Waterbirth: A Social Phenonemon

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 1987
Judith Elaine Halek

Twelve years ago, if I was to mention waterbirth to someone on the street, or a pregnant couple I was working with, most would not know what I was talking about. Now, in 1997, after two International Waterbirth Conferences, media exposure from two segments of 20-20, 60 Minutes, two programs of the Phil Donahue Show, an accidental water birth in a bathtub mentioned on the Oprah Winfrey Show, a Good Morning America segment, America’s Talking; Alive and Wellness highlight, numerous articles and countless parents choosing this alternative approach to childbirth, water birth has become a household term.

In 1985 you could count on one hand the number of books and video tapes available on the topic. Now, you’ll need your other hand, both feet, a friend’s set of limbs and possibly another set of limbs from the community of people, to count the information available. Bibliographies, medical protocols, world wide web are overflowing with information. As with everything that’s alternative and unfamiliar, it takes time for the studies to be calculated and presented in the medical journals.

The Society of Obstetricans and Gynecologists of Canada is preparing to release what may be the most comprehensive guidelines for the management of normal pregnancy and delivery in North America. The 78 page guidelines, to be distributed to all Canadian physicians practising obstetrics, represent an update of SOGC’s existing antenatal guidelines. 1 The SOGC guidelines endorse waterbirths with instructions for safe practice, which primarily involves lifting the baby’s head out of water as soon as it is born.

Sheila Kitzinger’s “Letter from England: Is Water Birth Dangerous?” in the Birth Journal 22:3 September 1995 is an excellent review of the first International Conference on Waterbirth, Exploring the Issues, which took place in London, April 1-2, 1995. This conference attracted over 1,500 participants from 36 countries and reported on at least 19,000 births. Janet Balakas of the Active Birth Movement, Beverly Lawrence Beech of the Association for Improvements in Maternity Services, Jay Ingrey of Splashdown Waterbirth Services and Sheila Kitzinger organized the conference.

The second International Conference; First North American Conference on Nurturing Women: Integrating Water into Maternity Care, held in Greensboro, North Carolina on April 12-14, 1996 was organized by Joanne Zaleski with Wake Area Health Education Center, Barbara Harper with Global Maternal/Child Health Association, Inc, (GMCHA), North Carolina’s ACNM, the University of North Carolina School of Medicine, North Carolina Department of Environment, Health and Natural Resources and Maternal Child Health Division. There were 403 participants, and eight countries represented.

There is a projection date for a third International Conference scheduled for Spring of 1997 in the United States and a fourth Conference in 1998 back in London.

Dr. Michael Rosenthal, formerly the obstetrician at the Family Birthing Center in Upland, Southern California reported at both conferences on his 10 years experience and 948 water births. Dr. Rosenthal brought the concept of waterbirth into a medical setting in the United States in 1985. “Only nine percent of women had drugs for pain relief, compared with approximately 80 percent in hospitals with a similar patient population in the area. The cesarean section rate was under 10 percent but 34 percent at the adjacent community hospital and 86 percent of women with previous cesarean sections gave birth vaginally.” 2

Studies presented at the Conferences revealed that fewer babies needed resuscitation, fewer went to the intensive care nursery, fetal heart rates were significantly more likely to be abnormal on land than in water, women needed fewer pain-relieving drugs when in water, and episiotomy rates were reduced from 38 to 19 percent. 3

Dr. Faith Haddad, a consultant obstetrician at the Hospital of St. John and St. Elizabeth, London, discussed water births that had occurred since 1987. Data gathered in 1993 and 1994 contained vital information confirming that water reduces the use of analgesia, helps to keep perineum’s intact yields healthier babies and can accelerate the second stage of labor. Dr. Haddad stated that 76 percent of the women studied, used water during labor and birth.

Water labor and birth has been known to help lower blood pressure, reduce edema, help reduce asthmatic responses. The water also enables a women to organically discover her birth position.

Paul Johnson, a physiologist and specialist in fetal breathing riveted attention as he spoke at the first Conference about what happens before and immediately after birth. In his research, the main factor involved with the first breath is the chemoreceptors in the larynx.  During pregnancy, the lungs, of the fetus, “breathe” off and on (fluid moves through them). About 48 hours before labor, the prostaglandins in the fetus increase and “fetal” breathing stops. The baby continues to receive oxygen only through the placenta until specific chemical changes trigger the breathing after birth.

When the baby is born into water, water goes into the larynx, the chemoreceptors are stimulated and this in turn triggers the dive reflex, inhibiting breathing, slowing heart rate, and reducing the need for oxygen. The glottis is closed, swallowing occurs instead of aspiration and the baby continues to receive oxygen from the placenta. In other words when the newborn is born into water, it continues to experience fetal circulation. The baby does not attempt to breathe under water.

As the baby emerges from the water and experiences the change in air pressure, the chemoreceptors in the larynx are stimulated, there is a change in the PH of the cerebrospinal fluid, and the respiratory center in the brain is commands the baby to breathe. The placenta continues to supplies oxygen through the cord for a number of minutes while this transition takes place. Other factors, such as changes in light, sound, temperature and gravity affect the breathing as well.

In all the studies presented at both conferences, there was never a report of fetal or maternal death or infection due to the water labor or birth. Some medical caregivers believe the water dissipates the bacteria. The key is to make sure the tubs are cleaned with a strong bacterial agent and a chlorine bleach rinse. Bensilkonium spray (diluted 4%) is used after the scrub. Bacterial cultures should be taken monthly and any debris that accumulates while the mother is in the water must be strained out as quickly as possible with a disposable fish net.

Contraindications for the use of water for labor or birth include anticipated birth complications anticipated, thick meconium in amniotic fluid (as there would be a need for perineal oronasal suctioning,) any obstetrical risk that would be cause for transfer to “high risk” unit, fetal distress, membranes ruptured and the amniotic fluid consistency and color not known, prolonged rupture of membranes (selectively greater than 24 hours with a maternal temp). 4

The use of water is not just another technique. It provides direct phisological benefits to mother and baby by increasing comfort and reducing medical interventions. And babies like it. A father of five who’s last two babies were born under water, swears his waterbabies looked happier and calmer at birth than his “airborn” babies.

FOOTNOTES
1. Medical Post, Vol 32 (5), 1996, page 1. “Healthy Beginnings…Guidelines for care during pregnancy and childbirth.”

2. Birth Journal 22:3 September 1995, Sheila Kitzinger’s Letter from England: Is Water Birth Dangerous?

3. Analysis of first 501 water births a t hospital in Bensburg, Germany. First International WaterBirth Conference, London, April 1-3, 1995.

4. Prodedures and Protocols for Hydrotherapy for Labor and Birth for use @ Harris Regional Hospital, Sylva, NC, July 1995.

Historical Documentation of WaterBirth at Roosevelt Hospital, NYC

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 2000 Judith Elaine Halek

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The week of June 27, 1994, a memo was sent to employees of the Obstetrical Department at Roosevelt Hospital regarding the temporary closure of tub water labors or births until further medical protocol has been established. The development of a medical protocol could take from 6-12 months.

Within the last year, a handful of parents, brought in their own tubs, hired private physicians affiliated with Roosevelt Hospital, labored and some birthed underwater. Of the 9 water labors there have been five successful water births.

ariellabjround 1. October 2, 1993 at 12:22 a.m., an 8 pound 14 ounce beautiful baby girl, Ariella Renee Garmaise-Schlossberg, her parents Judy and Boris, medical caregiver, Dr. Juanita Jenyons marked the first successful water birth at Roosevelt Hospital.

