Reminder to all colleagues who are collecting data for third degree tears and waterbirths – observational survey concludes end of June 2016

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REMINDER to all colleagues who are collecting data for third degree tears and waterbirths – observational survey concludes end of June 2016
Newsletter June 2016
Travelling out to Hyderabad in August to open and speak at the new birth centre

Review my web site and next newsletter for more information about the wonderful work that Vijaya Krishnan Director at Healthy Mother Wellness & Care and her colleagues are undertaking and supporting.

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How valid are the common concerns raised against water birth? A focused review of the literature

12 May 2016: Sourced from MIDIRS Reference Database

Young K; Kruske S, (2013). Women and Birth: the Journal of the Australian College of Midwives , vol 26, no 2, June 2013, pp 105-109.

BACKGROUND: Women have birthed in water for many years, with researchers finding a number of benefits for mother and baby.

Despite these benefits, many health institutions and clinicians are hesitant to support women’s access to water immersion in birth for a number of reasons.

As such, this paper aimed to (1) select five common concerns raised against water birth and (2) examine whether research supports these concerns as being evidence-based.

METHOD: A literature review was conducted to (1) select the concerns for review and to (2) review each selected concern as to whether they were supported by the current evidence.

A recent review of women’s access to, and uptake of, water immersion in Queensland, Australia, was also used to determine the concerns for review in order to better capture concerns relevant to Australian practice.

FINDINGS: Three clinical concerns were selected for review: water aspiration, neonatal and maternal infection, and neonatal and maternal thermo-regulation; and two concerns around the practice of water birth were selected: skills and education of workforce, and emergency procedures in case of maternal collapse.

The three clinical concerns were not found to be supported by the available evidence and the two practice concerns can be addressed by appropriate policy, guidelines and practice.

CONCLUSION: The reviewed common concerns against water birth are not evidence-based nor are they sufficient to prevent women from accessing the use of water in labour and birth.

Health institutions and clinicians should ensure they take adequate precautions to enable women access to this valued and effective method of birth.

EastEnders' James Bye opens up about 'amazing' moment he helped with son's water birth

EASTENDERS actor James Bye has spoken out about his newborn son's water birth, with him going into detail about the "amazing" moment the little one came into the world.

By Becca Longmire

PUBLISHED: 11:39, Tue, May 3, 2016 | UPDATED: 11:55, Tue, May 3, 2016

Botched Water Birth Results in Biggest Malpractice Settlement in 10 Years

Most water births are successful, but sadly, this one was not.

According to a recent study, most water births are successful. But for one Oregon couple, whose water birth was botched by midwives, a settlement of $13 million is a small consolation for the life-long difficulties their son now has to live with. This sizable settlement marks the largest in 10 years for a hospital birth malpractice case, according to The family's lawyer Rich Rogers says in 2011, Amy Benton was told by midwives at the Legacy Emanuel Medical Center she was an ideal candidate for giving birth in the water. "And they actually told her that it's just as safe and even more safe," he says. But the lawsuit claims Benton was not an ideal candidate given that Luca's fetal heart rate was abnormal upon her admission into the hospital.

Still, they proceeded with her planned water birth, and because she was in the tub, midwives did not monitor the baby's fetal heart rate. The suit alleges that if they had, they would have realized there was a problem, and given Benton an emergency c-section. Instead, Luca was delivered vaginally, but as Rogers says, it was too late. Baby Luca was deprived of oxygen for 15 minutes. The suit also claimed the Benton and her husband Matthew Marino were told doctors would be consulted during the delivery, but in fact, they were not.

Four years later, Luca is left unable to walk or talk, having been diagnosed with birth-induced cerebral palsy. Rogers explains his abilities further, saying "He makes cooing sounds. He smiles brightly. He loves attention. If you walk into the room and you say 'Hey, Luca!' He smiles."

The Marino's initial lawsuit sought $36 million, and cited a 2014 joint statement from the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists on the topic of water birth safety. In that statement, the American Congress of Obstetrics and Gynecologists (ACOG) says being immersed in water during early labor can be beneficial for women with regards to decreased pain from contractions. However, the organization is quick to note no benefits have yet been found to delivering a baby in the water, and that the practice can be risky.

