by Raichal Reed
Waterbirth has become more and more popular in the United States as a way to experience labor and another way to give birth. Birth pools, bathtubs, and showers are only a few options that birthing people have started to utilize in their birth plan. Currently, with the rise of COVID-19 there has been some debate about waterbirth during this pandemic and whether the birthing person is testing positive for the virus or not. Before we get there, we should review what exactly is COVID-19. The coronavirus 2019 is a respiratory illness that can spread from person to person. The way it is transmitted and how long it lingers after the infected person leaves is currently up for debate but at this time the best prevention is social distancing and sanitizing your environment.
Based on prior research around respiratory illnesses and pregnancy (pneumonia, sinusitis, cold, or flu), all infections can give a risk of issues to the fetus in utero, but so also can the social determinants of health combined with or in absence of. The social determinants of health encompass everything else around the birthing person that also affects their health and way of life (access to fresh food, access to healthcare, transportation, community, etc.). According to a 2017 study conducted by Samantha Parker and her colleagues, they found that 49.6% of pregnancies deal with some sort of upper respiratory infection either periconception or sometime during their pregnancy prior to delivery. Their study found that from birth to year three, cognitive function of the offspring was not affected significantly but there was an association with behavioral problems especially in birthing people who were exposed to a respiratory infection from 16-20 weeks and later. There was also a higher risk if the infection was not treated with medication and resolved on its own. Another research study on waterbirth and infection found that water does not enter the birth canal and travel upward during labor and therefore there is no increase in incidence of infection of the birth canal or uterus despite the person being sick. A 2018 study on the survival rates of viruses in water found that most viruses can only either decrease in amount or stay the same but will always rapidly decrease when in the presence of warmer to hot temperatures of water which is the standard in proper waterbirth guidelines.
According to the CDC, “There is no evidence that COVID-19 can be spread to humans through the use of pools and hot tubs. Proper operation, maintenance, and disinfection of pools and hot tubs should remove or inactive the virus that causes COVID-19”. All rules that currently stand for a birthing person to be able to be in the pool (no fever, respiratory issues, etc.) should stay the same so that those who are sick in general are not in the water. Infections and how they spread vary and because there is no current documentation as to every way a person can contract the COVID-19 it is important to have proper personal protective equipment with each birthing person. Currently the CDC has not found any traces of COVID-19 in any municipal water systems, but they have not properly studied well water so their research is to be determined. There have been some cases of the fecal matter of the birthing person containing some amount of the COVID-19 virus but in the pool it is diluted and should just be quickly disposed of. The birthing person and baby should not be separated because the baby is at minimal risk of contracting an infection from the birthing person. The CDC and WHO actually still encourage the birthing person to chest-feed as they see fit even if they are confirmed to be infected. The child is not at a greater risk of incurring the infection and will receive antibodies from the birthing person as they fights the virus.
This article and the information within it is bound to change over time and should be taken as a summary of the current information presented to the public at this time concerning pregnancy management and COVID-19 concerning waterbirth.
Raichal Reed – ”So my name is Raichal Reed. I am a 24 year old, fourth year student midwife originally from South Mississippi now residing in Central Texas. I’ve always been in love with the birthing world ever since childhood and decided in the second grade I was going to work with women and children. Coming to Texas I found that midwifery was regulated and decided to take that route instead of medical school after receiving my Bachelors in Sociology/Pre-Med. I am the current volunteer director for Giving Austin Labor Support, a non profit of volunteer doulas, and a midwife student to two wonderful Midwives (one CPM and one CNM).”