2. Almost exactly 4 months later, February 4, 1994 at 4:49 p.m. breechbirth history presented itself in the first United States, documented hospital frank breech underwater birth. The courageous parents of newborn, Damon, are Stacie Teele and Dan Varrichione. Dr. Gae Rodkey was the medical caregiver.

3. By May 15, 1994 the familiar room 12-A 21 on the 12th floor of Roosevelt, was occupied by Dawn and Harold Person-Hampton, a VBAC (vaginal birth after caesarean), water birthing their beautiful daughter Amara Renee at 1:53 PM. Dr. Juanita Jenyons attended this labor and birth.

eve2 4. Come July 7, 1994, Janis Enzenbacher MD, chose water as a labor and birth tool for the underwater birthing of her daughter Eva Liana, entering the world at 11:11 pm with Dr. Rodkey as the attending physician and Isadora Guggenheim as the attending Labor Support Doula and Massage Therapist.

5. Shortly after, on July 9th, Mindy and Kirk Van Nostrand underwater birthed Samantha Claire at 6:42 AM with Dr. Rodke as the medical caregiver.

I commend these bold parents, medical caregiver and Roosevelt Hospital for stepping forward with an inexpensive, innovative, progressive approach to labor and birth. It is time that the epidural become a relic of the past and the future wave is replaced with the waters of life.

As of December 1999, an independent birth center is located just below the obstetrical eve1 ward in Roosevelt Hospital. The OB ward no longer allows parents to bring in their portable tubs. The birth center has 3 rooms with 3 tubs to labor, but not to birth in. It is my hope that eventually the birth center will open its doors to the water birth option as well.

I would encourage all parents seeking this alternative approach to labor and birth to write the administrative departments of your hospital or birth centers. The administration needs to know this is an alternative option the public wants.

UPDATE as of 2013: Each room on the obstetrical floor in Roosevelt Hospital has been equiped with a tub to labor in only. Bring your own PLUG because all plugs to the tubs have ‘mysteriously’ disappeared. IF you can be so lucky as to NOT be attached to the monitors or epidurals or drugs, you will be able to move around much more and engage in a bath!

My Reflections On Labor And Birth

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 2000 Judith Elaine Halek

I was sitting at a dinner table with a group of women in their late thirties and forties. I, myself, am in my early forty’s, not married, been working in the birth modalities for the past twelve years and at present, am not seeing anyone in particular. I commented, “I don’t think it’s in the cards for me to have a baby this lifetime.””Really!” exclaimed a couple of the women. “How old are you?” inquired one woman. “Close to my mid forties.” I responded. “Oh, that won’t be a problem,” she said matter of factly, “You can always do invitro, or donor insemination.” I looked at her and then to other women around the table as all eyes were set on my response. I was surprised and disappointed that conception has become a casual ‘technocratic procedure’ in the minds of the public. I began to explain IVF and donor insemination requires massive douses of antibiotics, a large bank account, arranging one’s work schedule around clinic visits, undergoing countless invasive, often painful, always emotionally charged procedures, all for the chance that I might be the one of ten to be blessed with the news of a cyborg conception. Please understand, I am not judging anyone who chooses this path of conception. It is not my preference of choice and thank goodness, we still have a choice.

Or do we? When I reflect back on my experiences the past twelve years as a labor support specialist, childbirth educator, birth counselor, massage therapist, yoga instructor I’ve found far too many women who did not exercise their options of choice and gave their power away to the medical caregivers, especially in hospitals. After attending over 100 births in hospitals, birth centers and homes, I have had the opportunity to experience a variety of possibilities. It is my vision, that all labor and delivery nurses and obstetricians witness 30 home births or birth center births as part of their medical training.

I remember at one hospital, a nurse commented, “Having a baby at home is one of the most dangerous experiences a mother could put her baby and herself through.” I asked if she had ever attended a home birth, or studied the statistics of home birth practices. She admitted she had not attended a one or knew anything about recent studies on home birthwith midwife practices. I asked her, as I’ve asked many people who make blanket statements without any information to back up their claims, “How can you make such a definitive comment when you’ve not any experience with what you are judging?”

It’s rather ironic that we in our intellectual aspects, read, watch videos, attend classes, surf the internet, express our gathering feminine nature, becoming an ‘informed consumer’, yet when it all comes down to the real deal, one of my favorite mentors, Dr. Michel Odent states, “Forget the books, tapes, videos. Go to a quiet, dark place, private and safe, trust the process, surrender to your bodies and have your babies.”

I believe women have forgotten how to birth, trust, listen, go deep inside and communicate with their bodies and their babies. I also believe women can remember.

What are the choices, options, for non-technocratic pregnancies, labors and births? I have treeoflife been an advocate of midwifery for the past 12 years. After researching international statistical outcomes regarding midwifery vs. obstetrical care, midwives have far exceeded the lower infant mortality rates, fewer medical interventions and higher results in more empowering births.

Having a baby with an obstetrition in a hospital? Create a birth plan, a “guide line,” toward the ideal birth you would like to create. Birth plans are generally discussed in your childbirth classes. Look in various childbirth books early on in your pregnancy and begin to educated yourself. A few favorites are, “The Birth Book” by Sears and Sears, MD, “The Complete Book for Pregnancy and Childbirth,” by Sheila Kitzinger and “New Active Birth, a Complete Guide to Natural Childbirth,” by Janet Balaskas. To find out about midwifery based practices in your area, call American College of Nurse Midwives, (ACNM,): 202-728-9860 (general number), 1-888-643-9433, (toll free locator number). Or contact Midwives Alliance of North America, (MANA): 1-888-923-6262.

Bring questions to your medical caregivers, be attentive how they respond. If you experience not being heard or rushed through prenatal visits, go over in your mind and with your partner why you don’t feel supported. If you do your work early on, talking further or switching medical caregivers will not be as problematic.

Over and over I have encouraged women to trust your highly sensitized instincts, do research and own this birth. This labor and birth will only happen once and it’s vital to be with people you feel safe, listened to and trust. I believe, the only way change will take place among the obstetrical practices is through the public. By asking for what you deserve, you educate and introduce the medical profession to another possibility.

Another alternative is a labor support doula. A ‘doula’ is a Greek word for ‘woman assistant.’ She meets with a couple and gathers information prentally. She’s on call before and after the due date, attending to the parents needs during early and later stages of labor and birth, following up with a post-natal visit after the birth. Doulas have statistically proven to lower cesarean sections by 50%, length of labor down 25%, oxytocin use, down 40%, pain medications (narcotics) down 30%, forceps down 30%, and epidurals down 60%. A labor doula is by no means to replace the partner of the mother. No one can replace the relationship or connection of a woman’s partner. The doula helps to relieve the pressure and enhance the experience.

Since 1993, when Doulas of North America, (DONA,) began a certification program there are now over 8,000 certified. For referrals call, 206-324-5440. Book referrals for becoming a doula: “The Birth Partner,” by Penny Simkin, PT, “Mothering The Mother,” by M. Klaus, MD , J. Kennel, MD and Phyllis Klaus, M.Ed., CSW. If someone would be interested in setting up a doula program read, “Doula Programs: How to Start and Run Private or Hospital-Based Programs with Success!,” by Paulina Perez and Deaun Thelen.

