Positive Health Online

A successful pregnancy is akin to completing the most demanding endurance test. It is an experience which has a predictable course but is also full of unexpected turns. Rarely are two births alike, and pregnancies often arise during other stressful times of life. Labour is described as having distinct phases, but the duration of a labour is immeasurable. Sometimes babies appear almost to birth themselves; on other occasions they seem reluctant to arrive.

Many women endeavour to become as fit as possible for childbirth but it is not possible to anticipate all its demands or the pain and distress involved. This article discusses the role of hydrotherapy in minimising discomfort and injury during pregnancy.

Because pregnancy is understandably birth-focused, the mother's welfare, while subject to clinical monitoring, is sometimes neglected. This is especially true after delivery, where even rudimentary first aid is rarely observed. Failure to acknowledge and treat the adaptive strains on the system during pregnancy makes a woman more vulnerable to complications.

The body's physiological response to water makes hydrotherapy the perfect accompaniment to all stages of pregnancy – in preparing the circulatory, neurological and musculo-skeletal systems during the phases of labour, and most importantly, immediately after delivery of the baby. Hydrotherapy is also ideal in that it is self-applicable, reliable and safe, and very pleasant to experience.

How Hydrotherapy Works

Hydrotherapy is massage treatment using water. It is the most commonly applied form of massage world-wide, yet most people who utilise hydrotherapy are not aware that they using it. They simply know that water is a great healer of aches and pains, strain and tension. All life begins in water, so hydrotherapy reconnects us with a naturally life-giving and healing environment.

Hydrotherapy was developed in 19th century Europe from techniques used in folk remedies. Preissnitz is credited as the pioneer in the field, but the most famous early hydrotherapist was Sebastian Kneipp, a Bavarian Priest. Kneipp avoided an early death by embracing hydrotherapy, and later became an internationally renowned healer. Kneipp's followers have succeeded in bringing the traditions of hydrotherapy into the modern era, and there are numerous well-documented examples of its effectiveness in pain relief, as a reliable sedative and in the restoration of healthy circulation.

Physiological Effects

Being warm blooded, the human body benefits from contact with cool water. Briefly applied, water acts as a tonic, while extended applications have a calming effect. Contrasting hot and cold is also used, and occasionally, longer hot applications for relaxation. Keeping an injured area moist also relieves pain by reducing stiffness and congestion.

The influence of hydrotherapy is initially recorded in the skin and then distributed throughout the body via the nervous reflexes and circulatory routes. Water is administered by various methods ranging from splashing to immersion as well as moist compresses.

* Cold water limits blood loss from the easily damaged small blood vessels. Although ruptured capillaries constrict spontaneously, cold helps to restrict pressure from nearby vessels by reducing blood flow;
* Cold water reduces pain of pressure or inflammation. Peripheral nerve-endings are almost immediately desensitised by the application of cold;
* Cold water is reassuring. If the local application is complemented by a cool cloth to the neck or forehead,the patient will relax and breathe easier, feel more confident, and be less likely to lose consciousness;
* Cold water keeps an injury supple. Moisture stops the tissues drying out, preventing the injury from becoming irritated;
* Cold water encourages elimination by relaxing the skin. Even if debris is deposited deeply within a wound, it will be pushed up by the deeper layers of the skin as long as the surface is kept moist;
* Hot and cold water provides a gentle massage effect. It is the first form of pressure to be applied to an injured area;
* Hot water is able to re-direct blood flow from congested areas. Applying heat to the uninjured side attracts blood flow and reduces pressure at the site of tension or injury;
* Water is ecological and economical.

Hydrotherapies throughout the Course of Pregnancy Paddling

Run six inches of tap cold water into a bath. Walk up and down the bath, raising the feet clear of the water on each step. Start with 30 seconds on day one and build up to two minutes.