That being said, or course water birth is increasingly popular in the U.S., and women who have chosen one would tell you there are many benefits to the experience. If you plan to have a water birth, it's important to follow these safety tips:

  • Only consider a water birth for an uncomplicated pregnancy, that is not considered high-risk.

  • Deliver your baby in the presence of a trained medical professional, or midwife.

  • Make sure the tub is clean, and well-maintained.

  • Allow for the monitoring of you and your baby the entire time.

  • Have a plan for what to do if a complication arises during your birth, and you must be moved to a bed, or a medical facility in the case of a home birth.

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Water Birth Craze: Does Giving Birth In Water Harm Newborn Babies? By Samantha Finch, Parent Herald | May 6, 5:19 AM

Giving birth underwater has become an increasingly common fad among pregnant women. The process veers away from the traditional birth experience in hospitals, making the experience more unique and exciting. The only question, however, is whether water birth is safe for newborn babies.

Water Birth Is Safe After analyzing information from 29 previously published studies, researchers found that there isn't a huge a difference between traditional delivery methods in hospitals and water birth, Reuters reported. The studies didn't report differences in complications, infant mortality and admissions to intensive care.For water birth, women deliver their babies in a pool of warm water. The warm water comforts and relaxes mothers and boosts their energy in the early stages of labor. The water's buoyancy also gives better uterine contractions and blood circulation, which means mothers experience less pain and the newborn have more oxygen, according to the American Pregnancy Association.Being soaked in a tub of warm water also lowers mothers' need for anesthesia. However, some experts not involved in the study argued that water birth could have serious complications for the newborn baby.

Health Risks For The Baby Dr. Amos Grunebaum, high-risk pregnancy specialist and director of obstetrics at the New York Weill Cornell Medicine, said water birth delivery poses health threats to newborns such as infection, pneumonia and seizures, Reuters listed. Grunebaum insisted that the popularity of water birth doesn't mean that it is safe or beneficial to both the mother and baby.Like Us on Facebook The recent study, however, argued that babies born underwater have higher Apgar scores. The quick test is performed on babies at one and five minutes after birth, and records breathing, heart rate, muscle tone, reflexes and skin tone.

Giving Birth With Dolphins Around 7,000 women in England and Wales have given birth underwater, the Independent wrote. Some women, however, are more adventurous with the practice and have chosen to give birth underwater while surrounded by dolphins.The Dolphin Attended Water and Natural Birth Center at Hawaii's Sirius Institute is one of the establishments offering underwater birth delivery while surrounded by dolphins. They believe that dolphins are capable of healing numerous medical conditions, and so their presence alongside women giving birth has huge benefits.Dr. Christie Wilcox, a science journalist and evolutionary biologist, said giving birth surrounded by dolphins is one of the worst natural birthing concepts, the Independent reported. Wilcox said male dolphins' unpredictable and aggressive attitudes could give harm to the mother and newborn. She added that both people and animals can acquire infection and injury in this program.

Is water birth safe for babies?Thursday, May 05, 2016 11:28 a.m. CDT By Lisa Rapaport

(Reuters Health) - Giving birth in water is becoming more popular, particularly among women seeking an alternative to a medicated or hospital birth experience. But a new review finds little evidence on whether this option is good for babies. Researchers analyzed data from 29 previously published studies and found no significant differences between water births and other delivery methods in terms of complications, infant mortality or admissions to intensive care. Most of these studies were small, however, and didn’t show any advantages of water births, either.“The notion that it is safe to have the baby under water has not been shown as safe or unsafe in our review,” said senior study author Dr. Alastair Sutcliffe, a pediatrics researcher at University College of London Hospitals in the U.K. “Whilst it is a good plan to try labor in water, my advice is to wait until there is more convincing evidence of safety before having the actual delivery in water,” Sutcliffe added by email. For mothers, laboring in a pool of warm water can help ease pain, lower the need for anesthesia and potentially speed up the early stages of labor before the cervix is fully dilated and the baby is ready to emerge. Once it’s time to push, however, the benefits are unclear.