An aquatic analgesic alternative to medical pain medication or an epidural is water labor or water birth. As the east coast resource center for water birth, my organization, Birth Balance, has educated countless couples on this unique and growing approach. A shower is great during labor, yet, it can’t compare to submerging half to three quarters of your body in a tub of water. Advantages to water birth for the mother are: easier coping during dilatation of the cervix and the pushing stage, softening of the perennial tissues, bones, muscles so lacerations are minimal, ability to move in whatever position her body organically discovers, less interventions, faster labors and births. Advantages to the baby: a medium which softens the baby’s bones and tissues thus creating a softer birth experience, babies appear to be less traumatized, a drug free beginning and more immediate bonding with mother.

wavecave A concern regarding water labor or birth is infection. When in the water, bacteria is diluted. Unless someone enters the water with an infection of some sort offering foreign bacteria, there wouldn’t be problems with the mothers infecting herself or the baby. A study in 1996 of 1385 women with prelabor rupture of the membranes after 34 weeks gestation concluded a tub bath did not increase the risk of maternal or neonatal infection after premature rupture of the membranes and prolonged latency. (1)

Another randomized, controlled trial was with 785 women. The results were as follows: tub group required fewer pharmacological agents, fewer deliveries by forceps and vacuum, more likely to have intact perineum and an overall positive effect on analgesic requirements, instrumentation rates, condition of the perineum and personal satisfaction. (2)

Another concern people have is the drowning of the baby at birth. The baby is in a womb of water from conception and is born into an extended womb of water later. The baby receives oxygen from the umbilical cord which is attached to the placenta. As the baby is born, the placenta is detaching from the mother, thus the supply of oxygen becomes depleted and bringing the baby up to the surface as soon as possible is imperative. Another atmospheric pressure, such as air or gravity is what stimulates the babies chemoreceptors to take a breath. That is why, in water, the baby will not take a breath.

Water birth has been around for centuries. In the contemporary times the concept began in Russia in the 60’s,, spread to France, England in the 70’s and come to the United States in the 80’s. For further reading on the subject check out: (book and video) “Gentle Birth Choices,” by Barbara Harper, RN, “Water Birth, A Midwife’s Perspective,” by Susanna Napierala and “The Waterbirth Handbook, ” by Dr. Roger Lichy and Eileen Herzberg.

No matter what choices you make for this birth or future, each pregnancy, labor and birth will teach you what to do differently or the same the next time. Remember, everything is an opportunity for learning. Keep an open mind and heart and learn.

(1), (2): MIDIRS Midwifery Digest, (Mar 1997) 7:1.

Fathers Take The Plunge: A Look At Waterbirth

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 2013 Judith Elaine Halek

Being a good dad is like being a good husband–learn as you go and do the best you can. One thing prospective fathers should keep in mind is this: a couple-focused pregnancy provides both a healthier pregnancy and birth experience and is a time when all three parties bond. Although fatherhood is probably the most important role a man will play in his lifetime, many men have been culturally and emotionally separated from pregnancy and the childbearing process.

As an observer at many births, my grandest observation is the remarkable change that takes place in men (whether the actual father or partner, a friend, brother or family member) while assisting the labor and birth. One father commented, “I have a newfound respect for my wife. I don’t think I could have ever done what she did, go through what she went through to have our child.”

During a baby’s birth, the father’s presence can markedly alleviate a mother’s pain and anxiety, and it certainly enhances his experience of the birth. It is crucial the mother not feel alone during this strenuous time. Many studies have shown that infants recognize and respond to voices they hear in the womb, therefore it is important to maintain a modicum of peace, tranquility and communication at all times.

One father who acted distant and angry during the labor and birth of his child finally let go of most of his defenses when I challenged, “Can we put the weapons down and let the egos go so we can help your child enter a place of welcome and peace?” By the time the baby was actually out daddy had softened immeasurably.

Those of you who have witnessed a birth know what I’m talking about. A sacred transformation takes place that crosses beyond the boundary of mere words.

My extensive work assisting people make the informed choice to birth babies in water and/or use water labor instead of the traditional “drug the mother” syndrome has brought both myself and the clients’ experience to newer, loftier heights. I have become very curious about fathers’ reactions and level of participation. I began to keep data–who initiated the idea and when the decision was made, were fathers able to support their partners during preparation, and did they clean up after the event?

It was important for me to know exactly what these new fathers would say about their waterbirth experience to other prospective dads. I set about doing this by interviewing six waterbirth fathers. They ranged from thirty to sixty years old with Indian, Italian, Hispanic and African American backgrounds.

Heads Bowed - Copyright 2004 Birth Balance When I asked the father why he chose to attend the labor and birth of his partner, the responses were uplifting. “Why not?” said a new daddy, “It’s my child as well. To me it was a moment getting to know and get closer to my wife. I can assure you, it did. It took the relationship to another level. Relationships are a collection of experiences and it’s brought us closer together. Forget the candlelight dinners guys, you can’t compare it and it may happen only once or twice in your life. Don’t miss it.”

Another father told me,” I felt it would be a good thing to see a baby born into this world. Doctors see this all the time, why can’t I?”

One man said, “I wanted to be part of it. We are a team. I was also curious to see the whole process. I’m in my thirties. Most of the guys in my generation are really into supporting their partners as opposed to older generations who might not be so interested in seeing the whole experience.”

When asked whose idea it was to have the waterbirth, most men responded, “both partners.” One father commented, “We were unhappy with conventional births. When we heard there was a more gentle, drugless approach to having a baby we went to a waterbirth educator and realized it was more normal to have the baby in water than the air. My wife’s obstetrician told us about a waterbirth educator. When we saw the videos I was really more supportive of doing the birth this way. At first I had to talk my wife into it. But that didn’t take too long.”

Another father told me, “The midwife suggested it. My wife was very open to it so I had no objections. We’d had three babies the traditional air birth. My second wife and I were having our fourth when we saw pictures of water babies. They looked so much calmer and happier. That’s when we decided to have our next child underwater.”

When asked about concerns or fears regarding this alternative method, one father replied, “No concerns. The water looked less traumatic and more comfortable for my wife and baby. It was something completely new to us.” Another dad added, “We had only heard of it two to three weeks prior to the birth of our child. It was a little nerve-racking, but I had no specific concerns.”

It was the father’s choice to enter or not enter the birth pool. One dad had a cold and didn’t think going in was a wise decision; others just felt a little overwhelmed. One excited father who did enter the pool said, “This goes to show how things can change. I thought I wouldn’t go in, but I was in the water ten minutes before my wife. I didn’t want to miss a moment of the birth. It was OK. I was behind my wife. I could hear the doula and the documentarian say, ‘Here comes the head.’ When the moment came, I was crying like a baby. I was totally overwhelmed!”

When queried about how important a part the water played, one father responded, “Vital–the only thing that prevented her from getting drugs!” Another stated, “The water was like a lifeline for her, something she could hold onto even if she didn’t use it very much until the birth. Just having it was her security.”

Preparation for a waterbirth means going to a waterbirth educator, getting an OK from the medical caregivers and institutions, looking at videos and pictures, ordering a tub, and lots and lots of talking to each other. If your facility does not supply a tub, you’ll need to rent one. Once done you must make contact with the hospital or birth center maintenance staff to ensure that the hot water hose adapters match the water faucets. Prior to the labor you will want to actually set up the tub.

Filling up the tub is optional but timing is everything, so get an idea from the staff how long your tub might take to fill. Knowing this relieves both parents of undue stress.

