Welcome to another Midwife Motivation Monday, the place to get midwifery mojo back. This job can give you some of the best experiences of your life - but it can also be very hard work at times! On MidwifeDiaries.com, Monday is the day I try to write to give myself (and hopefully you!) perspective on how important and valued midwives really are.
I hope the last 7 days have been good to you midwifery wise. I hope you've had happy precipitate primips coming out of your ears, and exclusive breastfeeders, and magnificent multips. I hope the documentation wasn't too bad, and I hope you had good camaraderie with your colleagues. Or if you're studying, I hope you've got good assignments you can see the point of. Ones that will help you look after the women!
I've had a couple of quiet shifts, just nice interaction with clients, catching up on sleep and then.... one lovely water birth! My favourite. I trained for a while in a birth centre where 40% of women gave birth in the water. Water births are sometimes referred to as a 'midwife's epidural', and you just have to see a few of them to know why.
You can take a terrified, pain stricken, labouring woman, who doesn't want pain relief but doesn't see how she can go on. She might be in a difficult place mentally. Or she might be very young and unsupported. Or the baby might be presenting in a difficult position. I've seen all of these women get into the water and their faces sort of go 'Oh! This is why water births are popular', and then go on to have nice normal vaginal deliveries.
Midwives and water births go hand in hand. We should be really proud of our part in them.
If care was obstetrician led, like in America, I'm pretty sure waterbirth wouldn't be an option for most women in the UK. In fact the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP) have as of two months ago issued a statement saying water births are an 'experimental procedure that only should be performed within the context of an appropriately designed clinical trial with informed consent'.
But over in the UK, the Royal College of Midwives (wahoo!) and the Royal College of Obstetricians and Gynaecologists (thanks guys!) have offered a joint statement supporting waterbirth for low risk women. They unequivocally say the evidence points to more normal vaginal birth without epidurals of water immersion is used. They also say that ACOG's statement was 'disappointingly biased' and 'partially incorrect'.
Although Michel Odent is the father of modern waterbirth, it was the midwives who applied his ideas and research throughout. Without grassroots midwifery, water births would never have reached a 40% of births rate in any of the small midwifery centres around the UK.
Now don't get me wrong, I like clear, objective research results. And water births certainly don't have as much research supporting them as I would like. There are important things to discuss with parents making an informed choice like unknown levels of infection, what happens if a baby is compromised, and in what circumstances water births are a dangerous option.
But according to this Cochrane review, the side effects and causes for concern appear to be minimal. It's also important to note water births decrease the use of epidurals, which in turn reduces the need for instrumental births.
Surely in a financially struggling area of care we should be proud midwives are skilled enough to support women in labour using an unbelievably cheap resource: water.
But we certainly haven't in my opinion come up with a way of improving normal vaginal birth.
That's where a midwife's role comes in. We spend time with the women and we know what works to get a normal vaginal birth. This knowledge has allowed us to fight for the right of women to have water births.
The water births that I have been privileged to attend stick in my mind as my favourite midwifery moments. You can (and should) read endlessly about the benefits of waterbirth because they feature midwifery centric skills.
Things like, leaving the woman alone to get into her own comfortable rhythm with contractions. It makes it much easier for a woman to do this in warm water. Both because it's oxytocin inducing and because she has a barrier between her and everyone else in the room. Mammals like quiet and calm to give birth. Basically, women who use the pool end up with a moat around them protecting them from unwanted intervention!
I'll leave you with a video from 'One Born Every Minute' of a waterbirth. It looks to me like quite a quick birth but the baby is still pretty relaxed compared to a land birth, just a couple of quick squarks and then she's happy having a cuddle.
Water Births are so important and intriguing that I have no doubt 'Midwife Motivation Mondays' will feature again! So consider subscribing if you want Motivation to come straight to your inbox every Monday.
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Have a wonderful week, whatever you get up to, and please share this article around if you enjoyed it!