A ban on water births in coronavirus hotspots has distressed expectant mothers and ignited impassioned debate among medical professionals across the country.
Government advice to temporarily suspend water-based birthing techniques is linked to concerns that wet personal protective equipment (PPE) is less effective at shielding medics from COVID-19, leaving them vulnerable to contracting the virus.
But the controversial move, mooted by the the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), has been rebuked by the Australian College of Midwives as lacking in evidence and damaging to women’s health.
Irish midwife Aoife Kenny, who lives in Collingwood and works at a Melbourne hospital, argues all mothers deserve access to what she calls ‘life-changing’ pain and stress relief.
‘Water and birth are inextricably linked. Water simply makes us feel better,’ the 28-year-old told Daily Mail Australia.
‘If we think back to times where we’ve felt aches and pains, a warm shower or bath tends to save the day and wash away any stressors.
‘Water immersion is an incredibly useful tool in labour – it’s an effective form of natural analgesia [pain relief].’
Countless studies have shown that hot showers soothe pain for labouring women, while immersion in water during delivery can reduce the need for epidurals and other pain medication.
In fact, one of those studies was published by RANZCOG – the organisation advising the suspension of water-based services.
The recommendation initially included the suspension of hot showers, but following widespread condemnation the Victorian Department of Health clarified that showers would still be available in maternity wards.
Ms Kenny, who is offering support to expectant mothers during the pandemic on her Instagram account Back to Birth, believes the decision to deny women access to water births is rooted in fear, not evidence.
‘To be immersed in an intimate pool during labour is a magical, life-changing experience, both for women and midwives. Women deserve this experience,’ she said.
Australian College of Midwives midwifery advisor Megan Cooper agrees.
Ms Cooper told Daily Mail Australia that water provides a ‘sanctuary-like sense of safety, privacy and protection’ and called for access to be reinstated to protect women’s physical and psychological health.
‘While this situation is unprecedented, it’s important that we refrain from ‘blanket’ approaches that do not speak to the unique needs of each individual woman, especially when there is no solid evidence to support such directives or recommendations,’ she said.
Ms Cooper said stripping women of the choice to deliver in a birthing pool could have grave emotional consequences for mothers bringing children into the world at a time of unprecedented uncertainty.
Distressed women who have contacted the Australian College of Midwives with concerns about the ban are now exploring other options including publicly funded home births or care from a privately practising midwife, she added.
In its updated guidelines for Victorian labour wards under stage four lockdown, RANZCOG says ‘services are advised to suspend the use of water immersion for labour and birth for all women’.
The statement continues: ‘The protection of our maternity and neonatal healthcare workforce is essential.’
‘Temporary guidance from Safe Care Vic for maternity providers and midwives advises against water births,’ it said in a tweet.
‘PPE is not effective when wet – safely caring for women in a bath presents an unacceptable COVID-19 risk for healthcare workers at this time.
‘Pregnant women are still able to use a shower. This guidance is being reviewed and updated weekly, and water birth will be available again when it’s safe for all involved.’
Meanwhile on social media, comments on the Instagram page of pregnancy podcast ‘Australian Birth Stories’ reveal a community split between wanting to support mothers and protect frontline healthcare workers.
‘From what I can tell this recommendation was made to minimise the risk of infection to healthcare workers as PPE is not as effective when wet. Surely there is a way around this?’ an Adelaide woman wrote under a post about the ban.
‘This pandemic has really highlighted the fact that pregnant women seem to be treated like a lower class within our society. Why is adequate pain relief in pregnancy seen by some as optional or unnecessary?’
‘If men gave birth I suspect this would not be the case.’
One mother-of-two said: ‘This is truly heart breaking. Makes me definitely think seriously about having bubs at home. Water plays such a big part of labour for so many women these days.’
Another first-time mother who welcomed her baby daughter after a 40-hour labour in June said she simply couldn’t imagine delivering having a birthing pool on hand.
‘This is this completely heartbreaking,’ she said.
‘Even though it ended in an emergency C-section I look back on my labour as the most magical, life changing and beautiful experience of my life, all because I was immersed in an amazing labour pool and showers for most of it.
‘I couldn’t fathom going through the marathon of labour without water.’
A third said she would have been ‘absolutely lost’ without hot showers during two of her three deliveries, recalling: ‘I spent my whole transition [the final stage of the first phase of labour] in there.’
An expectant mother from Queensland whose September due date is fast approaching asked: ‘What more do they want to take from us?’
‘I’ve had it with people telling me what I can and can’t do for myself and my unborn baby,’ she added.
But doctors saw the situation from the other side.
Obstetrician Dr Patrick Maloney responded by arguing that PPE ‘unfortunately doesn’t work if it gets wet’ – thus leaving maternity staff susceptible to the respiratory disease.
‘As an obstetrician I know that water is an incredible help during labour, I’m sad that the current use of water recommendation in COVID-19 hasn’t been communicated well and a lot of women are rightly stressed by this announcement,’ he said.
However Dr Maloney – who co-hosts pregnancy podcast ‘Grow My Baby’ with blogger and mum-of-three Bridget Jarrad – said people must also consider the risk posed to healthcare workers.
He pointed to the deaths of doctors and nurses overseas as a warning to Australian hospitals to avoid complacency and remain vigilant in protecting their staff.
‘As a registrar (junior doc) was quoted the other day – he didn’t sign up to this job to die,’ Dr Maloney said.
‘Instead we will keep on working at a cost to our families and ourselves to help women have their babies safely and for us to go home at night knowing we get up and do it all again the next day.
‘We are all doing our bit. We are trying to support women as best we can in times that are unprecedented.’
An online petition opposing the water birth ban has exceeded its target of 25,000, with 25,584 signatures at the time of writing.
Daily Mail Australia has contacted the Royal Australian and New Zealand College of Obstetricians and Gynaecologists for comment.