child to sleep at his usual time, because his routine isn’t greatly affected by one late nap. However, you may want a regular caregiver to follow the same routine as you do at home.
Depending on your budget, your child’s needs, and your personal preferences, you may be looking at the following types of care:
2. Get referrals and check references. When looking for care, ask your friends, family members, and neighbors for referrals. No matter what kind of care you are looking for, if you can get a referral from a family who has had personal experience with a caregiver, you may have more peace of mind about leaving your child with them.
If you can’t get personal referrals, you can get referrals from local parenting groups, or you can view ratings on child care sites like care.com. You can use a child care agency; they screen their caregivers in advance, conduct background checks, and may require them to have a minimal level of experience or training.
When you find potential caregivers, ask for references from families with whom they have worked in the past. If they can’t or won’t offer references, this can be a sign that they are inexperienced or have had negative experiences you may want to avoid.
3. You make the decisions. You have the right to choose a caregiver who will respect your parenting choices, including how and when to feed your baby, how to respond to crying and other cues, how their sleep is structured (or unstructured), how often they are held, how they comforted, how they are disciplined, and more.
Look for child care providers who will work with you to accommodate your preferences. Sometimes they may have limitations due to the number of children they care for. Know which areas are the most important to you, and find a care provider who can meet your needs in those areas.
When your care provider is a family member, your parenting choices should be respected. A family member who ignores your instructions may not be the best person to watch your child, even though they may be more emotionally attached to your baby than a professional caregiver.
Also consider an out-of-home caregiver’s policies on dropping in to see your child. If a facility limits your ability to visit your child, or requires advance notice, this may be a red flag that they will present a different picture to you of the care your child is receiving when you are not around.
4. Ease into a schedule. If you have the flexibility, consider leaving your baby for small increments of time with their caregiver, and build up to a regular schedule over a period of weeks or months. This period of transition will help both you and your baby get used to being apart.
A slower approach can also apply to occasional or part-time care. Have your sitter watch your child in your home while you are there before you leave your baby alone with them for the first time. The sitter can become familiar with your home and the baby’s routines, the baby won’t consider the sitter a stranger, and you will get a sense of how the sitter will care for your baby when you are gone.
If you are breastfeeding, easing back into work may help you maintain your breastfeeding relationship while you pump to build up a supply. It may also give a baby who is reluctant to take a bottle time to adjust to a new method of feeding.
5. Consider alternatives. Sometimes, the needs and priorities of your family change after your baby is born. When pregnant, you may have had a plan to return to work after six weeks but now that your baby is here, you feel you need an extended maternity leave. Or maybe you planned on hiring a nanny, but you found an in-home daycare that seems like a better fit.
Some families re-evaluate their need for a two-income household, and one parent decides to stay home to care for the baby full time. Or one parent transitions to work from home for a time, to be more available to help with child care.
If you find yourself re-thinking your child care needs, there are many options available to parents these days. Start a discussion with your employer about what flexible options may be available to you. Examine your family budget to see if one or both parents can stay home with the baby, or work from home for a while. See if a family member is available to help out on a regular basis.
Make the choices that are right for you new family, even if those choices are different than what you thought they would be when you were pregnant!
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley.
Planning for birth and postpartum can be just as stressful as choosing child care. Find out how a doula can help you as you bring your new baby into the world.
If you are pregnant, sooner or later you will think about how to manage the pain of labor. Some clients know they want to get an epidural, and others would prefer to either forego pain medication entirely, or see how they feel in labor and make a decision in the moment.
Pain management and comfort measures are topics I discuss at length with my clients in our prenatal meetings. When clients want to avoid or delay pain medication, we talk about natural pain relief methods like counter pressure, hydrotherapy, heat therapy, and position changes.
When clients are open to pain medications, but want to avoid or delay an epidural or narcotic medication, nitrous oxide can be a great option.
Nitrous oxide has been used by laboring people in the United Kingdom, Australia and Canada for decades. The ACNM (American College of Nurse-Midwives) supported its use in a 2011 position statement, affirming nitrous oxide as a pain relief option that fits into the midwifery model of care.
While nitrous oxide was once frequently used in United States, in the 1970’s its use declined as epidural analgesia surged in popularity. As of 2017, one report stated that nitrous oxide was available in only around 150 hospitals and 50 birth centers nationwide.