One of the most important elements mentioned by all six men was the hiring of a labor support specialist or labor doula. This is a person specializing and certified in assisting couples during their labor and birth. The doula attends the mother and baby while the father is busy with the tub before and after the birth. It is an added bonus if the doula is experienced in the waterbirth arena. She can give helpful tips on when to utilize the water and when it’s unnecessary.

One father advised, “Let the midwife and doula, if there is one, do their job. This is the best way to go if you don’t want to see your wife suffer.”

If you are considering the unique joy of waterbirth, make sure you employ a doula who is a team player. She should be open to allowing your full participation. Knowing and trusting her methods can really relieve the pressure. Though it may take some time, get the medical establishment to support you in your choice. Next, seek out a waterbirth educator or a labor specialist interested in waterbirth. Watch as many videos as possible and above all, be patient. Talk to people who have had this experience. Remember, knowledge is power. Make a choice to become intimately involved in one of life’s greatest moments. You won’t regret it.

Tokyo Dives In With Waterbirth

Posted on 25 October, 2013 by Judith Halek

  By Judith Elaine Halek
Photos and Article Copyright @ 2000 Judith Elaine Halek

YAquaHouse1

On February 12, 2000, Judith Elaine Halek, Director of Birth Balance and producer for a NYC cable program on underwater births, through the assistance of Japanese interpreter midwife, Yoshiko Niino, interviewed, Setsuko Yamada, a midwife of 20 years. Yamada, a calm, confident businesswoman is busier than ever despite Japan’s new plunging birthrates. Not only does she run “The Aqua Birth House,” located in the narrow back streets of Tokyo’s Setagaya Ward, she is also the owner of a coffee shop in trendy Aoyama district. Yamada comments “The cafe is a welcome change of atmosphere from my job as a midwife which can become very tense.”

Her philosophy reflected through her two books she co-edited and wrote with a medical doctor on pregnancy and birth reflect a more ‘active birth’ approach. One is written in a comic book fashion with mostly illustrations making it easier for younger mothers to read. The other book has some illustrations but is mostly text covering topics on ‘initial pregnancy and birth.’

Midwifery work in Japan has a long history. The midwife has been included in social welfare work. “Many people use to have their babies at home because they felt pregnancy was natural and they can take care of themselves quite well. But nowadays the society has changed and so do the women. The women who choose a birth center are very educated and they want to eliminate drugs or medical intervention as much as possible,” Yamada comments.

Yamada’s practiced as a registered midwife in Japan first in a hospital, then as a teacher ybooks in a nursing school and continued until she got sick and decided to become an independent midwife.

Why Yamada became a midwife was not from a deep concept. When she had worked with the ‘American system of childbirth’ in the hospital where many of the women had anesthesia she realized, if she was pregnant, she wouldn’t want to have a baby that way. Along with those feelings and her belief about ‘childbirth naturally’ she became more interested in assisting the birth from the beginnings of life.

Almost 2 years as an intern at another birth center, after consulting with her CPA, Yamada decided to set up her own practice in 1995 under the original name, “The Birth House.” In late 1998, Yamada bought property, moved to a roomier location, opened “The Aquatic Birth House” and resides there as well with her husband.

Since 1995 Yamada has attended almost 400 births including the home births and half of these were waterbirths.

She believes the fact that one is 37 doesn’t mean anything if they are healthy and haven’t had any serious illnesses. “These women can birth naturally,” Yamada comments. Three of Yamada’s clients gave birth naturally after having a C-section at a hospital the previous time. “There were no problems,” she added.

There are no doctors or nurses, epidurals, episiotomies, or separate rooms for the newborns at her Aqua Birth House. Instead one is greeted with a waterfall, African carvings of a mother and her child, fresh flowers and a table of birth icons. There are sensitive and beautiful photos of natural birth throughout the House and slippers for everyone provided at the front door.

yoshiko The labor and birth area, downstairs, contains an aqua blue oval tub, covered with a sterile plastic cover, weighted down by sterling sliver dolphin, moon and starburst clips, keeping the tub clean and available to use at any time. The tub is next to a cluttered desk, a bed that rotates up and down, colorful bean bags to sit or lean on, a short low birth chair, a geriatric stool to lean over with a hidden foam pad which Yamada quickly retrieves from under the bed. With a press of a button a heat a toilet is seated. With a press of a few more buttons a genital area is washed and dried automatically. Ah, the wonders of another country. Yamada believes in low light levels and keeps the overhead lights off and the decorative side wall lights on. Midwives utilize an underwater doppler stethoscope to check the babies heart tones. The house includes steep staircases, a modest kitchen, an additional room with a jacuzzi tub, areas for weighing, bathing and checking the jaundice levels of the babies.

There is an antiquated ultrasound machine available if Yamada needs to check the position of the baby. She rarely uses this machine and never charges extra if she does. (Tell that to an American hospital!)

Yamada proudly displays how the ‘regular bed’ not ‘delivery bed’ in the room with the tub has a vibrating massage feature as well as the head reset and the end of the bed rotate up and down. Between the bean chairs, birthing stool, kneeling on the floor, “many positions for the mother,” becomes one of Yamada’s trademark

During the summer, an option in the House for women who want to labor longer in a pool, is the smaller jacuzzi tub in an adjoining room. As a result of longer periods of time in this pool, some women and babies are content to birth here instead of the main tub. During the winter, this room is not available because it doesn’t have the appropriate heating. Yamada’s plans for next year to redesign and install a heater in the space will make this room available year round.

In another area of the cozy Aqua Birth House is a small bathtub set on a ledge near the sink for bathing the baby. There is an external heater on to keep the temperature safe for the baby.

It is the practice of the Birth Center to incorporate the father as the main person to practice YAquaHouse3 washing the baby in the bath before they leave the House. Yamada teaches only the father how to bathe the baby, not the mother. This is a way to establish a special commitment from the father in his assistance and caregiving for the child. The bath is not given the first day of the birth, only the second day after. Every day Yamada checks the babies jaundice with a small, handheld portable machine.

Under the sink where the water source is, there are two different colored tubes. Yamada explains, “One of the most important aspects of a waterbirth is that the water should be very clean.” Therefore she has one tube indicating, clean water in and the other, contaminated water out. She also has a water pump she only utilizes after the mother and baby is out of the tub.

There is also a rather primitive tabletop scale to weigh the baby. Yamada comments, ” This is a scale for the baby. All babies get their mother’s milk and don’t have to be checked after each feeding. It is important to check the weight when the baby is first born.”

We ascend the narrow winding stairs to the postpartum rooms. There are three adjoining rooms with soji sliding screens made of a blonde wood and simulated rice paper. In actuality the paper is the farthest thing from fragile, light rice paper. It is a plaster fibrous material that is actually quite strong to the touch. Futons on the floor with brightly colored linen create a cozy haven to nest in after the arduous miracle of birth. Yamada states, “Some women have their babies in this bed, but not many. Always after the baby is born he/she stays with the mother and the father can stay here too. So the parents and babies sleep together in this bed.”

