Hydrotherapy can promote relaxation and reduce pain during labor.
I remember my first labor all so well. I arrived at the Cambridge Birth Center, moaning while in transition. My midwife immediately filled the tub with warm water and encouraged me to get in.  Once I was immersed, my husband instinctively picked up the emesis basin, scooped up some of the tub water and began to pour it over my belly. The gentle sensation of the water dripping over my skin immediately relieved the intensity of my contractions. I felt so relaxed and told my husband to just keep doing what he was doing.Â
I moved through transition within the hour and began to feel the urge to push. I got out of the tub to push in the bed and had my baby 30 minutes later. My daughter had her arm wrapped around her head, a complex presentation that typically would lead to a much longer labor and pushing stage. I attribute my shorter and more relaxed labor to the home-like birth center environment, personal midwifery care, the use of HypnoBirthing and the benefits of hydrotherapy.
I found the labor tub so incredibly useful in my own labor and also in my experiences as a nurse-midwife. Many of my patients chose to labor and/or birth in the tub with great success. For these reasons, I am concerned that the Department of Public Health has recently banned the use of labor tubs unless the tub is accessible from 3 sides.  This decision was made for safety reasons which may be justified; however, most currently installed labor tubs are accessible from only one or two sides. I worry that recently squeezed hospital and birth center budgets may not allow for the installment of new tubs and women will not have the same opportunity that I had to experience the pain-relieving effects of hydrotherapy.
The light touch of water on the skin causes a release of endorphins, hormones that promote relaxation and decrease pain sensation. Water from a shower head can also create an endorphin release but I preferred the tub where I did not have to hold myself up while sitting on a stool or birthing ball. Instead, I could completely give in to the total relaxation I experienced.
Hydrotherapy in labor tubs can be especially useful to those who are looking for a natural birth or trying to hold off an epidural as long as they can. I hope that hospitals and birth centers are able to continue to provide this option under the new DPH requirements so women continue to have the choice to labor and birth in tubs.
Did you enjoy the benefits of hydrotherapy during your labor?
Chris Just, RN CNM Executive Director of Prenatal Services at Isis
Do you know where we can find out more information about this? I’m giving birth at Mount Auburn in July and was planning on laboring in the tub. Based on your comments, I’m wondering if the tubs will be available to me? Thank you.
Comment by Breean Canzano — February 17, 2010 @ 12:46 pm
Mt. Auburn has in-dwelling tubs which do not comply with the new DPH standards; however, they also have one “Aquadoula”, a portable, circular tub which is accessible from all sides and OK’d by DPH.
Comment by Chris Just — February 18, 2010 @ 10:46 am
I was very concerned when my midwife told me the DPH banned use of birthing tubs. I had a very successful natural birth at MGH in July 2009 and I don’t know what I would have done without the tub. I got in the tub twice and transitioned the second time. I was then able to get out, push for 30 minutes, and my son was born. I’m not exactly sure where the concern stems from. I highly doubt a health professional would allow a laboring mother to use a tub if they didn’t think they were physically able to get in and out of the tub safely. Given the extreme pain I was in as I transitioned, I was still able to easily maneuver the tub. What a shame that this great option has been taken away!
Comment by Beverly Blair — February 18, 2010 @ 12:21 pm
This is really disturbing. The tub made a huge difference for me when I gave birth and I spent most of labor in it. Is this an evidence based decision? This might push me toward having a home birth over birth center birth in the future (which is the opposite of what the DPH intends I would guess) since they can’t stop me from using my tub at home!
Comment by Jamie — February 18, 2010 @ 4:18 pm
I was wondering the same thing myself: Is this DPH decision evidenced-based? In my experience as a midwife and as a patient, the tub has never presented safety concerns. Protocols are already in place to prevent higher risk patients from using the tub. This kind of decision negatively affects the vast majority to potentially protect very few patients from rare, unexpected situations.
Comment by Chris Just — February 19, 2010 @ 8:59 am
I’ve been searching the Massachusetts DPH website and the U.S. Department of Health and Human Services and can’t seem to find this information anywhere but in this blog. Do you know where we might be able to find more information on this? I’m expecting my second in July and had a waterbirth with the first. My plan was to labor in the tub this go round and push “on land”. Just wanted to find out more info before I start changing the mental preparation process. Thanks!
Comment by Rebekah — February 19, 2010 @ 9:06 pm
I have had a hard time reaching anyone at DPH too. Both Mass General and Mt. Auburn have confirmed the DPH ruling. I am trying to find out if only Boston hospitals have been affected or if this is a state-wide decision. (If not yet state-wide then it may only be a matter of time). For now, your best bet is to contact your hospital and find out the current status of their labor tubs to see if you will personally be affected.
Comment by Chris Just — February 20, 2010 @ 1:28 pm