April 24: Allina halts all water births, upsetting expectant moms

Water births were a celebrated feature of Allina Health's Mother Baby Center when the $50 million Minneapolis facility opened last year and Allina's chief medical officer hailed it as a place to "support every mother" and birthing style.

Until last week, at least, when Allina pulled the plug on water births at its 11 Minnesota hospitals and the Mother Baby Center, citing new guidance from the nation's obstetricians and pediatricians about persistent safety concerns.

Now, expectant mothers are scrambling to find new locations to accommodate their water births, and leaders in the Twin Cities' alternative birthing community are protesting the decision. "They're taking away my choice," said Tara Rajdl, a 25-year-old Blaine woman who planned her second water birth at Allina's center. "It's my choice how I want to bring my child into the world."

Immersing pregnant women waist-deep in water is thought to reduce labor pains and assist delivery without pain medication; its growing popularity is why a birthing tub was built into the new Mother Baby Center and featured at its grand opening in February 2013.

Allina's enthusiasm dimmed last month, however, when the American Academy of Pediatrics discouraged water births because of safety concerns, including the possibility of an umbilical cord rupture if a baby is rushed above the water too quickly, or of aspiration of water if the baby is left underwater too long.

The academy, in conjunction with the American Congress of Obstetricians and Gynecologists, recommended that water births be performed only in research studies to determine their safety.

Allina is planning such a trial and expects to resume water births on a study basis within six months, said Dr. Lisa Saul, president of clinical service at Allina's Mother Baby Center. The nature of the safety concerns prompted Allina to halt water births immediately rather than phase them out with existing patients, she added.

"If it's an issue of safety, there really isn't a grace period for that," Saul said. "I certainly understand the disappointment of the mom who is due in the next few weeks who had planned to deliver in this manner."

The decision will cost Allina business, as 147 of the 5,153 deliveries at the Mother Baby Center last year were water births.

Competing hospitals within the Fairview, HCMC, HealthEast and HealthPartners systems plan to continue the practice.

Last month's statement was the first official policy guidance by the Pediatrics Academy regarding water births, though it did publish similar concerns in 2005. Much of the evidence regarding safety concerns existed well before Allina decided to promote water births at its Mother Baby Center.

Saul said the latest guidance had more power than previous reports because it came from two major medical groups. The recommendation also weighed heavily on Allina, she added, because it needs to make sure water births are provided consistently by doctors and midwives across its entire hospital system.

Rajdl is 34 weeks pregnant and scrambling to find another birthing center with a water birth option. Insurance restrictions won't allow her to return to the center in St. Louis Park where her first son was born in a tub, but she is visiting others.

Rajdl might need to find a new midwife as well; her current one has credentials to perform deliveries only at the Allina facility.

"The only thing would be the timing," she said, because some doctors and midwives won't take new patients so late in their pregnancies. "Otherwise, I'm ready to go."

Allina's decision triggered criticism from doulas and midwives who support natural childbirth in the Twin Cities. They held a protest Monday in front of Allina's St. Francis Regional Medical Center in Shakopee.

Traditional and alternative birthing advocates have long quarreled over the depth of evidence needed to prove the safety of options such as water births — especially when mainstream options such as epidural anesthesia and C-sections aren't risk-free.

Women who chose the Mother Baby Center because it touted water births are being treated unfairly, said Liz Hochman, a doula and leader of the Childbirth Collective, a Twin Cities advocacy group for alternative birthing methods. "They could be in labor today, and they made that decision because of this big marketing ploy that, 'Hey, we have water births now!' "

Allina still offers hydrotherapy, meaning that women can sit in tubs during their initial labors to reduce the pain of contractions.

If Rajdl can't switch birthing sites, she plans to make use of the tub at the Mother Baby Center so she can try to give birth again without pain medication. She wondered aloud what would happen if she got in the tub, then refused to get out.

"Could they physically make me get out?" she asked with a laugh — sort of.

Jeremy Olson • 612-673-7744