Yamada continues, “The purpose of placing the rooms so close together was planned. It is our belief when a baby cries and the other people can hear this, they can join in on learning to raise a baby in ‘a family way’ where crying is normal. Sometimes other babies will cry when one baby cries.” There is also a rather large hole in the handle of the sliding door. “The purpose in the planning of this,” Yamada demonstrates “is to keep open to everybody what is going on. For example, those inside the room need to see what is going on outside and those outsides the room can see in so they don’t feel a necessity to go in and interrupt so often. A closed door, not know what’s going on inside or outside needed to be eliminated. This is the way we do that.”

mwass Yamada’s assistant and midwife in training, Ms. Megumi Tanaki was seven months pregnant when I did the interview. Tanaki’s background as a nurse for many years in a private hospital and University Medical Hospital left her feeling limited as a nurse. Tanaki shares, “When I worked as a shift nurse and the Hospital became bigger and bigger, I wasn’t able to manage what I wanted to do as a nurse because it is institutionalized and I had to work as a group organization.”

Tanaki continues, “In the older days, midwives were called ‘sambas.’ They could ork even if they became aged. I felt it was a worthy position, so by the age 30 after I graduate school, I decided I wanted to work with midwife, Yamada.”  Tanaki’s greatest happiness comes from assisting the births. “I don’t have any conflict with what I am doing. I have been married for 6 years but my period was not so regular. Since I have worked with Yamada and the parents and YAquaHouse2 babies, my physical balance is quite good. I believe my hormones become more balanced when I assist the births with the mothers and babies. I work in good circumstances so this is my happiness,” concludes Tanaki.

Judith Elaine Halek is the Founder and Director of Birth Balance, the East Coast resource center for underwater birth, which she began in 1987. One of the original labor support doulas in New York City, she has pioneered alternative choices in childbirth throughout the tri-state area. A birth consultant and counselor, massage and fitness therapist, writer, educator, speaker, photographer, videographer and producer of Birth Balance Presents: Water Birth, a Manhattan Educational Cable Station, Judith is airing her third thirteen-part weekly series on underwater birth and midwifery related issues.

If you would like to contact Judith directly by email she’s at: Judith@BirthBalance.com.
Her contact numbers are: 212-222-4349 (phone/fax) and mailing address: Judith Halek, Birth Balance, 309 W. 109th St., Suite 6D, NYC, NY 10025.

There is a beautiful Photo Documentary by Shin. Sawano, narrator Chara, Music Naoko Etoh, produced by TELEMAC video and CD format available entitled, “Born To Be Loved,” Yamada is featured assisting water births, as well as other professionals and parents labor and birthing in more traditional settings. To purchase a copy of the video or CD, contact: www.LEMITON.com and click on Family Ties. If you would like to contact the Yamada you may write to: The Aqua Birth House, Midwife Setsuko Yamada, 4-16–21 Sakuragaoka, Setagaya Ku, Tokyo, 156-0054, JAPAN. Phone: 03-3427-1314, Fax: 03-3427-1314.

A Labor of Love

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek
Photographs © Judith Elaine Halek

Women In Photography debuts an photographs and an article on
photographing water labors and births in the No. 8, Fall Issue,
October 1, 2001 Issue. The following is a rendition of the
article written by Judith Halek that appeared in this issue.

To view the website of Women in Photography, click here.

Archive 8 – WIPI News Article 3

Documenting births has been an obsession of mine since 1987 when
I assisted the first homebirth, waterbirth in New York City. Over the past fourteen years
I have slipped in and out of one of the most intimate experiences known to life.
I’ve had the privilege of documenting three separate environments;
homes, hospitals and birth centers. My specialty is underwater birth.

Waterbirth takes place when the baby is actually born from the womb of water inside the mother, to an extended womb of water, which could be a bathtub, a portable birthing pool, a jacuzzi, a water trough, or an ocean.

On my first contact with a couple, I give them a package of information and refer them to my website. After they have received the package and reviewed the site, we discuss what they like, what more they want and if whether there is a preference for a specific format, i.e., transparencies, and negatives, black/white, color.

Personally, I prefer to shoot with color negative because it offers more advanced emulsions. The additional color layers give better control in Photoshop. Black and white is the heart of photography, and from the purists point of view, film is superior to digital, yet, in the last three years technology has changed this. Today printing from a digital file with the special small gamut or monochrome black and white inks, creates a cutting edge print as acute as the traditional print from a darkroom.

The first thing to establish is the due date. One can be on call
approximately three weeks before the due date and two weeks after, unless it will be a home birth where the post dates could last up to four or five weeks. We discuss whether the couple wants me to be at their home before they go to the hospital or birth center.

It’s imperative to have permission to photograph from the hospital or birth center. Put something in writing and submit it to the medical facility before hand. One doesn’t want to become an intruder and sometimes medical personnel can be security conscious. When parents create their birth plan, photographic permission ought to be included as part of the labor/birth.

I work with the available light. Because of its invasive nature, I rarely use a strobe. I find available lighting creates a truer, softer,
journalistic reflection. I work with the fastest film for the camera:
Ilford and T-Max 400 and 800 for black and white and Fuji color (I find the skin tones are truer with Fuji). Sometimes I’ll be creative and shoot 1600 and 3200 when I’m at a home where candles are the only light source. I then utilize a monopod.I take anywhere between 5-8 rolls of film. I participate quietly in the labor and birth dance by making myself as inconspicuous as possible and shoot further away rather than close up. I work with the Canon EOS, SLR system; two cameras at a time with the Canon Elf as a third back up if we are transferring to the hospital or birth center. I use a EF 50mm f1:4 and EF 70-200 f1.2.8 lenses. I advise taking along a wide-angle lens such as a
21mm or 28mm for the confined areas.
When shooting, it1s important to focus on the details. Focus on becoming a Zen photographer and capture tender moments of father comforting mother, a gentle touch on a belly, a reflection in a mirror, a flower floating in water.If you are fortunate enough to be invited into the OR in a hospital,
you’ll wear their sterile gowns. Pay attention to where you can and cannot be, and don’t touch anything! Take a small fanny pack for your film. In a birth center you can wear comfortable clothing to move around in, climb on top of tables, beds, chairs, or edges of the tub. A home birth environment is the most relaxed. Wear clean clothes, shoes that slip on and off easily, take time to use the bathroom, eat and hydrate yourself with something other than caffeine.Labors and births can take from 25 minutes to 18-20 hours. Patience and vigilance are the keys. It’s like covering a sporting event. You have no idea what’s going to happen minute to minute. Conserve your energy by breathing in such a way as to stay in a calm, neutral state, both mentally and physically. Most importantly, enjoy… the miraculous experience.

Judith Halek is the director of Birth Balance, the east coast resource center for under water birth. Judith is now in the process of moving her 15 years of photography out to the public. She has been published in numerous birth journals such as Midwifery Today, The Journal of Perinatal Education an ASPO/LAMAZE Publication as well as New York Magazine. She will be debuting her first solo show at a prestigious birth center in New York City this winter.

