Boy's birth wet, but not wild.

Byline: THE HEALTH FILES by Tim Christie The Register-Guard

AN EXTREMELY PREGNANT Gila Fox leaned against a counter in a birthing suite at McKenzie-Willamette Hospital, her legs shaking so badly she could barely stand. She understood why they call it labor.

Then she settled into a large, portable hot tub and sighed in relief as the 100-degree water relaxed and supported her. Fox labored there for the next four hours until, at 6:23 a.m. on Oct. 23, she delivered an 8-pound, 12-ounce boy.

Galen Olallie Fox became the first official water birth at the Springfield hospital and the latest member of a growing roster of babies born under water.

Water births, once considered an alternative medicine fad practiced primarily by women who deliver at home, is gaining credibility and acceptance at hospitals and birth centers as a safe option for mothers who want more control over their labor. Fox is a believer.

"Gravity wasn't an issue," she said. The buoyancy meant she could float easily to different positions until she found one that was comfortable. "Your consciousness dissipates into the water. I felt I was conserving energy, knowing the water was supporting me physically."

As recently as 1996, only seven hospitals nationwide permitted water births. Today, nearly 200 across the country, including five in Oregon, allow doctors, midwives and mothers to do water births.

"It has been an exponential increase," said Barbara Harper of Wilsonville, a leading advocate and national expert in water births.

"Birth in water really returns the control of the birth to the woman," she said. There are very few medical interventions doctors and nurses can do when a woman is laboring in a hot tub. "It becomes a hands-off procedure."

Harper is founder of Waterbirth International, a research, resource and referral service, and author of "Gentle Birth Choices." She and others attribute the growing acceptance of water births to a number of factors: Several studies have found them to be safe; consumers are demanding more options; and hospitals are looking for ways to attract more customers.

The method can shorten labor by easing a woman's pain and helping her mind and body relax, experts say.

Water births have been offered at European hospitals for years. American hospitals have long encouraged women to labor in water to ease their pain, but have been slower to actually allow births under water. The first U.S. water birth occurred in 1991 at Monadnock Community Hospital in New Hampshire.

While Galen Fox was the first official water birth at McKenzie-Willamette, he was not actually the first baby born under water there.

In October 2000, a woman was laboring in water and when it came time to deliver, she refused to get out of the tub. Hospital officials were not amused, though both mother and baby were fine.

It took about a year for McKenzie-Willamette to establish a protocol for water births and a system for practitioners to obtain water-birth privileges.

Registered nurse Syndee Carlson, patient care coordinator in the hospital's Women's Health and Birth Center, first began researching water births several years ago, but the idea died for lack of consumer interest, she said.

But then more women began asking about water births, and Dr. Jan Stafl, a Eugene obstetrician, and Springfield midwife Michele Bouche asked McKenzie-Willamette to again consider permitting water births.

"It did meet a lot of resistance from skeptical physicians," Stafl said.

Carlson admits that she was dubious when she first looked into water births several years ago. "I thought, `Oh man, how did I get assigned to this.' Now I look at it as an acceptable birth choice."

Members of the hospital's medical staff also had concerns. Some viewed water births as "a counterculture-type procedure" associated with lay midwives and home births. Others were concerned about the risk of infection and about technical aspects of monitoring the baby's health during labor.

With the help of various experts, Carlson was able to address those concerns, and McKenzie-Willamette is now planning to buy its own tub for water births.

Brian Terrett, PeaceHealth spokesman, didn't respond to repeated queries about whether Sacred Heart Medical Center in Eugene was considering granting privileges for water births.

One of the most common questions about water births is whether they pose a danger of drowning to the baby.

"Gasping is the very last thing on the baby's list of things to do if he gets into trouble," said Polly Mawlby, a certified nurse midwife and assistant professor at Oregon Health & Science University in Portland.

A normal, healthy baby is coming from an environment where there was warmth, water, pressure and darkness, and as his head comes out of the birth canal, he finds those same conditions in the tub, she said.

"It's not a big surprise to him," she said.

The baby's first stimulus to breath is not being delivered but exposure to air, Stafl said.

Once delivered, the baby will stay in the water for less than a minute, and often only for 10 or 20 seconds. The key is to gently bring the baby up to the mother's chest, making sure the umbilical cord is not wrapped around the baby's neck and taking care not to break the cord, Mawlby said.

There's some question about whether women experience more perineal tearing with water births. Stafl said research shows women experience fewer tears, but Mawlby said some women tend to push more quickly under water, and a midwife isn't able to keep pressure on the perineum to prevent tears.

Stafl has become a believer in water births because it fits his philosophy of holistic medicine, which tries to account for a patient's mind and spirit as well as body.

He prefers to call it water-assisted birth. A woman can start out in the water as an aid to labor but choose to get out to deliver.

"The expectation should not necessarily be having the baby under water," he said. "The expectation is having a healthy mom and a health baby."

Not every woman is a candidate for a water birth. Women who are obese, or giving birth to twins, or have some maternal illness, or whose babies have shown signs of fetal stress, shouldn't try water births.

"It's considered a technique for low-risk moms," Stafl said.

For Gila Fox and her husband, Tim, both wildlife biologists who work for Oregon State University and live at McKenzie Bridge, water-assisted birth made sense.

Gila wanted to have a natural childbirth, with no drugs to dull the pain. She thought about how relaxing it was to take a nice hot shower or bath. She liked the idea of being more in control of her labor, without a lot of medical intervention.

In the tub for four hours, she pushed for about 48 minutes and Tim joined her in the tub for the last 20 minutes, supporting her back.

The final moments, she said, "are more emotional than verbal." After a moment of self-doubt, she found the strength to make it happen.

"I knew I was ready to meet our child on the outside," she said.

Galen came out in the water, looking "kind of ghostly" and blue, not uncommon with water births. Less than a minute after delivery, the midwife Bouche floated the infant up to Gila. She and Tim cradled their new son while helpers rubbed his limbs.

"I'd really recommend it," Fox said. "It treats the whole birth process not as a disease but as a beautiful, natural event."

Tim Christie covers health and medical issues. Call 338-2572 or e-mail tchristie@ guardnet.com.

CAPTION(S):

Newborn Galen Olallie Fox is the first official water birth at McKenzie-Willamette Hospital and the latest member of a growing roster of babies born using the technique. For Gila Fox (right) and her husband, Tim, water-assisted birth made sense. NICOLE DeVITO / The Register-Guard