About 9 percent of babies in the U.K. were delivered under water last year, Sutcliffe and colleagues note in the Archives of Disease in Childhood – Fetal and Neonatal Edition. In the U.S., however, the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics recommend against underwater deliveries due to potential complications for babies such as infections, breathing difficulties and drowning (

To assess the risks and benefits for babies, Sutcliffe and colleagues looked at data from studies that, combined, included about 39,000 births. All of these studies were done in hospitals or birthing centers. Most were small observational studies with brief follow-up periods, and many were limited to women with uncomplicated, low-risk pregnancies.

The studies did point to one possible advantage of underwater delivery – slightly higher newborn Apgar scores, which measure heart rate, breathing, muscle tone, reflexes and skin tone.But because most studies didn’t randomly assign some women to water births and others to more traditional deliveries, it’s impossible to conclude that water births cause higher Apgar scores.

“There is no evidence that delivering underwater has any benefits and the authors of this study fail to acknowledge a benefit other than to mention that whales and dolphins give birth under water,” said Dr. Amos Grunebaum, director of obstetrics at New York Weill Cornell Medicine. “Just because something is popular does not mean it’s safe or has any benefits,” Grunebaum, who wasn’t involved in the study, added by email. “In fact, there is plenty of evidence to suggest harm like infections, seizures and pneumonia in the (infant).”

SOURCE: Archives of Disease in Childhood – Fetal and Neonatal Edition, online April 28, 2016.

All in a day's work? YouTube couple with no inhibitions share video of their son's natural water birth in a very candid clip - less than a year after filming their ectopic pregnancy

Family bloggers Dan and Elle Lindquist documented the birth of their second son Cohen from the start of contractions through to the birth

  • The husband and wife, from Toronto, Canada, opted to have a natural unmedicated water birth in their tub at home

  • The video of Elle giving birth, which they filmed for their YouTube channel, The Lindquists, has been watched more than 1.2million times

  • Afterwards, the natural birth advocate claims she felt so good that she could 'run a marathon'

By Miranda Bryant For May 2016

The Hindu India April 2016

Nithyakala and her husband K. Karthik had never heard of water births until a few months ago. “But once the hospital told us this was an option, we looked it up online, watched dozens of videos and decided to opt for it,” said Karthik. One appealing factor was the pain relief and the non-usage of drugs, he said. Antenatal class, a couple of aqua natal classes and a lot of training in exercises later, the couple were comfortable with the idea. For Valarmathi, the motivation was different – she’d had her first child through a C-section, and wanted the second delivery to be normal – the water birth, seemed like a good option.

“With an increasing number of births happening through C-sections and women even opting for them, I wanted to encourage normal, natural births. Our grandmothers gave birth naturally, many of them in the squatting position, with no drugs. The water births are a step towards that – no drugs are used, and the labour takes place is a pool filled with temperature-controlled water. Trained professionals supervise the procedure. And we also involve the husband to a large degree – it creates a lovely bond between the parents,” said Dr. Gautham. Jaishree Gajaraj, senior obstetrician and gynaecologist said water births were excellent for the first stage of labour but some care was needed for the delivery under water. “Obstetricians and midwives have to well versed with the method, as there is a risk of the baby aspirating. No analgesics can be provided to the mother and it’s also difficult to support her, so there is a possibility of bad perineal tears. If more obstetricians and midwives were trained in it in Chennai, it would be a good birthing option,” she said. Sumana Manohar, consultant obstetrician and gynaecologist at Apollo Hospitals said she would recommend water births for low-risk patients, not high risk ones. “The patient has to be constantly supervised. I would also recommend it for the first stage of labour,” she said.

March Birth centre should be developed USA    

Editor: As a follow-up to Rayna Tupper’s letter Re: Tubs needed for delivery rooms, I would point out that the hospital’s administration is predictably following the industrial birthing model that is gaining momentum across North America.In April 2014, the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) stated that immersion in water during the second stage of labour (i.e. underwater delivery) has not been associated with any maternal or fetal benefit.In fact, they stated that there have been case reports of rare but serious adverse effects in the newborn, and, therefore, the practice of underwater delivery should be considered an experimental procedure done within the context of an appropriately designed clinical trial.

Despite the considered and reasoned protests from midwifery organizations whose members have conducted countless successful underwater deliveries for decades, hospitals all over the U.S. began suspending or shutting down their water birth programs. This despite the fact there are scientific studies that contradict the conclusions of the ACOG and AAP on this matter.