Her website is www.birthbalance.com
Her email is Judith@BirthBalance.com
Phone and Fax: 212-222-4349

*Judith Halek is among the photographers of
WIPI’s 20th Anniversary International Tea Time exhibit

A Doula’s Waterbirth Toolbag

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Published by Midwifery Today in 2000
Photos and Article: Copyright @ 2000
Judith Elaine Halek

In my tool bag as a water labor or birth labor assistant,
I include extra equipment besides the standard labor assistant accoutrements:

rubberized thong slippers
a one piece swimsuit or body leotard (in case I have to get into the water; first I take a shower)
a short terry cloth robe
a water bottle for myself filled with part juice or tea mixed with honey and water
an underwater watch to check a second hand during contractions
Rescue Remedy (a Bach flower remedy) for all attending the birth
one or two sterilized small inflatable pillows for the mother to lean against in the water
an infusion of raspberry leaf tea, a spoon and honey for the “drizzle” mentioned earlier
a bag of bendable straws for the mother in the shower or tub
an extra set of clothing if something gets wet
a green sixty-five centimeter birthing ball for birth attendants to sit on while the mother is in the tub or for the mother to use while in the shower
two rolls of soft toilet paper wrapped in a clean plastic bag o a small box of soft Kleenex
lavender essence oil (5 to 10 drops in the tub, great antiseptic); I also like to keep on hand a spray bottle of lavender: using a small spritzer bottle filled with purified, filtered or distilled water, I add 10 drops of lavender essence oil (I buy a large supply bottle then put into a smaller dropper bottle), ice chips to make it cool, and spray on the mother when she¹s in the waterbirth tub (I make sure ahead of time that lavender does not make the woman nauseous‹so far, all women like it)
hand lotion that is not greasy
lip balm because the water tends to dry out my lips and hands
three books: Water Birth, A Midwife’s Perspective by Susanna Napierala16; The Waterbirth Handbook, The Gentle Art of Waterbirthing by Dr. Roger Lichy & Eileen Herzberg17; and Water Birth, The Concise Guide to Using Water during Pregnancy Birth and Infancy by Janet Balaskas and Yehudi Gordon.18
thermometer: If I am attending a homebirth, I usually include a thermometer to check temperature of the mother if I suspect she might have a fever. It is amazing how many people do not have a thermometer in their homes. Generally a doula does not perform any medical procedures, and taking the temperature is such a procedure. I have the father take the mother’s temperature to see if it is high.
scooper: I also suggest to the parents that if the pool rental does not supply a scooper for scooping out fecal and birth matter released in the water during labor or birth, they purchase one from a local pet store, sterilize it and wrap it in a plastic Ziploc. Urinating in the water is fine. Urine is sterile and clearing the bladder will make room for the babies’ head to dip down. I suggest, however, that all labor attendants in the water use the bathroom facilities.
stainless steel or plastic bowl: Birthing the placenta under the water is medically safe. Generally it is up to the medical caregiver and his or her comfort level and experience in supporting this. Whether birthing at a home, birth center or hospital, I suggest parents bring a clean, large stainless steel or plastic bowl to place the placenta in if birthed in the water. A small bowl floating on the water will sink with a good size placenta.

Aquadurals and Douladurals Replace the Epidurals

Posted on 25 October, 2013 by Judith Halek

Printed in 2000 by Midwifery Today

In an ancient tradition of “woman supporting woman,” my friend asked me to do something I’d never done before attend the birth of a child. “Just be there and support me, massage me, talk to me,” she said, then added matter-of-factly: “Oh, by the way, we’re going to have the baby underwater.” It was a cold, blustery evening in November 1987 when baby Maxx appeared, landmarking the first home underwater birth in New York City accompanied by a midwife. Thus was conceived my passion for birth. Without much information available to us at that time, we were all virgins finding our way as comfortably as possible to fulfill the mother’s wishes. We had three resources: books by Erik Sidenbladh1, Timothy Wyllie2 and Dr. Michel Odent.3 In 1987 very few if any hospitals in the United States had birthing tubs. In 1996 a handful of U.S. hospitals offered birthing tubs; today hundreds do. Waterbirth, which started in Russia during the 1950s and 1960s, moved to France and England in the 1970s and to America in the mid-1980s, was once considered a fad. Today it has become the “aquadural,” replacing for many women the epidural. Innovative and controversial, the aquadural involves laboring and/or birthing under water. After my initiation in 1987, I became one of the first of a handful of doulas in New York City. The doula, a specialist in labor, has become another significant element in late twentieth and early twenty-first century birth, one that decreases the need for drugs, interventions and surgical procedures up to 50 percent. 4 A “douladural” is a non-medical person who has certification training or life experience in the birth field. She acts as a liaison between medical caregivers and parents by offering physical, mental, emotional and spiritual support. She does not perform medical procedures or make medical decisions, yet she does advise the parents on these matters.

Safety Reports and Stipulations

During the early 1980s, Estelle Myers, at the Rainbow Dolphin Centre in New Zealand, led the first two waterbirth conferences.5 International waterbirth conferences were held in London, England in 1995 and Greensboro, North Carolina in 1996. Thousands of births reported at these conferences confirmed no increase of infection to baby or mother or fetal or maternal deaths due to the water. 6 The next international waterbirth conference will be held in Portland, Oregon in September 2000 and is co-sponsored by Midwifery Today.

