DELIVERY IN THE WATER

Prof. Giuseppe Grimaldi MD

We are in an unusual delivery room. There is a two-meter wide round bathtub, filled with warm water, where a woman is in labor. In the room everything is calm. The light is dim and people are speaking quietly. The obstetric and the doctor are assisting the mother to be. Even the father is informed and aware of what is happening. The pregnant woman's privacy is preserved thanks to a series of partitions that surround the tub. Only one person at the time is allowed near the pregnant woman, everybody else is unobtrusively present. It is crucial that everybody stays calm. An emergency team is on stand by in case of emergency.
The tub's warm water alleviates the pain from the contractions, especially when the uterus dilates. The woman can freely adjust her position without much effort. At any time she can decide to get out of the water or stay in it until the baby is born.
Water makes it very easy for her to readjust her body to whatever position best suits her.
Suddenly the contractions intensify and the woman's impulse is to push. She is not aware of what is happening so we encourage her to touch the partially out baby's head. There is no need to apply any oil to help the head come out because the water itself is doing that.
When the baby is born he goes from the amniotic fluid to the comforting tub's warm water. The umbilical cord, still intact, is still safely feeding the baby oxygen. The water protects the fetus in the expulsion phase, reducing the pressure's difference between the outside and the inside of the birth canal. The pressure exercised by the tub's fluid is, in fact, the best physiological support for the baby's head and can reduce the occurrence of an edema more efficiently than any other manual technique. Furthermore, the water reduces the need of oxygen and helps the fetus being expelled. Until the baby is submerged by water, he/she will not feel the need to breath, therefore no liquid will be inhaled. The umbilical cord will keep of functioning for a few minutes (four or five) without the risk of IPOSSIA (low level of oxygen).
Slowly the baby emerges from the water next to the mother: first comes the head then the rest of the body. The emerging sensation andthe difference in temperature - the water is 37 centigrades - stimulate the baby to breath.
Thanks to the lubricating action of the water on the PERINEO, in my experience, I rarely had to apply suture to it, even in the event of large babies who weighed up to 5 Kilos.
The technical requirements are similar to those of other types of birth methods. Drugs and IV tubes are available. The water is kept clean by frequently changing it and by a few drops of TINTURA DI CALENDULA. The tub can be installed in any delivery room. If space is a problem, a rectangular model can be used instead. This method of birth in water is used by other well-known gynecologists, among which Michel Odent, who uses common household bathtubs. In our experience with home-based deliveries, we prefer to use round mobile tubs, which give more comfort to the woman.

D. In conclusion, what are the method's principles?
R. Respect for the mother, at all times, for her pain, for her choice on how to expel the baby; love for the baby; involvement of the father during gestation time, delivery, and afterwards.
The relationship between mother and child is paramount. The psyche has a predominant role in helping hormones facilitate the production of milk. The mother's happiness is influenced by a less painful delivery. In the words of Lucrezio "may they have a serene delivery".
("Et partu possent ditescere dulci").





Prof. Giuseppe Grimaldi MD
Novara University

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