Pregnant women are outraged over controversial water birth ban in Victorian maternity wards – as midwives argue all mums deserve the ‘life-changing’ pain and stress relief
- Debate rages over moves to ban water births and showers for labouring women
- The Department of Health recommendation applies to COVID-19 hotspots
- It’s linked to concerns that wet PPE is ineffective at shielding medics from virus
- Midwives and expectant mothers are railing against the suspension
- Melbourne midwife Aoife Kenny argues all mums deserve access to water births
- Studies show immersion in birthing pools relieves pain and stress during labour
A ban on water births in coronavirus hotspots has distressed expectant mothers and ignited impassioned debate among medical professionals across the country.
Government advice to temporarily suspend water-based birthing techniques is linked to concerns that wet personal protective equipment (PPE) is less effective at shielding medics from COVID-19, leaving them vulnerable to contracting the virus.
But the controversial move, mooted by the the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), has been rebuked by the Australian College of Midwives as lacking in evidence and damaging to women’s health.
Irish midwife Aoife Kenny, who lives in Collingwood and works at a Melbourne hospital, argues all mothers deserve access to what she calls ‘life-changing’ pain and stress relief.
‘Water and birth are inextricably linked. Water simply makes us feel better,’ the 28-year-old told Daily Mail Australia.
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Irish midwife Aoife Kenny (pictured), who works in Melbourne, says water and birth are ‘inextricably linked’
‘If we think back to times where we’ve felt aches and pains, a warm shower or bath tends to save the day and wash away any stressors.
‘Water immersion is an incredibly useful tool in labour – it’s an effective form of natural analgesia [pain relief].’
Countless studies have shown that hot showers soothe pain for labouring women, while immersion in water during delivery can reduce the need for epidurals and other pain medication.
In fact, one of those studies was published by RANZCOG – the organisation advising the suspension of water-based services.
The recommendation initially included the suspension of hot showers, but following widespread condemnation the Victorian Department of Health clarified that showers would still be available in maternity wards.
RANZCOG study on water in labour
Healthy women with uncomplicated pregnancies may find that having a warm bath in labour helps with relaxation and reduces their need for other sorts of pain relief.
A warm bath increases relaxation and production of endorphins (the body’s natural pain relief hormone). It reduces the pain of contractions and the pressure on your pelvis and muscles.
Water immersion during labour leads to a reduction in the use of pharmacological pain relief and their associated side effects.
Source: RANZCOG ‘Warm water immersion during labour and birth‘ July 2017
Ms Kenny, who is offering support to expectant mothers during the pandemic on her Instagram account Back to Birth, believes the decision to deny women access to water births is rooted in fear, not evidence.
‘To be immersed in an intimate pool during labour is a magical, life-changing experience, both for women and midwives. Women deserve this experience,’ she said.
Australian College of Midwives midwifery advisor Megan Cooper agrees.
Ms Cooper told Daily Mail Australia that water provides a ‘sanctuary-like sense of safety, privacy and protection’ and called for access to be reinstated to protect women’s physical and psychological health.
Ms Kenny (pictured) believes the decision to deny women access to water births is rooted in fear, not evidence
‘While this situation is unprecedented, it’s important that we refrain from ‘blanket’ approaches that do not speak to the unique needs of each individual woman, especially when there is no solid evidence to support such directives or recommendations,’ she said.
Ms Cooper said stripping women of the choice to deliver in a birthing pool could have grave emotional consequences for mothers bringing children into the world at a time of unprecedented uncertainty.
Distressed women who have contacted the Australian College of Midwives with concerns about the ban are now exploring other options including publicly funded home births or care from a privately practising midwife, she added.
In its updated guidelines for Victorian labour wards under stage four lockdown, RANZCOG says ‘services are advised to suspend the use of water immersion for labour and birth for all women’.
The statement continues: ‘The protection of our maternity and neonatal healthcare workforce is essential.’
