The concept of hydrotherapy use during labor is not new. The first documented water labor (and subsequent birth) occurred in 1803 in France. In 1963, Igor Charkovsky experimented with water and labor in the Soviet Union. Hydrotherapy in labor has been used in the United States for many years.

For many women, hydrotherapy or the use of water as a non-pharmacologic pain relief technique is highly desirable for labor. Hydrotherapy may be in the form of a warm spray of water from the shower aimed at the lower uterine segment to relieve the stretching sensations of the ligaments and areas associated with posterior presentations.

Laboring in a labor tub can increase a laboring woman's pain tolerance (the duration or intensity of pain that the woman is willing to endure). The hydrostatic pressure of the water relieves some of the discomforts of the contractions. Tubs that maintain the water temperature at or around body temperature (98° F - 100° F) also soothe tired and aching muscles and ligaments - furthering relaxation of the mother. Research reviewed in the article by Schorn, McAllister and Blanco show "the benefits of water immersion include faster cervical dilation resulting in shorter labors, increased relaxation and decreased pain". Cervical dilation was more rapid in one group (2.5 cm/hour) as compared to 1.25 cm per hour in a control group. These authors also discuss the rate of infection as a concern with use of water during labor. They site a 1960 published article by Siegel (4) siting that water does not enter the vagina during tub bathing. Schorn, McAllister and Blanco also site their own study at Upland Family Birthing Center in Upland, California found no difference in the rate of chorioamnionitis or endometritis between water immersion and non-water immersion groups studied (5).

Buoyancy [a concept discovered by Greek mathematician Archimedes (287-212 BC)] in the labor tub allows for an almost weightless feeling. Women who need to move during labor to enhance progress truly benefit from the ease of movement in a labor tub.

According to Sheila Kitzinger in her book The Complete Book of Pregnancy and Childbirth (2): "Lying in warm water increases venous pressure so that veins can return blood to the heart more efficiently. It also enhances cardiac action and slows the pulse rate." Kitzinger also includes a wonderful section on "Exploring Birth Movements In Water" - the photos are a must-see for those working with women and labor tubs.

 

 

Reference:

1. Church, L.K. Water birth: One birthing center's observations. Journal of Nurse Midwifery, Vol. 34, No. 4, July/August 1989.
2. Kitzinger, S. The Complete Book of Pregnancy and Childbirth (1996) New York: Alfred A. Knopf Publishers.
3. Rush, J., Burlock, S., Lambert, K., Loosley-Millman, M., Hutchison, B., and Enkin, M. The effects of whirlpool baths in labor: A randomized, controlled trial. Birth, Vol. 23, No. 3., September 1996.
4. Seigel, P. Does bath water enter the vagina? Obstetrics and Gynecology, Vol. 15. 1960.
5. Shorn, M.N., McAllister, J.L., and Blanco, J.D. Water immersion and the effect on labor. Journal of Nurse Midwifery, Vol. 38, No. 6, November/December 1993.