10. Multiple pregnancy.
11. Babies who are estimated to be born premature (2 weeks more or before the time of confinement)
12. Condition that needs continual monitoring unless there is a condition where the waterproof transducers (Doppler) are available.
WATER BIRTH TECHNICAL ASPECT
Provision facilities and infrastructure of water birth in general can be adjusted with the place where water birth will be implemented. Clinics, hospitals and even at home can also be good settings for water birth as long as criteria is still met and the rules and guidelines are followed. Based on the above, the technical procurement of water birth that must be owned: 16
Technical procurements on hand:
1. Confinement pool 2. Water pump: electric water pump works more quickly than hand water pump 3. Water pipe: choose a quite long water pipe in order to reach water sources and confinement pool. 4. Faucet hose adapter: choose the adapter that is easily removed and not part of other circuits
Other suggested equipment:
1. Debris removal Net. It is normal for the mother to defecate during second stage of labor, in this case, use debris removal net to retrieve and dispose of it.
2. “Y” pipe adapter and End Cap to connect between Faucet adapter and water pipe.
3. Hand-held Mirror. Many women in labor who start to push in hands and knees position. This position makes the mother unable to see the baby when the baby is born. By placing the mirror at the bottom of the foot and the light to the mirror, the mother can see the birth process easily.
4. The lamp can be placed in the water directed to the mirror at the top so that the mother can see the birth process easily
5. Thermometer in the water. This device helps care providers to regulate water temperature.
6. Submersible water sucker. Portable sucker pipe means that pipes can be used to drain the pond without the need to find a power source.
7. Gloves of sufficient length to protect care providers while listening to the heart of the baby or checking dilatation.
In addition to standard equipment, some equipment below should also available in the water birth service: 12
1. Maternal thermometer. 2. Waterproof Doppler. 3. Water resistance cloth. 4. Additional that can help the mother out of the pool if necessary. 5. Knee bolster, cushion, low stool and birthing balls should preferably be provided so that care providers are comfortable (Burn & Kitsinger 2001).
In 1995, Alderdice et al., conducted research on 4494 retrospective confinement in the water made by midwives in England and Wales. They reported the deaths of 12 infants, 51 cases of illness (respiratory infection). However, the researchers concluded that no evidence found that confinement in the water is less safe than conventional labor 20 American Academy of Pediatrics 19 mentions that the safety and effectiveness of the baby in water birth cannot be confirmed. Meanwhile, the British Pediatric Surveillance9 mention deaths or the need for special handling of babies born in water from years 1994-1996. Some reports of cases 21 mention that there were sepsis of the baby because of pool contamination, but the numbers cannot be proven scientifically. Based on that, the procedure to maintain pool water cleanliness needs more attention by each provider of water birth.
Below are the procedures and guidelines quoted from the Australian government for the water birth: 12.
1. Clean portable swimming pools with disposable liners
2. In the practice of swimming pools, spa regimens should use solvents in jets, sucker pipes, pipes and filters. Between births the tub must be cleaned by using liquid Chlorine each time it is used. 3. Cleaning fluid is a liquid that is commonly used in hospitals or who has received approval by the local organization. 4. Birth tubs should be dried under the air. 5. Birth tubs before re-use should be cleaned again. 6. Reinforced with routine maintenance. 7. Routine testing is done for Legionella in hospital water supply where the test bacteria is adjusted to the recommendations of local government.
Controversy about water birth has been around since 1723. It cannot be not separated from the various research results that have been conducted by various researchers in various countries. In fact this method is widespread and popular in the community. Use of analgesia during labor is low and comfort earned by the mother during childbirth is a strong attraction for the candidates and the water birth services. Quality improvement and standardization of services in accordance with guidelines is the key to comfort and safety of this technique. Therefore, researchers should continue to seek accurate information so that hey may develop reasonable guidelines for water birth. Valid research, of course, is supported by good research methods and controls. Hopefully in the future with the increasing number of randomized and controlled trials we will be able to improve the scientific assessment of water birth. In summary water birth can be one of the best methods of childbirth sought after by expecting family”s aiming for baby”s gentle landing on earth.
Warmly
Yesie Aprillia S.Si.T, M.Kes