A woman queues outside a coronavirus testing centre at The Royal Melbourne Hospital on July 16, 2020, one week into the city’s second lockdown
Benefits of water immersion in labour
· Provides significant pain relief
· Reduces the need for drugs and interventions, particularly epidurals
· Encourages a sense of control in labour
· Increases satisfaction in labour
· Provides a feeling of weightlessness, reliving tired muscles and stress
· Accelerates labour
· Promotes relaxation and conserves energy
Source: Mater Mothers’ Hospital
‘Temporary guidance from Safe Care Vic for maternity providers and midwives advises against water births,’ it said in a tweet.
‘PPE is not effective when wet – safely caring for women in a bath presents an unacceptable COVID-19 risk for healthcare workers at this time.
‘Pregnant women are still able to use a shower. This guidance is being reviewed and updated weekly, and water birth will be available again when it’s safe for all involved.’
Meanwhile on social media, comments on the Instagram page of pregnancy podcast ‘Australian Birth Stories’ reveal a community split between wanting to support mothers and protect frontline healthcare workers.
‘From what I can tell this recommendation was made to minimise the risk of infection to healthcare workers as PPE is not as effective when wet. Surely there is a way around this?’ an Adelaide woman wrote under a post about the ban.
‘This pandemic has really highlighted the fact that pregnant women seem to be treated like a lower class within our society. Why is adequate pain relief in pregnancy seen by some as optional or unnecessary?’
‘If men gave birth I suspect this would not be the case.’
One mother-of-two said: ‘This is truly heart breaking. Makes me definitely think seriously about having bubs at home. Water plays such a big part of labour for so many women these days.’
Another first-time mother who welcomed her baby daughter after a 40-hour labour in June said she simply couldn’t imagine delivering having a birthing pool on hand.
‘This is this completely heartbreaking,’ she said.
A pregnant woman wearing a face mask walks past a street mural in Hong Kong on March 23, 2020, the day the Australian government ordered bars, restaurants and gyms to close to slow the spread of COVID-19
‘Even though it ended in an emergency C-section I look back on my labour as the most magical, life changing and beautiful experience of my life, all because I was immersed in an amazing labour pool and showers for most of it.
‘I couldn’t fathom going through the marathon of labour without water.’
A third said she would have been ‘absolutely lost’ without hot showers during two of her three deliveries, recalling: ‘I spent my whole transition [the final stage of the first phase of labour] in there.’
An expectant mother from Queensland whose September due date is fast approaching asked: ‘What more do they want to take from us?’
‘I’ve had it with people telling me what I can and can’t do for myself and my unborn baby,’ she added.
But doctors saw the situation from the other side.
Gold Coast nutritionist Ellie Bullen who welcomed her first child, son Bowie, on July 12 in the midst of the pandemic; Ms Bullen (pictured on May 24) used a birthing pool to soothe labour pains and said she ‘cried into a towel’ when she learned visitors were banned from hospitals
Obstetrician Dr Patrick Maloney responded by arguing that PPE ‘unfortunately doesn’t work if it gets wet’ – thus leaving maternity staff susceptible to the respiratory disease.
‘As an obstetrician I know that water is an incredible help during labour, I’m sad that the current use of water recommendation in COVID-19 hasn’t been communicated well and a lot of women are rightly stressed by this announcement,’ he said.
However Dr Maloney – who co-hosts pregnancy podcast ‘Grow My Baby’ with blogger and mum-of-three Bridget Jarrad – said people must also consider the risk posed to healthcare workers.
He pointed to the deaths of doctors and nurses overseas as a warning to Australian hospitals to avoid complacency and remain vigilant in protecting their staff.
A spokeswoman for the Australian College of Midwives criticised the decision to strip women of the choice to deliver in a birthing pool (stock image)
‘As a registrar (junior doc) was quoted the other day – he didn’t sign up to this job to die,’ Dr Maloney said.
‘Instead we will keep on working at a cost to our families and ourselves to help women have their babies safely and for us to go home at night knowing we get up and do it all again the next day.
‘We are all doing our bit. We are trying to support women as best we can in times that are unprecedented.’
An online petition opposing the water birth ban has exceeded its target of 25,000, with 25,584 signatures at the time of writing.
Daily Mail Australia has contacted the Royal Australian and New Zealand College of Obstetricians and Gynaecologists for comment.