WATER BIRTHING: : Gimmick or Godsend?

When her labor pain got worse, April Halprin Wayland could have asked for medication. Instead, she lowered herself into a 4x6-foot bathtub at the Family Birthing Center of Upland and let the warm water reduce her feeling of pain. An hour later, still in the tub, she gave birth to 8-pound, 5-ounce Jeffrey.

The baby was whisked to the surface immediately by her obstetrician, Dr. Michael J. Rosenthal, and Wayland cuddled him before stepping out of the tub to join her husband, Gary, who had been at her side during the six-hour labor.

“People attending an orientation class at the center burst into applause when they heard his first cry,” the new mother recalled, laughing that they also had heard her moaning in pain during the difficult transition phase of labor. Later that night, Wayland verbalized something not always on the tip of brand-new mothers’ tongues: “I could do this again.”

To believers like Wayland, a 35-year-old Brentwood children’s book writer, water birthing--an unusual and controversial delivery method--is psychologically and physically good for the entire family. The theory is that the water--straight from the tap and kept slightly warmer than regular bath water--relaxes the mother, partly by reducing the secretion of Adrenalin and partly because immersion creates a more comfortable feeling of weightlessness.

But no one really knows exactly how the water eases labor, said Rosenthal, who opened his San Bernardino County birthing center in 1985. Since then, 475 women have given birth in water there, Rosenthal said. Some use the tub only during the first stages of labor--to slow their contractions and reduce pain--leaving the water to actually give birth. Others stay in the tub throughout. In many cases, Rosenthal believes, the water actually helps shorten labor. Water birthing can be good for the baby too, he said, because a relaxed mother often has an easier time bonding with her infant.

Critics Call It ‘Gimmicky’

Critics take a harsher view of water birthing, calling it “silly,” “gimmicky” and fringe medicine that can endanger the baby’s life. They point to such tragedies as the death of a baby during a 1987 water birth in Florida. Although water birth proponents say the Florida tragedy had nothing to do with water birthing per se--but rather with such factors as inappropriate medication given the mother and the baby’s breech presentation--the attending physician’s license was revoked in late February by the Florida Department of Professional Regulation.

Water birth advocates are divided into two camps: Those like Rosenthal who, for safety, believe the baby should be brought to the surface immediately, and those who claim the infant can remain safely under water for a few minutes, still connected via the placenta to the mother.

However diverse its fine points, water birthing isn’t new. Mentioned in medical literature as early as 1805, it was first practiced in the Soviet Union and France and in recent years has enjoyed a modest increase in popularity in Europe. But the technique is still not widely available in the United States. Rosenthal believes his clinic is the only such center in California, although perhaps not for long. The Natural Childbirth Institute and Women’s Health Center in Culver City will soon offer the option of water birthing, said Nancy McNeese, co-owner and certified nurse midwife.

Rosenthal said he decided to open the Family Birthing Center of Upland after reading “Birth Reborn,” a book published here in 1984 and authored by Dr. Michel Odent, a French surgeon who pioneered water birthing in his country about a dozen years ago. (Another French doctor, Frederick Leboyer, pioneered the Leboyer method, a technique of “gentle birth” in which delivery room lights are dimmed and the baby is laid in a bath of warm water immediately after birth to ease its transition from the watery environment of the womb.)

Dislikes Traditional Techniques

Although traditionally trained and board-certified, Rosenthal takes a dim view of conventional obstetrics, charging that most obstetricians demand too much power over their pregnant patients. A case in point, he said, are traditional birthing techniques in which women are delivered while lying flat on their backs. Water birthing, he believes, returns control of childbirth to the mother: “Women come here not to be delivered but to give birth.”

And while water birthing is the option that grabs headlines, it’s just one of many alternatives offered at his center, Rosenthal said. Women also are encouraged to walk around if it eases labor pain and to squat during a natural childbirth delivery if it’s comfortable. Of the 1,500 women who have given birth at his center, 1,000 have entered the tubs of water during labor, with nearly half of them remaining to give birth there.

Rosenthal is the first to admit that water birth--and birthing centers--are not every woman’s choice. A fourth of his patients deliver at San Antonio Community Hospital a block away.

As for professional medical associations, most maintain a middle-of-the-road or negative stance on the technique. The American College of Obstetricians and Gynecologists has no official stand, but spokeswoman Teri Malone said, “ACOG doesn’t believe water birthing is the safest way of birth.” The American Academy of Pediatrics has no official stand on the technique, nor does the American Society for Psychoprophylaxis in Obstetrics/Lamaze, which certifies Lamaze teachers.

Some physicians offer little praise. “There’s no scientific evidence in the medical literature that there’s any benefit to baby or mother,” said Dr. Philip Brooks, an obstetrician-gynecologist at Cedars-Sinai Medical Center. “Things in medicine have to be proven.”

Less adamantly opposed to water births is Dr. Loraine Stern, a Newhall pediatrician. She called giving birth in water “a lovely idea,” but added that the technique is “cumbersome and not natural. I think it’s kind of silly.”

Reports of water birthing are scarce in medical literature. Odent, the French doctor, summarized his experience with 100 such births in 1983 in the journal Lancet. “We had no infectious complications,” he noted, “even where the membranes were already broken. There were no perinatal deaths.” The mothers’ ages in the study ranged from 19 to 43.

His record speaks for itself, said Rosenthal.

Indeed, there are no complaints about water births under investigation by the California Board of Medical Quality Assurance, said spokesman Vern Leeper.

Even without a wealth of published studies, satisfied veterans seem sold on the technique. A case in point: Julie Antillon, 26, of Alta Loma, who had her first baby delivered by Cesarean, and her second baby in water at Rosenthal’s clinic 10 months ago. Waiting recently for a postnatal checkup appointment at the Upland center, she said she’s convinced water birth, for her, is the way to go: “I wouldn’t have been able to make it without the water.”