18 Aug 2009, NST
By Suzanna Pillay
SHE may not be Malaysia’s first, but little Neena Ruth Mia Cheryan made history of her own earlier this year when she was born on June 14. She became the first baby to be delivered via water birth in Kuala Lumpur.
The water birth method is where a mother is immersed in warm water (equivalent to normal body temperature of between 35°C and 37°C) for some part or the entire part of her labour and delivery.It is a simple birthing option for low-risk mothers with uncomplicated pregnancies.
Joanna, who is married to a Malaysian, is a member of the Gentle Birthing Group, a support group in Kuala Lumpur for natural and water birthing.She delivered her first child via water birth in the Netherlands. Neena is her third child. Her second child was delivered normally, as at that time water birth services were not offered in Malaysia.
Besides having mothers share their water birth experience, the forum, which was held at the hospital, also included talks by practitioners about the safety, benefits and risks of water birthing, and the current practices around the region.
Vanessa Beyer is a certified professional midwife and doula from the United States. Beyer, who welcomed her son via water birth earlier this year, spoke about the benefits to the mother."She will still feel contractions and pain but the process is bearable. The water birth experience is gentle and empowering for the mother.Where a pregnant mother finds it cumbersome to move about because of her size, she can move about easily into any position in water because of its buoyancy.”
Apart from greater comfort and mobility, another advantage about water births is that not only do they reduce the need for drugs and intervention, they also promote relaxation and give the mother more control.
The mother has her own private, protected space which encourages an easier birth and a gentler welcome for the baby. Other benefits are that a water birth speeds up labour, reduces high blood pressure caused by distress, perineal trauma and eliminates episiotomies.
PHKL consultant obstetrician and gynaecologist Dr Choong Kuo Hsiang who assisted Joanna with her water birth said most women who have had water births are likely to opt for the method of delivery again, if given the option.He has performed two successful water births at PHKL.
He said mothers are usually introduced into the birthing pool when their contractions are well established and they are in advanced labour. They are also free to move in and out of the pool, and if they are trying the process for the first time and are not comfortable with proceeding with a water birth after a few hours in the pool, they can opt for a normal delivery.
There are two aspects to water births, said Dr Choong. “Some mothers use it for relaxation or comfort until normal delivery, or they go the whole way and deliver in the water.” Although water births are safe, there is a very minimal percentage of risk which include possibilities of drowning, water inhalation, infection, cord avulsion and water embolism. Risks usually arise if the procedure is performed incorrectly or if the mother has some complications with the pregnancy. Therefore, water births are only suitable for mothers with healthy, normal, low risk pregnancies.
The procedure may not be an option:
● if the baby is in a breech position
● in the case of shoulder dystocia (when one shoulder is preventing the baby from birthing)
● the baby has an irregular heartbeat
● in cases of multiple births or IVF babies
Mothers who have undergone C-sections, have high blood pressure or other complications are also excluded. Water births are also not suitable for parents who wish to store cord blood stem cells as the practice is to cut the umbilical cord later to establish proper respiration in the baby first “and there may not be enough cord blood left”.
In the United Kingdom, The Royal College of Obstetricians and Gynaecologists endorses the use of water in labour provided that there are suitably trained attendants to assist the women who opt for water births. However, it noted, that there may be rare but significant risks for the baby to be born underwater and mothers who choose this option should be screened for any complications and informed of the risk. Water births are offered in 64 per cent of hospitals in the United Kingdom.
In Singapore, the National University Hospital welcomed its first water birth in April 2006.The American College of Obstetricians and Gynaecologists has not taken any official position on water births as it feels more research in the area is required.
Despite this, Dr Choong said that as of 2005, 300 hospitals in the US offer the option.Dr Narinder Singh Shadan, who performed the first water birth delivery in Malaysia on Feb 14 last year, said water birthing is not for everybody.
“It’s a choice some mothers’ make. There is a group who wish to do things the natural way. People who choose it are those who do not want intervention or medication.
“The water process relieves anxiety and pain during labour. Mothers who opt for it are usually prepared for the process, have read up on it and know the journey they will be embarking on.”
In Malaysia, the practice is for interested mothers-to-be to approach their gynaecologist to ask for water births. The doctors will assess whether the pregnancy is safe and if it is possible to go ahead with a water birth.
“Age is not a barrier in water delivery provided there is low risk to both mother and baby, and there are no complications up to the time of labour.”
Dr Narinder said after handling his first successful water birth in Malaysia at Island Hospital there were plans for six more waterbirth deliveries. However, labour being a dynamic process, three had to opt for another method of delivery. So far there will be one water birth due at the end of this month.
