Help me decide about a water birth

[karatekimmi]

I'm 28 weeks pg with my first, and trying to decide my birthing plan. At my first mw appt I was told i had to go to the hospital at the next town as MLU at local hospital only and because my bmi is over 35 (37.4) I would have to go to the hospital where the consultant is. I wanted a water birth and was told no.

After speaking to the mw today she suggested another local hospital in the other direction ( same distance away, but different local authority) I phoned them and they said they'd be quite happy for me to water birth there.

So I phoned the first hospital and they said I could labour in the Pool but not give birth due to higher risk of shoulder dystoria (basically I think when the shoulders get stuck) but I shouldn't give birth in the pool.

I don't want to go against advice but the hospital where they would let me also has a consultant ward.

Is a water birth good and should I stick my neck out to get one? Or is the risk too much and should I not bother?

Thanks

Water birth would be my ideal. Couldn't last time due to premmie birth and lots of bleeding, but perhaps this time.... I think if you can get in the pool for the most part but then deliver out of the water then that would be the best of both worlds - you do want to consider what is best for your baby, and I think by that stage you'll probably not be caring anymore anyway Water is a really effective pain reliever and will help with the contractions and make you feel relaxed but as for the baby coming out in the water, not sure if it makes much difference... I could be wrong though!!

Yeah, I would like a water birth, but don't know if I'll want to get out to give birth? I suppose I need to chat with the hospital about when I would be made to get out?

Do they mean the risk of shoulder dystocia is higher in women with a high BMI or do they just not allow anyone to actually give birth in one. Fwiw, we were shown a birth pool on our tour of the MLU and I was horrified at the tiny wheeled steps that I need to climb to get in and out. I asked if people had problems and the midwife told me some do, but one of the reasons a high BMI stops people from having a waterbirth at my unit is the sheer difficulty of getting the women in and out of the pool. I'm in the healthy BMI category and tbh I pity the midwife who has to haul me out of there, it does look very very cumbersome.

I'd like to see them force you out of the pool if you decided you were giving birth in there and not getting out

FWIW, I am high risk (different reasons to you) and planning a home water birth. My baby is predicted to be big, I have discussed the risk of SD and the procedures they go through if it happens with the Supervisor of Midwives.

The main concern for her was will there be someone with me who can get me out of the pool if I need to get out, and DH is confident that he would be able to do so.

I think the risks of sd are higher with obesity, although according to an American site this isn't necessarily the case, and they can't monitor you as well ( although surely the case for normal people). Fwiw I am a fairly active fat person, I was still "running" albeit slowly and going to the gym till the mw told me not to four weeks ago.

Never thought about what would happen if I wasn't able to get myself out of there, but that would be an issue in whichever place I went.

I hated mine, was scared and the pain was like Dante's seven stages of hell. Had an epidural the second time. Pure bliss, baby out in two pushes. And I slept through labour. HTH

Epidurals increase the likelihood of shoulder dystocia.

Do the hospital discourage epidurals for women with high BMI? Bet not.

Re: waterbirth - you need to think through what your priorities are for the birth.

This is your first baby. Would you like to reduce the likelihood of an emergency c/s? Would you like to reduce the likelihood of needing forceps or ventouse? If both these things are more important to you than having really good pain relief, then go for a waterbirth in an MLU.

If your priority is having a high degree of pain relief, then go for an epidural.

If there is a risk for you / your baby I would advise against prioritising a water birth. I eventually got into the pool during the birth of my son, after what felt like hours of them filling it up. The steps (mentioned above) were a nightmare to navigate and I had to be virtually lifted out. I found the pool nice in theory and I too was keen for it, but it actually had no effect on reducing the pain for me and I demanded to be taken out and given an epidural! My husband and MW had to help me out of there. It provided a change of scene during a long labour though

I would think your risk of shoulder dystocia would go down being in the water as shagmundfreud suggested. I gave birth on my knees leaning over the side of the birth pool which just seemed the natural position to be in. This sort of position, rather than lying on your back (a la OBEM) helps your pelvis open to its full potential and gives the baby full room to get into a good position to be born in. Being on your back with an epidural means your coccyx can move back out the way and you're pushing up hill.
For what its worth, after giving birth I leapt out of the pool, holding the baby who was still attached by her cord, with no steps or anything - I felt great (everyone else leapt to catch me but I was fine). Would definitely recommend it

Sorry your coccyx can't move out the way

I loved my wb's. First one, I laboured but Ds was facing the wrong way, so had to have forceps delivery in the end, but with Dd, I gave birth in the pool and it was a wonderful experience.

If you want a water birth, I say go for it if all is well.

Should say 'I laboured in the pool, but had to get out to go to theatre'.

I had a water birth with dd2 and loved it.

however there would have been no way I could have got out of there mid labour. DP and the mw couldn't even get me to change position.

Everyone is different, but I found it really helped with the pain.

not heard the risk of shoulder dystocia before.

our pct is happy with waterbirths an d they actively encourage to use water for at least part of your labour.
it helps with pain relief.

Thanks for all your advice. I'm going to see the hospital which will let me water birth and see how I feel after that. I think I'm going to try and go for it.

Good luck karatekimmi :)