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Pregnancy

Legionnaire’s Disease Linked to Immersion Birth, Says CDC

Kristie Rivers, MD, FAAP, Board Certified Pediatrician
January 3, 2019 . 2 min read

Mothers have many choices when it comes to creating a birth plan, and some of them are quite controversial among the medical community. Water births — also called immersion births — have long been viewed as problematic for a variety of reasons, but now doctors and public health officials have identified even more reason for concern.

Last year, two infants born in birthing pools in Arizona contracted Legionella, a potentially deadly bacteria that thrives in damp environments. Both infants who contracted Legionella from birthing pools during water births were thought to have inhaled contaminated water into their lungs during the birth. Fortunately, with antibiotic treatment, both infants survived.

Legionella is a bacteria that lives in warm, damp environments, so it can easily multiply in water tanks or pipes. People can then become infected by breathing in the contaminated water droplets, or if the water accidentally goes into their lungs. Legionella can cause pneumonia and other respiratory problems. Left unrecognized and untreated for too long, this can prove to be deadly, especially among immunocompromised individuals, such as infants and the elderly.

Legionella can cause outbreaks of illness, often in areas with large heating and cooling systems. This bacteria has been linked to outbreaks in hotels, nursing homes, hospitals, and cruise ships.

Public health officials do state that such infections are rare, but infants born in water are at risk due to the fact that there are no standardized infection prevention measures for water births. Even if the birthing tub is thoroughly cleaned and disinfected prior to use, the plumbing system itself could be contaminated.

The American College of Obstetrics and Gynecology (ACOG) does not recommend water births, as they have shown no proven benefit to the mother or the newborn. They also state that the safety and efficacy of submersion in water during delivery has not been established, so both the mother and the baby could be at risk.

If you do decide to give birth in a birthing pool or tub despite the risks, there are precautions you should discuss with your physician or midwife before you go into labor. Make sure the facility you are using has strict protocols to maintain and clean the tubs as well as criteria for monitoring both the mother and the baby during active labor while submerged. Also make sure the facility has a plan in place to move you quickly and safely out of the water if an unexpected complication arises.

Sources:

  • American College of Obstetricians and Gynecologists
  • Immersion in Water During Labor and Delivery.
    Centers for Disease Control and Prevention
  • Legionnaire’s Disease.
    Red Book Online
  • Legionella pneumophila Infections.
    Washington Post
  • Infants born in water births at risk of Legionnaires’ disease, CDC says.

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