Bamboola Baby

I have recently been asked by several expectant parents here in Jersey City and Hoboken about their options regarding water birth. If you live in North-East New Jersey and would like to have a water birth, you may be facing the same dilemma and losing your sleep (and nerves) trying to figure out which caregiver and subsequently which hospital will let you labor in the water. Let me break it down for you. Because I think water birth is a wonderful way to labor and bring a baby to this world, so I’ll do anything to make the search easier for you (even if it means another sleepless night … but I’m not blaming you, I have two kids, including a breastfed baby who wakes up all the time so I don’t really know what sleep means anymore). I didn’t want to freak you out. But yes, you will miss sleep. Back to water birth…

Where can I labor and give birth in the water?

Basically, there are 5 fairly local places to go to, unless you’re planning a home birth in which case you can do whatever you please (you may have to purchase or rent a birth pool).

• 2 hospitals in Northern New Jersey – Morristown Medical Center in Morristown, NJ, and Mountainside Hospital in Montclaire, NJ
• 3 birthing centers – Our Birthing Center in Morristown, NJ, Brooklyn Birthing Center in Brooklyn, NY, Birthing Center at St. Luke’s Roosevelt Hospital in Manhattan, NY, and

While all 5 allow you to labor in the water, only 3 will let you push and give birth in the water. Mountainside Hospital (and probably some other ones) and St. Luke’s Roosevelt Birthing Center will only allow you to labor in the tub, not actually give birth in it, so you will have to get out for pushing. Morristown Hospital, Our Birthing Center and Brooklyn Birthing Center offer a full water birth experience, so you can stay in the tub even for pushing and have your baby in the water. Review your labor preferences and tour the hospitals/birthing centers you’re considering to make the best informed decision. Choosing the right caregiver and subsequently the place of birth is one of the most important decisions you make as it has direct impact on your labor and your baby’s birth.

How do I find a caregiver who supports water birth?

So now that you have chosen your birthing place, you have to select a caregiver who can make your waterbirth wishes come true. I can only recommend midwives – not just for a water birth, but for any birth. Obstetricians are surgeons – while they are needed for complicated pregnancies and births, they should not provide prenatal care to low-risk, healthy women expecting healthy babies, and they should not be present during a normal, uncomplicated labor & birth. Having a surgeon supervise a normal, uncomplicated labor is like having a fireman supervise me baking a cupcake. Yes, I may need some help along the way but I will ask someone who has already baked a cupcake, I’m not going to ask a fireman. I don’t need a fireman looking at me baking, or telling me how to bake the cupcake or what ingredients to add, or trying to tell me it’s finished and it has to come out. The cupcake’s just fine in the oven and I know how to tell it’s done. I can do it. Thank you very much. Yes, there are times when baking goes wrong and one may have to call a fireman (like those neighbors on the second floor – thanks for the middle-of-the-night evacuation alarm with two kids, that was lovely). But seriously, how often does this happen?

Midwives delivering in hospitals and birthing centers are almost always Certified Nurse Midwives (CNM) with a Bachelor Degree in Nursing and a Master Degree in Midwifery. They do everything an Ob/Gyn does – with the exception of a surgery, and with an added bonus of compassion and trust – trust in your body’s ability to create, carry, grow and birth your baby safely. Should your midwife notice any red flags during your prenatal visits, she will consult with her backup Ob/Gyn and make necessary arrangements. And should you require a cesarean section it can easily be done since you are in the hospital. So – no, you are not compromising your or baby’s safety. Quite the contrary, actually, because births attended by midwives have better outcomes. According to this study published by NYU, women with midwives are:

• more likely to have spontaneous vaginal birth, have high perceptions of control, and initiate breastfeeding
• less likely to use analgesia or anesthesia, need hospitalization, have an episiotomy (a surgical cut between vagina and rectum), or need forceps or vacuum assisted birth
• more likely to have infants that had shorter stays in hospital

Midwives who deliver in hospitals work with insurance plans just like doctors. Additionally, midwives also offer well women care, so you can enjoy benefits of seeing a midwife even before getting pregnant and after having your baby.

Let’s break it down by place of birth:

Morristown Medical Center (Morristown, NJ) – as I already explained above, it is the only hospital around allowing you to have a water birth (= not just labor in the water, but actually give birth in the water). They have three spacious water birth rooms. If Morristown is the place of your choice, you can now select between two wonderful midwifery practices – they are (alphabetically) Avalon Midwives with offices in Morristown and Caldwell, and Midwives of New Jersey with offices in Madison and Hackettstown.