Fortunately for those in the Treasure Valley, both major hospital systems, St. Lukes and St. Alphonsus, offer nitrous oxide, also known simply as “nitrous,” in their labor and delivery rooms.
With all interventions, there are benefits and risks. Here’s what you need to know if you are considering using nitrous oxide in your upcoming birth:
The Benefits of Nitrous Oxide in Labor
The Risks, or Downsides of Nitrous Oxide in Labor
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley.
Are you considering using nitrous oxide in labor? Would you like more information about it?
It’s the holiday season, and that means interaction with family members you may see just a few times a year. Even if you have wonderful relationships with your extended family, if you are pregnant around the holidays, conversations can get difficult when talk turns to your plans for birth. Everyone seems to have an opinion to share about what you should or shouldn't do, or they offer a prediction of how your birth will go.
Here are five tips to navigate the holidays while pregnant:
1. Modify your holiday plans. Modify your plans, and minimize your stress. If you usually host a family gathering, ask someone else to host this year. Plan on bringing in prepared foods instead of cooking, or make the dinner a potluck event.
Can you limit family time this year? Use your pregnancy to your advantage. Perhaps you stay for just a few hours at your sister’s house instead of the whole day. Or take a nap while everyone else is watching football.
If you are nearing your estimated due date, your care provider may actually warn against you traveling more than a couple of hours from your home. That means you can avoid a prolonged visit with family altogether, if that is your preference.
2. Prepare for difficult conversations. Chances are, your family members are excited about the new addition to their own extended family. But instead of only sharing in your excitement, they may also feel the need to share their opinions.
Conversation will inevitably turn to your pregnancy, and will likely consist of three topics:
If you are making choices for your birth that are different from those your family members have made for themselves, be prepared for push back. You might hear things like, “Just you wait! You have no idea!” or “You’ll change your mind!”
If your choices are vastly different, you may even hear things like “You are putting your baby’s life in danger!” or “You are being selfish.”
With pregnancy hormones at play, and if you yourself are still navigating your birth options, these conversations can get heated, emotional, and very difficult.
If you anticipate these conversations in advance, you can avoid feeling blindsided. You might tell your family before the event (or have your partner tell their family) that you don’t want to have these conversations at all. Or, you may choose to be more selective or vague in your answers to probing family members.
3. Practice disengaging. Sometimes these difficult conversations can’t be avoided. Maybe your relatives already know your plans for birth and they are using this holiday gathering as one more instance to voice their disapproval.
In these situations, don’t try to defend your choices, or try to convince your family members to accept them. Instead, answer their questions or comments with a neutral phrase, like, “Hmmmmm” or “Huh!”
Or you can make them feel heard and say, “You know, that gives me something to think about.”
Sometimes, you may feel the need to stop the conversation entirely. You can say, “Thank you for your concern. I don’t want to talk about this anymore.” Or redirect the conversation to another topic: “Okay. Hey, congrats on your promotion. How do you like your new job?”
4. Make time for self care. Taking care of yourself is always important, but especially so during the busy holiday season. Book a prenatal massage, take a long bath, make time to exercise, or plan a night out with your partner. Enjoy the time you have now that is all yours.
Whatever brings you relaxation and calm increases your oxytocin levels. Oxytocin is the "love hormone" that plays a role in labor, attachment, bonding, and breastfeeding. Taking deep breaths, centering your mind, and finding ways to relax amidst the tension around you is also excellent practice for managing labor.
5. Create your own holiday traditions. With a baby on the way, your life will be changing in just a few short weeks or months. Whether this is your first baby, or you are adding a sibling, take the time to reassess what you and your partner want for your growing family. What traditions will you adopt? What will you let go? What is important? What’s not?
These answers look different for everyone. They may not fit into what your extended family has chosen. But when you take the time to pause and think about what you want for your own family, the stress and furor that accompanies this time of year lessens-- which makes for a better holiday season, and a better pregnancy.
I am a certified labor doula and professional postpartum doula serving clients in Boise, Eagle, Meridian, Nampa and the greater Treasure Valley.
This holiday season, ask for doula support! Elevated Birth gift certificates are available in any denomination and can easily be added to your baby registry.
These gorgeous photos are courtesy of Natalie Koziuk Photography. Clients of Elevated Birth get discounts on sessions with Natalie!
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I've worked in the forest, in the lab, and in an office cubicle. My favorite and most passionate work has been alongside clients as they reach inside to find their innermost strength, and give birth to their babies. Each birth is an honor to witness.