March - Birth underwater can sooth the mother, but raises worries about newborn safety

Posted Diane Dietz USA March 2016

There’s no consensus on an issue with implications for Oregon, which has the highest home birth rate of any state

Oregon State University associate professor Melissa Cheyney tried to demonstrate the safety of water birth, for example, in a study she published recently in the Journal of Midwifery and Women’s Health

The study was large — 18,000 births, with 6,500 in water — but the study included only voluntarily reported births by a self-selected group of midwives to the Midwives Alliance of North America — and Cheyney isn’t a neutral observer. She’s chairwoman of the group’s ­research division.

March- Photos: Home water birth of twins with one born en caul
Melissa Willets

posted: March 6, 2016, 6:12 am

It’s easy to see why this image taken by California-based birth photographer, doula, and placenta encapsulation specialist Robin Baker was one of the 2016 International Association of Professional Birth Photographers’ 2016 Image of the Year Competition winners.

March -Water birth less stressful, say City docs

Hyderabad: City doctors talk about various delivery options on the occasion of International Women’s Day, which will be celebrated on Tuesday. There are latest trends in which we can modify the existing delivery patterns to make it more comfortable for the mother as well as baby. This is also called as assisted delivery. Citing few of the latest techniques, consultant gynaecologist and obstetrician at Apollo Health City Dr Vimee Bindra said, “Some of the latest techniques include water birth in which the patient experiences a part of labour or delivery in warm water.Giving birth under water may be interesting to you as it is less stressful for the mother as well as the baby. It’s easier to move inside water as compared to movements on bed so it may make the labour little less painful as compared to normal labour without water. Painless labour or epidural analgesia is a way of providing pain relief during labour. An injection is given in epidural space in the back that delivers continuous pain relief to the lower part of the body while you remain fully conscious.

It decrease sensation but doesn’t result in total lack of feeling.” Sharing few pointers about the advantages of choosing few techniques, she said, “Advantages of epidural analgesia are that it provides effective pain relief. The dose, amount and strength of analgesia can be controlled. Medication does not reach the baby as it has local effect and in case of emergency, analgesia can be converted to anesthesia for cesarean delivery anytime.”

Speaking about the other methods, gynaecologist Dr D Padma said, “Vaginal delivery is the most common route of delivery and cesarean section which is a way of delivering baby abdominally can be used as an emergency procedure. Both are most common delivery options and it is important for women across the city to know the choices available to them as they should choose what is best for them.”

Study days are run throughout the year in various localities – these are usually open to external candidates although they maybe limited to the host trust or company. Many are also open to doulas as well as midwives and students.

International/UK study days 2016/17

Study days are run throughout the year in various localities – these are usually open to external candidates although they maybe limited to the host trust or company. Many are also open to doulas as well as midwives and students.

9th January – Dartford Kent – open to externals -

20th Feb.-Medway RCM – details below

24th Feb – Harrogate – open to externals

29th Feb- QE Woolwich – not open to externals

1st March – ½ day Homerton not open to externals

16th March – Whittingdon –open to externals

16th June – Cambrils Spain – details on request

18th/19th June – Castellon Spain – details on request

29th June – Keynote speaker Carmarthen Wales

2nd July – Bournemouth –open to externals

19th July – Croydon –open to externals

30th July – East Surrey –

7th August – Hyderabad India – awaiting details

24th August – Bracknell -

21st – 23rd Sept. – Birthlight conference –

10th/11th October – Switzerland – awaiting details

18th Oct. Nuneaton – not open to externals

19th /20th Oct.- Florence Italy - Childbirth in different Cultures and Religions.- awaiting details

2nd Nov- Bristol- not open to externals

5th Nov. – Cardiff Uni.- open to externals

12th Nov.- Birmingham details

15th Nov. Hull and East Yorks.- awaiting details

26th Nov. Queens University Belfast – Sarah Curran []

2-3rd Dec. Czech republic –details Zuzana Stromerova


2nd- 5th Feb.Mumbai India + Human rights and childbirth conference -

5th May – Cardiff Wales – awaiting details

18-22 June ICM Toronto Canada

Alternatively why not consider hosting your own day – details of costs/ venue and lecture requirements on request. These can often be run by trusts/ RCM local branch/ student unions, antenatal / doula educators and may generate useful income for the host.

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