Pelvic Splashing

Run lukewarm water in the bath. Splash up around the legs. Squat down and splash around the hips, between the legs and on to the abdomen. Reduce the water temperature over three days until only tap cold.

Step out of the bath into warm towels and dress quickly. These hydrotherapies can be alternated each morning and done later in the day before resting.

Benefits – Paddling and splashing help with the increased pressures of pregnancy, stimulating the circulation in the venous system and improving muscle tone generally. The birthing structures of the pelvis are especially affected. Hydrotherapy works deeper than 'stretching exercises' of the legs or vagina by influencing the internal muscles and their nervous controls. The softer tissues too are conditioned and are less likely to be seriously damaged by tearing or surgical intervention.

Hydrotherapies during Labour

Spraying or Splashing the Face

Use an atomiser or dip hands into cold water and direct to the forehead and eyes.

Benefits – The cranial nerves are stimulated, helping concentration and reducing anxiety.

Cold Compress of the Neck

Place a towel rung out in cold water around the neck.

Benefits – steadies and deepens breathing, relieves tiredness.

Hot Compress on Lower Back

Place a hot towel against the lower back, including the pelvis.

Benefits – Encourages relaxation of pelvis between contractions.

The Birth Pool

Float in the water, briefly at the beginning of labour, then increase the length of time in the third stage of labour. Giving birth under water is an option.

Benefits – Floating eases pressure on the spine, helping free the pelvis. While in the pool, posture does not have to be maintained and the body is decompressed, giving pleasant sensations, interrupting the intensity of labour pain. The baby's emergence underwater is less stressful on the perineum, even if tearing occurs.

Hydrotherapy Immediately after Delivery

"Extensive bleeding, torn muscles, dislocated pelvis, indescribable pain, post-traumatic shock." This could be a list of injuries sustained by an earthquake victim, but which are, in fact, typical in normal childbirth. Yet unless deemed life threatening, the mother's condition does not usually attract the first aid offered to a sprained ankle. Ironically, the appropriate hydrotherapy after delivery is almost identical to that given to a sprained joint.

Cold Compress to the Perineum, Extending to the Abdomen

Immediately after delivery of the placenta, place a towel wrung out in cold water under the pelvis, bring up between the legs and lay across abdomen. Replace regularly as towel dries out continuously for 48 hours. The mother should not walk around unnecessarily, and have massage of the limbs. This compress is so comforting, it may be used for many days after the birth, as desired.

Benefits of this hydrotherapy are considerable:

* The compress meets the urgent need to contain the pelvis and perineal tissues after birth trauma;
* The area is gently bandaged and bleeding is arrested but helpful eliminative flow is not stopped;
* After-contractions of the uterus are stimulated by nervous reflexes in the abdomen and the overall shock to the body is reduced;
* Even with a severe tear, stitching is not necessary using this compress;
* Perineal adhesion is unlikely and pelvic floor tone will be easier to regain.

Summary

Involvement of hydrotherapy is appropriate in pregnancy because the mother's body reverts to a dominantly aquatic condition. This process facilitates childbirth but is potentially straining for the mother, a fact which is inadequately acknowledged in contrast to concern for the baby's development. All conditions of strain associated with pregnancy can be relieved by hydrotherapy and simply applied, it minimises the risk of other conditions developing. Hydrotherapy also lessens the possibility of long-term birthing injury, has only positive side-effects, and encourages rapid recovery. Above all, hydrotherapy contributes to the comfort and ease in pregnancy expressed in birthing pioneer Grantly Dick Read's record of a delivery, when a new mother commented: "It wasn't meant to hurt doctor, was it?"

Recommended Reading

Mitchell Stewart. Understanding the Healing Power of Nature. Element Press. 1998.
Sidenbladh Erik. Water Babies. Adam & Charles Black. 1983.
Thomson C. Leslie. Water and Nature Cure. Kingston Publications. Edinburgh. 1990.
Odent Michel. Water and Sexuality. Arkana. 1990.