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 since the baby has already been in the amniotic fluid sac for nine months, birthing in a similar environment is gentler for the baby and less stressful for the mother.

Midwives, birthing centers, and a growing number of obstetricians believe that reducing the stress of labor and delivery will reduce fetal complications. Water birth should always occur under the supervision of a qualified health care provider.

What are the potential benefits of water birth?

Benefits for Mother:

• Warm water is soothing, comforting, relaxing.
• In the later stages of labor, the water has been shown to increase the woman’s energy.
• The effect of buoyancy lessens a mother’s body weight, allowing free movement and new positioning.
• Buoyancy promotes more efficient uterine contractions and improved 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.
• The water seems to reduce stress-related hormones, allowing the mother’s body to produce endorphins which serve as pain-inhibitors.
• Water causes the perineum to become more elastic and relaxed, reducing the incidence and severity of tearing and the need for an episiotomy and stitches.
• As the laboring woman relaxes physically, she is able to relax mentally with greater ability to focus on the birth process.
• Since the water provides a greater sense of privacy, it can reduce inhibitions, anxiety, and fears.

Benefits for Baby:

• Provides an environment similar to the amniotic sac.
• Eases the stress of birth, thus increasing reassurance and sense of 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 regarding the risks of water birth. Some studies in Europe have shown 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 might be a theoretical risk of water embolism, which occurs when water enters the mother’s blood stream.² Though the British Medical Journal is 95% confident in the safety of water births, they see a possible risk of water aspiration.

If the baby is experiencing stress in the birth canal or if the umbilical cord becomes kinked or twisted, the baby might gasp for air with the possibility of inhaling water.³

This would be a rare occurrence because babies do not normally inhale until they are exposed to air. They continue to receive oxygen through the umbilical cord until they start to breathe on their own or until the cord is cut. The final potential risk is that the umbilical cord could snap as the baby is brought to the surface of the water. This can be prevented 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 should discuss this risk thoroughly with your health care provider.
• If your baby is breech: Although water birth has been done with bottom or feet first presentations, you should discuss this risk 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: Although water births have been successful around the world with twin births, you should discuss this risk thoroughly with your doctor.
• 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 should thoroughly discuss this risk with your health care provider.