Watch a mom of three give birth to her fourth child underwater, in a special tub made for birth.
Video note: Contains medical situations and nudity. If you’re in a public place, consider watching it later.
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Narrator: We women love our tub time, and Mary is no exception. As a labor and delivery nurse, she's seen the best and worst of birth. For her, warm water is the ultimate pain reliever during labor.
Mary: I want to use the water to help me cope naturally with the contractions or the surges and to help me deliver the baby in a more calm environment.
Mary and Dean tried water birth for the first time with their daughter Aubrey's delivery. The experience was so positive they're headed to the tub again for the birth of their fourth child.
Mary: I will have two by land and hopefully two by sea.
Midwife Karen Shields: Baby's head is right here. Perfect position for labor, which is great.
Mary: Good girl!
Midwife: A water birth is my favorite way to catch a baby.
Narrator: Karen Shields, Mary's midwife, has delivered over 200 babies in the water.
Midwife: Everything has to be going terrifically for the baby to be born in water, as you know.
The baby's heartbeat has to be what we call reactive, which means that the baby's, when the baby moves, the heart rate goes up. And there's no areas where the baby's heart rate is going down and that your blood pressure's normal and everything's good.
Narrator: You should not attempt a water delivery if you have high-risk prenatal issues such as diabetes, high blood pressure, or preeclampsia; you plan to use any pain medication; or your labor will be induced.
While laboring in a warm tub has become more acceptable as a way to cope with pain during labor, actual underwater birth is still unconventional and considered risky. It's not recommended by the American College of Obstetricians and Gynecologists.
If you're considering a water birth, talk to your caregiver about the risks and benefits.
It's important to decide in advance what tub you'll be delivering in. You can use your bathtub if it's big enough, but most women either buy or rent a special birthing tub. Ask your midwife what she recommends.
Mary will be using a tub at the New Jersey Hospital System -- Elmer that's specifically designed for water birth. This tub keeps the water warm and has three access points for getting in and out in case of an emergency.
After a long wait, Mary's labor kicks in ten days after her due date. It's 9:30 p.m., and her water hasn't yet broken.
Midwife: You're about 80 percent thinned out.
Mary: Yes, we got our 80, girls.
Narrator: Mary is using HypnoBirthing techniques, dim lights, and soothing music to stay relaxed and get through her labor. After four and a half hours, Mary has progressed to 7 centimeters. The birthing tub is prepped.
The midwife breaks her water with an amni hook. This is done before entering the tub to make sure the amniotic fluid is clear and free of meconium.
The safe and comfortable water temperature for mother and baby is between 98 and 101 degrees.
While Mary's in the tub, she moves into the transition stage of labor. This is the most intense part of labor, but the water seems to be helping.
Midwife: It helps her mobility. It helps prevent tearing. It helps the mother's blood pressure be lower. And just really gives her an overall feeling of comfort and relaxation.
Narrator: The baby's heart rate is monitored underwater. It's hard to believe Mary is just minutes away from giving birth.
The mood is calm and peaceful, and Mary gently rocks her hips as she focuses on her baby descending into the birth canal.
Mary gets in position to deliver. Two nurses hold her legs back as the baby's head begins to crown.
Midwife: OK, I want a big push this time.
Narrator: With the next push, the baby's head is visible.
The midwife quickly lifts the umbilical cord, which has wrapped around the baby's neck during delivery and makes her appear bluish.
While she's underwater, the baby is receiving all her oxygen through the umbilical cord.
The midwife holds the baby's head for the final push.
Midwife: Here we go…
Narrator: Mary and Dean's baby daughter Ashlind is born.
In seconds, she's brought to the surface.
Midwife: Hi, beautiful. Let's float her a little.
I think the reason I like water birth so much is the baby's reaction. They come out so calm and relaxed. Their whole body just unwinds, and you can see the stress just leave them.
Narrator: Parents often wonder why a baby born underwater doesn't swallow the water or, even worse, drown. [Midwife] Karen Shields believes babies have an innate ability to avoid this.
Midwife: There's what's called the natural dive reflex in babies, and that is so they don't take a breath underwater.
The stimulus for a baby to breathe is atmosphere or air on the cheek. That is what makes the baby take that initial breath.
Narrator: The umbilical cord reacts to the air as well.
Midwife: Until the cord comes up and is actually hit by the air, that's when the cord constricts and the blood flow is stopped to the baby.
Narrator: In two minutes, Ashlind, covered in vernix, is breathing on her own, and Dad cuts her cord.
Mary gave birth to a healthy 8 pound, 15 ounce baby.
The water birth was everything she hoped it would be.
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ACOG. 2012. Committee opinion 679. Immersion in water during labor and delivery. American College of Obstetricians and Gynecologists. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Immersion-in-Water-During-Labor-and-Delivery [Accessed October 2016]
Harper B. 2014. Birth, bath, and beyond: The science and safety of water immersion during labor and birth. Journal of Perinatal Education 23(3):124-34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210671/ [Accessed October 2016]
Thoni A, et al. 2007. Giving birth in the water: Experience after 1,825 water deliveries. Retrospective descriptive comparison of water birth and traditional delivery methods. Gynakol Geburtshilfliche Rundsch 47(2):76-80. https://www.ncbi.nlm.nih.gov/pubmed/17440268 [Accessed October 2016]