Birthillogics # 4 – water and scar pain

sara_wickham_birthillogicsToday’s illogical policy is about water birth and scar pain.

It isn’t necessarily widespread, but I’ve now heard this one several times, from three different areas of the world.

Midwives and birth folk are reporting that a rather curious policy is being imposed upon women who have previously had a caesarean section and are seeking a vaginal birth with a subsequent baby (VBAC).

These women are ‘allowed’ and in some cases positively encouraged to have an epidural. But they are being told that they are not ‘allowed’ to use a water pool or bath for pain relief in labour.

4734329552_c3a0f0fc79The rationale?

‘In case the pain relieving effect of the water masks the pain of a uterine rupture’.

Notwithstanding the fact that uterine rupture isn’t always heralded by pain (and is not common and is not nearly as significant a risk as some people are being led to believe, and if you would like to read more on this then check out this fab blog post by Rachel Reed), such a policy makes no sense.

Unless you believe that water is a more effective form of pain relief than epidural analgesia?!

In which case, maybe we should be spending less on anaesthetists and more on birth pools?


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photo credit: 4734329552 via photopin (license)

2 comments for “Birthillogics # 4 – water and scar pain

  1. Alison
    July 21, 2015 at 8:46 pm

    Firstly, no woman is “not allowed” to do anything! Every woman is “allowed” to labour/deliver as she wishes. Informed choice is the key for ALL labours. The reason that a water birth is not the recommended choice is not for pain relief, but because electronic fetal monitoring is the gold standard for women labouring with a previous Caesarean section. This is because a suboptimal CTG can be the first sign of a uterine rupture, pain can often be a late sign! Look at the NICE guidelines. Midwives are there to facilitate women’s choice, and to empower women to make the right choices for them! Midwives are also there to facilitate a safe delivery for both mother and baby, in conjunction with these same mothers.

    • Heather
      July 22, 2015 at 6:15 am

      Alison you probably mean well but Sara covered the ‘”allowed” part by putting it in quotes and linking it to “Am I Allowed?” It sounds like you might’ve got the wrong end of the stick because she’s reporting what units are telling women, which I’ve heard too. It’s not meant to be a discussion of the evidence. Sara is the last person that needs a lecture on informed choice. Have you got “What’s right for me?” I lend it to all first time mamas. The NICE guidelines are only one side of the debate and I want to tell women to please look into the issue of monitoring with VBAC rather than taking Alison’s words as gospel. There’s always another viewpoint to consider. Sara, you’re doing great work, please don’t let people like this put you off. Heather xx

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