Water birth is relaxing, nurturing and healthy for babies and mothers, a natural event as it was intended to be. However, recent research has shown that not only is water birth a technique that is largely unrecognised in Egypt but that up to 80 per cent of childbirths in the country are also performed by Caesarean section. If you had the choice between delivering your child in a birth pool filled with warm water, or through a surgical procedure in which one or more incisions are made through your abdomen or uterus, what would you choose? If you had the choice as a child to be born naturally, saving your mother complications or surgical procedures, what would you choose? Such questions were discussed last month at the First Annual Natural Childbirth Conference in Egypt at the Bibliotheca Alexandrina in Alexandria. Technocratic, humanistic and holistic models of medicine were set out and discussed by obstetricians, midwives, labour and delivery nurses and laypersons, all with a view to deciding what the best delivery techniques should be. Only when the baby's or the mother's health is at risk should a Caesarean section be performed, but a very large number of Caesarean operations are performed at the mother's request without a medical reason to do so. It is for this reason that ARC Alex, the Alexandria Regional Centre for Women's Health and Development, an NGO, stated at the conference that there had been a sharp increase in Caesarean sections in Egypt, reaching 52 per cent in government hospitals and 80 per cent in private ones. This goes against World Health Organisation (WHO) recommendations, which state that the percentage of Caesarean should not exceed 15 per cent and that natural childbirth is the right of every woman. Women should have the right to deliver their babies naturally unless there is a pressing need for medical intervention. People sometimes see delivering a baby as a medical procedure, supposing that it requires surgery, anaesthetics, or sedatives and a stay in hospital. But pregnant women are not patients, and they may not need such procedures. “Women are women not patients. We should treat women in labour as women who are passing through a normal stage in their lives,” said Hana Qassem, an advocate for natural birth and water birth in Egypt and an affiliated scholar at the American Academy for Husband-Coached Childbirth. Qassem, who works as director of capacity building at ARC Alex, said that in Egypt there were many misconceptions regarding pregnancy and childbirth. “One is that many Egyptian women seek Caesarean sections thinking that the pain is less than with natural childbirth. This leads to a vast increase in the number of Caesarean sections. We are trying to correct such misconceptions at ARC Alex, helping women to understand that they can have their babies naturally,” Qassem said. ARC Alex gives classes in the Bradley Method of natural childbirth, also known as husband-coached childbirth, which cover a small programme with lots of individual attention. The standard length of the classes is 12 weeks covering 12 units of instruction. “The classes are all about mothers, babies and families and giving birth naturally. Every baby should have a natural childbirth. The classes are based on exercises and simple and effective techniques like focusing on natural techniques to manage labour and childbirth without the use of medications or medical interventions .These techniques and preparations result in an almost 86 per cent non-medicated birth rate,” Qassem said. It is also important for husbands to be their wives' coaches. “I know it is difficult for fathers in Egypt to change the way they view childbirth or pregnancy. However, it is important that coaches, preferably the husband, but possibly also the mother or the sister of the woman giving birth, understand that pregnancies should be kept healthy and low-risk,” she added. Alternate birthing positions, exercises, delayed cord cutting, breastfeeding immediately after birth, and other ideas are all taught during the classes. But the Bradley Method is just one natural childbirth method. AMANI, or Assisting Mothers for Active Natural Instinctive Births, is another approach, and this, handled from an Islamic perspective, is focused on giving training to midwives on how to empower expectant parents during pregnancy and birth. Water births have also taken place in Egypt, so far with great success. “Imagine yourself after a very long, tiring and stressful day. What would you do to relax,” Qassem asks. “In a water birth, a shower bath is filled with warm water to get the maximum degree of relaxation. That is what water birth is all about: to provide the woman with the highest possible relaxation for all her muscles and contractions.” Water birth carries the same risks as natural childbirth. It is “a gentle way to enter the world for the baby,” Qassem comments. “As the baby leaves the warm amniotic fluid, it enters the warm water of the birthing tub where sounds are muffled and then it is gently lifted up to the surface to start breathing.” “It is strange that more babies are not delivered in water. Water can help regulate blood pressure, respiration and heart rate. It raises endorphin levels, which are as strong as many narcotics. It decreases the adrenaline that can slow or stop labour. Scientifically speaking, babies are floating in water prior to birth. Water removes the weight of the uterus, making the mother feel lighter. She is able to change positions easily. It supports the labouring mother's body and muscles, greatly aiding in her ability to labour with less discomfort,” said Sandi Blankenship, an American certified midwife. “Water births also take less time than natural childbirths or of course Caesarean ones. They also do not subject the baby to respiratory problems. In the US, water births took off in 1991, and China has nine hospitals for water births. I think it is time for Egypt to take effective steps in this direction.” Any woman could easily choose to undergo a water birth, and Blankenship recommends that Egyptian women choose to do so. “It is not only about labour, but is also about how you want your baby to be delivered,” she said.