Mountainside Hospital (Montclaire, NJ) – here you can labor in the tub and use water for relaxation, comfort and pain relief (but you can’t push in the water). I can recommend a great duo of midwives delivering here: Lonnie Morris and Rachel Siegel with offices in Clifton and Montclaire.

Birthing Center at St. Luke’s Roosevelt Hospital (Manhattan, NY) – again, here you can labor in the tub, not actually give birth in it. St. Luke’s Roosevelt Hospital is staffed with 8 faculty midwives. Additionally, 3 independent midwifery practices deliver babies at St. Luke’s Roosevelt – they are CBS Midwifery, Midwifery of Manhattan, and Central Park Midwifery – here you receive care from two midwives: Georgia Rose and Elaine Keller-Duemig – Elaine used to work in Clifton, New Jersey, until December 2013.

Our Birthing Center (Morristown, NJ) – this place is a great option if you want to give birth in the water AND avoid a hospital. It is New Jersey’s only free-standing birthing center offering beautiful home-like settings – a perfect compromise for those playing with the idea of a home birth, but not entirely sure about it. They have their own midwife (Donna Roosa, MS, CNM) and a obstetrician (Dr. David Garfinkel, MD, FACOG). I have a personal experience with Dr. Garfinkel as he was the consulting OB of my homebirth midwife and I had to go for a checkup with him. He’s the one who gave me clearance for my homebirth and who my homebirth midwife consults with and who attends all her hospital transfers. He was very respectful of my birthing choice and I heard he’s a go-to doctor for women seeking a caregiver who’s able to do breech vaginal births and vaginal twin births. Other midwifes also deliver at this brand new birthing center, including both Avalon Midwives and Midwives of NJ. Their transfer hospital is Morristown Medical Center which is only 2 miles away.

Brooklyn Birthing Center (Brooklyn, NY) – another water-birth friendly facility, a free-standing birthing center with a home-like atmosphere. Their midwives have privileges at Maimonides Medical Center in Brooklyn, NY (their backup hospital). Their midwives and consulting obstetricians are listed here.

Why would anyone want to labor and give birth in the water?

Water is a wonderful tool for pain management and as a birth doula I always suggest using water in labor. Many laboring women love water – immersion in water promotes relaxation and reduces pain during labor and delivery. Studies indicate that the use of water during labor may also help to lower blood pressure, facilitate labor progress, and reduce the likelihood of perineal tears. It encourages the body to release more oxytocin, promoting more efficient contractions and shortening the length of labor, and it seems to decrease stress-related hormones, allowing the mother’s body to release endorphins which are pain-inhibitors. Water birth is not only gentler on the mother, it’s also a lot more peaceful way to enter this world for her baby as it eases stress of birth on the infant. Last, but not least, Labor & Delivery rooms with tubs are much more soothing than the regular L&D rooms – the tub dominates the room, instead of a scary-looking bed and a tower of monitors with cables all around them. See for yourself – how absolutely serene does this L&D room look – the inviting warm water, the intimate darkness, the soft glow from the holiday lights (I take these with me to every labor, it helps to make the atmosphere more mellow and intimate).

And how peaceful does this mom look? (FYI, she’s fully dilated and ready to push, so pretty much the most intense moment of labor but you can barely tell – relaxation masterpiece!) … What a difference to a loud and frantic pushing scene filled with screaming and shouting portrait in the media and executed in far too many L&D rooms.

Image used with the permission of my client.

Who determines if water birth is safe for me?

Water birth is a safe option for many moms and babies, though your midwife will need to help you determine whether water birth is right for you. Women are carefully screened to see if they are potential waterbirth candidates. Fever/infection, meconium stained amniotic fluid, or a non-reassuring fetal heart rate are some of the reasons that use of the tub would not be permitted.

For instance, my last doula client planned to labor and have her baby in the water but her midwife noticed meconium in the amniotic fluid so she was not allowed in the birth tub. This was a bummer but things like this happen. Thankfully, she was able to manage her contractions in the shower. No one knows how anyone’s labor will progress so it’s wise to be flexible and open-minded about all of your options.

Another thing to consider while planning for a water birth – do not rely solely on water for pain management. Hospitals and birthing centers have policies and regulations regarding your dilation. Most of them will need you to be in active labor with consistent, strong and frequent contractions, which means your cervix must be at least 5-6 cm dilated to get the permission to go into the birthing tub. And let’s keep it real – to reach 6 cm can take several long hours (or even days) of pretty powerful contractions. One of my most recent doula clients had a long labor – 34 hours to be exact. She reached 6 cm dilation after 25 hours of labor and two sleepless nights (she kicked ass, by the way). So prepare to tackle those contractions outside of the water too.