Water Birth

Water birth is the process of giving birth in a tub of warm water. Some women choose to labor in the water and get out for delivery. Other women decide to stay in the water for the delivery as well. The theory behind water birth is that the baby has been in the amniotic sac for 9 months and birthing into a similar environment is gentler for the baby and less stressful for the mother.

It is the belief of midwives, birthing centers and a growing number of obstetricians, that reducing the stress during labor and delivery also reduces fetal complications. Water birth should always occur under the supervision of a health care provider.

What are the potential benefits of water birth?

Benefits for Mother:

  • Water is soothing, comforting, relaxing.
  • In the later stages of labor, the water seems to increase the woman’s energy.
  • The buoyancy lessens her body weight, allows free movement and new positioning.
  • Buoyancy promotes more efficient uterine contractions and better blood circulation, resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby.
  • Immersion in water often helps lower high blood pressure caused by anxiety.
  • Water seems to alleviate stress-related hormones, allowing the mother’s body to produce endorphins, which are pain-inhibitors.
  • Water causes the perineum to become more elastic and relaxed, which reduces the incidence and severity of tearing and the need for an episiotomy and stitches.
  • As the laboring women relaxes physically she is able to relax mentally, concentrating her efforts inward on the birth process.
  • The water provides a sense of privacy, which releases inhibitions, anxiety, and fears.

Benefits for Baby:

  • Provides a similar environment as the amniotic sac.
  • Eases the stress of the birth, providing reassurance and security.

What are the risks to the mother and baby?

Over the last 30 years as water birth has grown in popularity, there has been very little research done to determine the risks of water birth. Some studies have been done in Europe demonstrating similar perinatal mortality rates between water births and conventional births.1 According to an article written by the Royal College of Obstetrician and Gynecologists, there may be a theoretical risk of water embolism, which is when water enters the mother’s blood stream.2 Though the British Medical Journal is 95% confident in water births, they do see a possible risk for water aspiration. If the baby is experiencing stress in the birth canal or the umbilical cord becomes kinked or twisted, the baby may gasp for air, possibly inhaling water into the lungs.3 This would be rare because babies do not inhale air until they are exposed to air. They receive oxygen through the umbilical cord until they start to breathe on their own or until the cord is cut. The final potential risk to consider is that the umbilical cord could snap as the baby is brought to the surface of the water. This is preventable by using caution when lifting the baby up to the mother’s chest.

What situations are not ideal for water birth?

  • If you have Herpes: Herpes transfers easily in water, so you will want to discuss this thoroughly with your health care provider.
  • If your baby is breech: Though water birth has been done with bottom or feet first presentations you will want to discuss this thoroughly with your health care provider.
  • If you have been diagnosed with one of the following: excessive bleeding or maternal infection.
  • If you are having multiples: Though water births have been successful with twins around the world, you will want to discuss this thoroughly with your health care provider.
  • If preterm labor is expected: If a baby is pre-term, two weeks or more prior to due date, water birth is not recommended.
  • If there is severe meconium: Mild to moderate meconium is fairly normal. Since meconium floats to the surface in a tub, your health care provider will watch for it and remove it immediately, or help you out of the tub. Meconium usually washes off the face of the baby and even comes out of the nose and mouth while the baby is still under water. If the water is stained and birth is imminent, the woman can lift her pelvis out of the water to birth the infant.
  • If you have toxemia or preeclampsia: You will want to thoroughly discuss this with your health care provider.

I thought hot tubs and whirlpools could be dangerous during pregnancy?

It depends on the temperature. If water is too hot, dehydration and overheating become risks to you and the baby. You will want to be sure to stay well hydrated and make sure the temperature of water stays at 97 degrees Fahrenheit. Birthing pools are specifically made with this precaution in mind.

How do I prepare for a water birth:

  • Check first with your health care provider. They may already be equipped for water birth with a special tub, or know where to refer you in your area.
  • If you plan to give birth at a hospital, make sure their policies are water birth friendly. More and more hospitals are welcoming parents who want to try water birth.
  • You can rent a birthing tub for about $350. Check online or in the phone book. Be sure to ask if fees include shipping both ways and any other extras to make your birth experience more enjoyable. Check with your insurance company to see if they will reimburse the expense of the rental.
  • Contact a local birth center to see if they provide water birth options.
Last Updated: 05/2007

Compiled using information from the following source:

1 Gilber RE, Tookey PA. Perinatal mortality and morbidity among babies delivered in water: national surveillance study. BMJ 1999; 319:483-7

2 LMM Duley MRCOG, Oxford. “Birth In water: RCOG Statement No. 1.” Royal College of Obstetricians and Gynecologist. January 2001.

3 “Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey.” British Medical Journal. August 21, 1999.

Gentle Birth Choices Harper, Barbara, R.N., Ch. 6

American Pregnancy Association, http://www.americanpregnancy.org

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