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?
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.