In the late 1980s to mid-1990s, a series of articles in the medical journals noted the death of a baby in Sweden, one death and one brain-damaged baby in Britain and one death in France due to water labor or birth. After further investigations, it was shown that the water was not the cause of these babies’ deaths and brain damage; rather, other mitigating circumstances were evident. 7 As a result of these incidents the following stipulations occurred and were administered: 1) decrease the temperature of the water to body temperature‹ 97 to 99 degrees Fahrenheit or 34 to 38 Celsius; 2) encourage the mother to get in the water no earlier than five centimeters dilated; 3) shorten the labor time a mother is in the tub; 4) shorten the amount of time the baby is submerged. The Royal Society of Medicine delivered an abstract on a comparison of 602 maternal and neonatal outcomes in waterbirths and conventional vaginal deliveries from 1989 to 1994 (301 women electing for waterbirths compared with the same number of age- and parity-matched low-risk women having conventional vaginal deliveries). The Society¹s conclusion: waterbirths in low-risk women delivered by experienced professionals are as safe as normal deliveries. Laboring and delivering in water is associated with a reduction in length of labor and perineal trauma for primigravidae and a reduction in analgesia requirements for all women. If a mother is in a prodromal labor pattern early on, having intense back-to-back contractions with a two to three centimeter dilation, she can become extremely tired. I suggest she sit in the tub for therapeutic rest and encouragement. If the temperature exceeds 99º F or 38º C, it can lead to hyperthermia and dehydration in the mother and baby. It is also imperative that the mother as well as the assistants in the room drink fluids with glucose. If the mother is not well hydrated, it leads to low blood volume and could possibly result in orthostatic hypertension, passing out when standing up to get out of the pool.9 Janet Balaskas states in her book, Water Birth: Maintaining the correct water temperature is very important. If the water temperature is too low the mother’s body temperature particularly if she spends a long time in the pool, will drop. The sweating mechanism for heat loss does not work in water, so if the water is too warm the mother’s body temperature will rise and her energy may be sapped. Doula Linda Cohen in Long Island, New York devised a rather simple recipe for situations in the hospital where the mother is not allowed anything but ice chips and water. She calls this “The Drizzle.” In a cup add: a bit of infused (very strong) hot red raspberry leaf tea and a teaspoon of honey; mix thoroughly and add ice chips. Feed to mother with a spoon while in the tub, on the birth throne (toilet), on a bed, kneeling over a physioball, walking down the hall or up and down stairwells. Once I was fortunate enough to be invited to a home birth with a small group of Russians from Moscow. I saw a small bowl of fresh cranberries on the side of the tub. Periodically the mother would suck on one, put it back in the bowl and go through the contraction. Sucking the cranberries, the mother claimed, helped stimulate her thirst. As an assistant, I periodically ask the mother if the water feels too cool or too warm. Placing a small thermometer in the tub helps monitor the temperature. If the water is too hot and the mother desires it to be even warmer, I suggest she get out of the water and walk. If the water became too cold I would add hot water away from the mother if she remains in the tub or get her out of the tub and add the water. Another trick the Russians taught me is, if the mother is feeling too warm in the tub yet doesn’t want to get out, she can hold onto pieces of ice to cool down, or sit along the edge of the tub with her feet still in the water. Barbara Harper explains: “The greatest benefit to immersion will be experienced in the first hour to two hours. Twenty minutes in the bath is not enough for the physiologic responses to work effectively. That is why some women, both primips and multips, get into the water at 7 cm or 8 cm dilation and begin to experience pushing urges within the first hour of immersion.”11 Keeping a woman in the water for hours is unsafe and unnecessary. I just received a call from a mother who labored in a rented tub at home but didn’t birth there. I asked her why not. She responded: “The water was filthy after being in it for six hours and by the time we had drained it and started to fill it again, the baby was born.” In Bristol, two women who had adverse perinatal outcomes had labored for more than seven hours in the birthing pool. There was one stillborn child with evidence of asphyxia and one baby with severe hypoxic-ischaemic encephalopathy. These women had labored, not birthed in the water. In neither case was any specific cause evident. 12 When helping the woman out of the water, one must be aware of the “fetus ejection reflex,” a term coined by Dr. Michel Odent. 13 This means there is a possibility of the baby slipping through the birth canal unexpectedly because of the change of atmospheric pressure and movement. I focus on the laboring mother¹s pelvic area and keep in touch with the physical sensations she is feeling when assisting her out of the tub. I also make sure if in a birth center or hospital, to wrap the mother in the kind of warm large white thin blanket supplied by the hospital or birth center. I use the small towels to wipe the legs and feet of the shivering woman stepping out of the water. I also make sure the room temperature is as warm as possible so the mother does not chill from water to air. In some facilities, especially hospitals, we have no direct control of the temperature. Most facilities are quite cold. In one hospital we fooled the thermostat by taking a rubber glove, filling it with ice chips, slipping a knot at the opening of the wrist and placing the dangling fingers of ice on the thermostat box. Worked like a charm. It is also important the mother does not slip when exiting the tub. I think it’s a good idea to put a large tarp underneath the portable tub. Towels placed on the floor beside the entrance to the tub help create an absorbent, non-slip surface. If there is full access around the tub, I place towels around the whole area. When a baby completely emerges from the womb it is logical to get the child directly into the mother¹s arms, or better, to assist the mother as she brings the baby to her belly or chest. Oxygen flows to the baby through the umbilical cord attached to the placenta. When the placenta detaches completely or partially from the mother, the baby¹s supply of oxygen is compromised. Thus emergence within a short time is of essence. There was a case during the early 1980s in the United States where a couple, unattended by medical caregivers, left their child under the water after the placenta was birthed. The baby died due to lack of oxygen. 14 When pulling the baby out of the water and onto the mother’s belly or chest, it is important to become aware of the length of the umbilical cord. It’s easy to snap a short cord if one pulls the baby up abruptly. In regard to the physiology of birth, each woman responds differently to pain, yet when mothers get into the water, there is a universal, “AhhhhŠoh my god, why did I wait so long!” After the tenth person responded with the exact words, I wondered if I was experiencing the “hundredth monkey” concept. Barbara Harper, director of Global Maternal Child/Health Association, reports on her survey of close to 2,000 women, when asked the question, “What feelings do you recall?”‹almost 100 percent of women stated in one form or another they were relaxed, calm, at peace in the water. 15 I can say that for every birth I’ve attended where there was a tub of water and a challenging labor or birth, that without the water, the woman would have received an epidural. During one of my interviews for my local cable program, Birth Balance Presents: Waterbirth, I was interviewing a mother who labored in water and birthed her baby in air due to meconium and late due date. When I commented to her, “From my observations of you during the labor, if you had not had the tub available, I believe there was an 80 percent chance you would have gotten an epidural.” “Eighty!” she exclaimed, “200 percent I would have gotten the epidural! The water saved me.” When sticking my hands in the water to massage or support I do not wear gloves. I wash thoroughly with antiseptic soap and make sure I do not have any staph infections on my body. In one case an infection was passed to the baby during a water labor because the father had a staph infection on his foot and was in the water when the baby was born. When I am pressing points on the mother’s back during a contraction or massaging her shoulders, legs or belly in between contractions, the warm water soothes my tired hands and arms. I am also given more breaks from actual hands on at a water labor because the women spend time rocking back and forth on their hands and knees moaning and breathing. This gives me time to talk gently to a birthing mother or massage the father. During my prenatal visits with parents to discuss their birth plans and choices for childbirth, I encourage them to stay open and unattached to birthing in the water. Waterbirth should not be the goal. Often times when a woman becomes fixated on any particular outcome of birth, there potentially are more difficulties because of inflexibility. Dr. Michel Odent speaks often of women getting out of the tubs right when they are to push their babies out, so that they then present right alongside the tub. Or when the water is running into the tub, the woman may grab alongside the tub and begin to scream as her contractions become stronger. In some cases, women actually birth their babies just by the sound of the water running. Listening to one’s body, trusting the process and going with the flow are vital. A question I am commonly asked is: “Is it a good idea to hire a doula who has little or no experience with water labor or birth?” In this day and age, there is so much information about this alternative method of labor and birth. If the doula is more inexperienced it would be worth her time to research through the Internet, read books, watch and listen to video and audiotapes. Anyone can read up, ask questions, talk to parents who’ve had a water labor or birth, and attend lectures or private consultations with a waterbirth consultant. It is more important that parents have a strong connection with the doula they have interviewed. Educating and participating is a moment to moment experience.

Click to View Judith Halek’s toolbaghttp://www.birthbalance.com/articles/toolbag.asp

Judith Elaine Halek is the founder and director of Birth Balance, an East Coast resource center for underwater birth that she started in 1987. One of the original labor support doulas in New York City, she has pioneered alternative choices in childbirth throughout the tri-state area. A birth consultant and counselor, massage and fitness therapist, writer, educator, speaker, photographer, videographer and producer of Birth Balance Presents: Water Birth, a Manhattan Educational Cable Station, Judith is airing her third thirteen-part weekly series on underwater birth and midwifery related issues. If you would like to contact Judith directly by email she’s at: Judith@BirthBalance.com.

