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I get it: you like your water birth…but here’s why I don’t recommend them

Not too long ago, we ran an article on the dangers of water births, after the Centers for Disease Control and Prevention (CDC) identified two cases of Legionnaires disease in babies delivered through a water birth. The infection was linked to contaminated water in the birthing tubs.

Since multiple medical organizations, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG), have already stated that they do not support water births (they say laboring in water may be acceptable), this recent news didn’t change their positions.

When this article was posted on Bundoo’s Facebook page, the response was overwhelmingly against it. Reader comments ranged from, “I had a water birth and my baby was fine” to, “This is just Big Pharma trying to profit off of giving birth in a hospital.”

So I thought I’d step in and take a stab at addressing this.

I want our readers to know — especially those who responded to on our Facebook page — that I hear you. I get why you might be suspicious of the birthing industry. Not too long ago, all women who gave birth in a hospital were sedated. Almost all had forceps deliveries and episiotomies, most of which were unnecessary. Babies were whisked away to nurseries for hours at a time. Formula was pushed heavily. A generation stopped breastfeeding, which left no one to help the mothers who actually wanted to nurse.

I’d be suspicious too, except as someone who is now part of the birthing industry as an obstetrician, I can confirm these antiquated mindsets are for the most part in our past. We realize that our C-section rates are far too high, and ACOG and other organizations have worked tirelessly to issue better guidelines about letting labor last longer and being more patient before recommending a C-section. We’ve set goals to lower our rates, and hospitals’ C-section rates are now closely monitored.

Routine episiotomies are a thing of the past. Breastfeeding is thankfully getting the attention and resurgence it deserves. Baby-friendly hospitals are growing by leaps and bounds, and our national breastfeeding rates are going up.

Rooming-in, delayed cord clamping, skin-to-skin … these are all the norm and expected at many hospitals across the country. For those who haven’t caught on, I think it is just a matter of time as more supportive data continues to come out.

So, back to water births. Does ACOG or the AAP support them? No. Am I going to recommend a water birth? Not yet. But am I going to still care for you if that’s what you’ve chosen and refer you to someone who does offer water births? Of course.

You see, I get your perspective, and I know you just want the best birthing experience for you and your baby. I’ve done it twice myself: once medicated and once unmedicated, so I can say I’ve been there and done that.

I can see that you think me recommending against a water birth is me trying to get you to deliver in a hospital so I can make more money. But most of us don’t do this for the money. Many of us are salaried, and it doesn’t matter how you give birth.

It comes down to this: if there is no data that a practice is better and there is evidence there is harm, I am not going to get behind that practice. Water births currently fall into that category, but if the data changes you can bet I’ll get on board. Not too long ago, I was trained to not perform delayed cord clamping because it increased a mother’s risk of bleeding. So I didn’t do it. Then data came out that that wasn’t true, and it was actually better for babies. Now I absolutely do it.

Most doctors are humble enough to change their practices once studies and data and science have shown them newer ways are better. Those that don’t are the outliers. And hopefully with closer monitoring of quality measures such as primary C-section rates, breastfeeding initiation in hospitals, and skin-to-skin rates, those doctors will be pushed into getting in line with current practice patterns.

So when it comes to hot button issues like water births, home births, vaccines, and more, I absolutely respect your right to disagree with me. However, please don’t think I’m doing it because of money or Big Pharma or the anecdotal “but I was fine.” Let’s agree to disagree, but respectfully, knowing we all want the same thing: healthy families.

Lastly, let’s keep fighting to keep organizations funded that can continue to keep medicine evidence-based with the latest data and healthcare that is available to everyone, since that is what this country’s smallest citizens really need, regardless of the way they are born.

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