Come February, moms in Alabama will have a choice they have never had before - to give birth in water, in a hospital.
Dr. Jesanna Cooper has been an OBGYN for 15 years. She practices at the Princeton Campus of Brookwood Baptist Medical Center, where the staff delivers between 300 and 400 babies a year.
“This is cutting edge for our state,” said Cooper. “When it comes to the medical community, you have to be brave to do this. It scares some people, so many doctors and nurses don’t do it. Something is comforting about doing things the way we always have – the way everyone else is doing it.”
Cooper said the only water birth options in Alabama right now are for at-home births, with a certified professional midwife (CPM) present.
“Yet our neighboring states, Georgia, Tennessee, and Florida all offer water births at the birth centers,” said Cooper. “We are so behind the times for pregnant women in Alabama, and I wanted to change that.”
Cooper said she started investigating hospital-based water births about five years ago. She has spent many hours reading, studying, and learning about the process.
“Alabama is behind other developed nations when it comes to water births,” Cooper said. “That’s not something the United States does a lot of because there is not a lot of guidance. You have to look outside to the Royal College of Obstetrics and Gynecology, based in London, United Kingdom; which is what I did - opposed to the American College of Obstetrics and Gynecology, where American doctors usually look.”
Over the past few years, Cooper started having conversations with the nursing staff and management to gather input and include everyone in the process.
“The administration and nursing staff verbally agreed and committed to the process,” Cooper said. “The final policy will go to a vote on January 20th, 2022, among the department which includes obstetricians, neonatologists, family practice physicians and pediatricians. Then it will go to the medical executive committee for a final vote before the hospital board signs off. And God-willing - the program will 'go live‘ on Valentine’s Day, February 14th. 2022.”
As it stands, the Princeton Campus of Brookwood Baptist Medical Center has four tubs, and the rooms have been refurbished to make room for the tubs.
“They are large, inflatable tubs with liners,” Cooper said. “We chose inflatables because they are more comfortable for women and soft on their knees. We have all the other equipment, and the nurses are undergoing training as we speak.”
When it comes to being a pioneer in this field, which many have called her, Cooper’s record speaks for itself. She also made it possible for certified nursing midwives (CNM) to join the hospital in 2016, and currently, three work at the Princeton Campus.
“The difference in Alabama, why more midwives are practicing in other states and not here is political,” Cooper said. “Pure politics. The medical association of Alabama, along with Blue Cross Blue Shield of Alabama, has not supported the expansion of nurse-midwifery. And that is a shame. It’s unfortunate for the women in this state. However, I believe it’s going to change because UAB school of nursing is opening up a midwifery program in the next couple of years. It will bring comfort and awareness because most physicians in Alabama have not been exposed in their formal education to midwives and don’t realize what an asset they can be.”
Through her own experiences, Cooper said she believes water births can provide many benefits.
“Here’s the thing,” Cooper said. “I had two children of my own back in the day. Normal medicated births. I was not unhappy with my births, but I also didn’t love them. I struggled with breastfeeding, and when I started reading about it, I learned that many things we routinely do in labor negatively affect your milk supply and breastfeeding success. And a woman’s supply in the first 24 hours determines their supply six months down the road. I suddenly realized a lot I never learned in medical school, and doctors are not prioritizing this. So, I began reading a lot of midwifery books, then started working with Doulas, and the progression led to water birth.”
Cooper said giving birth in the water is much less painful and more pleasant in some regards.
“Afterwards, the women who choose that route are empowered,” Cooper said. “They are so proud of themselves and can move around much easier and get back to themselves. My c-section rates have decreased a ton over the years once we learned that moving around can help the baby come out, so of course, in the water, you can move a ton because you are buoyant.”
Cooper does warn that not everyone is a good candidate for a water birth.
“Anyone who has an issue with their placenta would not be ideal - those women with high blood pressure, diabetes, intrauterine growth restriction (IUGR), and preeclampsia would not be good candidates for water birth,” Cooper said. “And of course, like any other birth, shoulder dystocia and post-partum hemorrhage are risks. The added struggle with a tub, hemorrhaging into water is harder to detect. What scares people is once the baby comes out of the water, it can’t go back into the water because the baby would drown. So, if a mom stands up, we have to make sure she doesn’t sit back down until baby is safe and snuggled on her chest.”
And the upside of water births, no narcotics, and no epidurals are required.
“My role as an OBGYN includes assisting women in giving birth in ways that are safe and also empowering,” said Cooper. “Having choices and options regarding birth experience is a significant factor in whether that experience is empowering or traumatic. Women want waterbirth, so I want to help make that a safe option that is available to them in the hospital setting.”
Cooper said water birth may not be appealing to all women, but the most crucial part of the option being available is that women in Alabama now have the choice.
“I have spent the last decade working to create a practice that supports and empowers families,” said Cooper. “This has meant looking outside of the medical culture in which I trained and looking at how things are done in developed nations with better birth outcomes than in the U.S. After working with doulas, credentialing nurse midwives, initiating group prenatal care, supporting water labor, achieving baby-friendly certification, and learning to address labor dystocia through position changes, water birth seemed the next logical step. My hope for Alabama is that we will see a cultural shift resulting in expanding access to these types of services across the state.”