Footnotes

1. Sidenbladh, E. (1982). Water Babies, A Book about Igor Tjarkovsky and His Method for Delivering and Training Children in Water. New York City: St. Martin’s Press. 2. Wyllie, T. (1984). Dolphins, Extraterrestrials, Angels, Adventures among Spiritual Intelligences. Boston Enterprises (distributed by Knoll Publishing Company, IN). 3. Odent, M. (1983). Birth under water. Lancet 2:1776-1477. 4. Klaus, M.H. & Kennell, J.H. & Klaus, P.H. (1993). Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth. New York City: Addison-Wesley. 5. Myers, E. (1976, 1999). Cross Your Bridges When You Come to Them. New Zealand: Rainbow Dolphin Centre. 6. Beech, B.L. (1996). Water Birth Unplugged, Proceedings of the First International Water Birth Conference. England: Books For Midwives Press. 7. Ingrey, J. (1993). Water birth press release. Midwifery Matters, Issue 59, Winter. 8. Royal Society of Medicine. A Comparison of Maternal and Neonatal Outcome in Water Births and Conventional Vaginal Deliveries. C171-29C-2986, p.10. 9. Harper, B. (1999). Water birth report. OBC News. 10. Balaskas, J. & Gordon Y. (1990). Water Birth, The Concise Guide to Using Water during Pregnancy Birth and Infancy. Great Britain: Unwin Hyman LTD. 11. Harper, B. (1999). Ibid. 12. Gilbert, R.E. & Tookey, P.A. (1999, Aug. 21). Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey. BMJ 319-483. 13. Odent, M. (1987). The fetus ejection reflex. Birth 12(2). 14. Ingrey, J. (1993). Ibid. 15. Harper, B. (1999). Ibid. 16. Napierala, S. (1994). Waterbirth, A Midwives Perspective. Connecticut: Bergin & Garvey (a branch of Greenwood Pub. Inc.). 17. Lichy, R. & Herzberg, E. (1993). The Waterbirth Handbook, The Gentle Art of Waterbirthing. United Kingdom: Gateway Books. 18. Balaskas, J. & Gordon Y. (1990). Water Birth, The Concise Guide to Using Water during Pregnancy Birth and Infancy. Great Britain: Unwin Hyman LTD.

Additional Resources

Gilbert, R.E. & Tookey, P.A. (1999, Aug. 21). Perinatal mortality and morbidity among babies delivered in water: Surveillance study and postal survey. British Medical Journal. 319:483-487.www.bmj.com/cgi/content/abstract/319/7208/483 under Obstetrics and Gynecology: Pregnancy. The conclusions from this paper: “Perinatal mortality is not substantially higher among babies delivered in water than among those born to low risk women who delivered conventionally. The data are compatible with a small increase or decrease in perinatal mortality for babies in water.” I have also found the waterbirth egroups, a group of like-minded people who share and question and learn more about waterbirth, to be informative and educational. To register: www.egroups.com/subscribe/waterbirth An online electronic Waterbirth Newsletter is debuting in April 2000. To subscribe: www.egroups.com/subscribe/WaterbirthNews

“Doula Unto Others…”

Posted on 23 October, 2013 by Judith Halek

Yoga

This is Judith Elaine Halek’s response to:
“Doula unto others – Forget the trendy labor coaches and
midwives – give me doctors and drugs,” an article written
by Martha Brockenbrough at Women Central.
The original article has since been removed from the web.

Martha:

Tribal conditioning has been a powerful imprint for you. It’s obvious you have been indoctrinated into the medical model mentality from utero.

I can’t tell you how many times in the past 14 years I have walked into a hospital and found pubic hair in the showers, (someone’s other than the woman I am with), dried blood under the beds, dry, caked, diarrhea under the toilet lid…sterile? Hairy back seats of cars? I would rather birth my baby in an environment and bacteria my body was USE TO being around.

“..back in the days when hospitals treated pregnancy and childbirth like a disease.”

What century are you living in? THEY STILL TREAT pregnancy and childbirth like a disease!!! As one of the largest industrial nations on this planet, we have one of the HIGHEST c-section rates, 31.5% in the world. This is because women are allowing the “medical experts” to tell them whether their bodies WORK or not.

That’s why so many hospitals have created comfortable birthing rooms (I refuse to call them suites) that simulate a homey environment. Just because a hospital rooms had facelifts…it doesn’t mean there is inner beauty. If the medical model philosophy of “delivering” vs. “birthing,” “drugs” vs. “alternatives such as: water, trust or assistance,” then it doesn’t matter what the room looks like, the treatment will continue to be the same.

“…mother who charges money for their services.”

I am a certified hypnotherapist, childbirth educator, certified labor support specialist, certified bodyworker, herbologist and nutritionist.

As an editor of the world’s third largest web site on waterbirth and labor support doula’s, I must say, like the television program “ER,” your lack of research reflects ‘pontification journalism’ as opposed to ‘legitimate, journalism that indicates intelligence and integrity.

My advice to someone who has such an overt disdain for ANYTHING on the level you do with Doulas is, if you haven’t experienced it, don’t knock it…you speak with false authority on the subject other than your own opinion which for me, as stated above lacks credibility.

In favor of respecting choice that is well informed.

Judith Halek
Director of Birth Balance
NYC, NY

Feelings of Fear

Posted on 3 September, 2013 by Judith Halek

Eyes of Hope stock photo

What do you do when you are sitting alone in your thoughts and all you can do is sit in fear? FEAR: False Evidence Appearing Real. Which brings up the question, is what we are feeling fearful about really real? Or are we making up, misinterpreting, projecting from past unhealed experiences something that is not really true and keeps us spiraling in a circle? Another interpretation for FEAR is : Feeling Excited And Ready. When one experiences a ‘healthy’ fear such as the butterflies in the belly before going on stage or giving a speech can be a motivation to push forward into one’s power. Others say it represents: F*%#— Everything And Run! This appears to be the definition most people adopt, consciously and unconsciously in ones life. It’s easier to run away, leave, think, act, do something else which take away the feelings. The truth is, ultimately we can’t get away. Whatever it is will always come back in one form or another to offer the opportunity for growth beyond that which we are fearful about. Abraham Hicks says fear and trust cannot occupy the same space in time. So, we choose, moment to moment, hopefully taking full responsibility in that choice.

Neale Walsch, author of Conversations With God Says: “On this day of your life, dear friend, I believe God wants you to know……that your fears have stopped you before, but they need not stop you now. What’s the worst that can happen? And if that happened, what would happen then? And if that happened, then what? Now…if you give in to your fears, where will that leave you? Right where you are now? And if that’s where you want to be, why is the other option even a little bit exciting to you?”

Eckhart Tolle, Author of The Power of Now, says fear is part of the “pain body.” The “pain body” is “the accumulated emotional pain from the past and an aspect of the egoic sense of Self. It is not always active. There are dormant and active periods. When it is dormant, you can live with yourself and so can others. It is still problematic and you can be a nuisance to yourself and others. Yet, when that sense of Self becomes energized, active, it’s based on the accumulated pain of the past that everyone comes into the world with, genetically, collectively, personally through childhood and into parenthood. Fear, an aspect of the ’pain body’ is a field of alive energy, contracted, temporary life form, that lives in each of us.”

Maryanne Williamson, from the Course of Miracles says, “Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you NOT to be? Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us: it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”

There is a wonderful book entitled, When Fear Falls Away, The Story of a Sudden Awakening, by Jan Frazier. Jan’s website is: www.whenfearfallsaway.com.

It is known, the fundamental emotion which creates havoc during pregnancy and labor is fear. Fear causes pain in the bodies; physically, emotionally, mentally and spiritually. The physical body is the grossest and densest of the bodies and the last to receive the information. (Unless you are putting your hand on a hot stove and it will be the FIRST of the bodies to receive the information!) When a woman or partner or birth caregiver is in a state of fear, adrenaline and catecholemines (fight or flight hormones) are being secreted which stop the flow of oxytocin (the love hormone) and endorphines and opiates (pain reducers).

So, when we are sitting in our ‘field of fear,’ is it only our own fear or everyone else’s fear in the collective field? Maybe it’s both, like Tolle says.

Whew…I am breathing it all off to the left. Remembering what I have forgotten which is I am so much more than all of it, including the FEAR.

By Judith Elaine Halek Photographs © Judith Elaine Halek

By Judith Elaine Halek
Photographs © Judith Elaine Halek