Water Birth: Benefits, Risks, and What You Need to Know

Childbirth in America is changing, and expectant mothers are becoming more vested in finding natural options. This has led to a rise in water births — a delivery in a tub full of water rather than a bed — which has been shown to increase a mom’s comfort during childbirth while decreasing their pain.

If you’re nearing your third trimester of pregnancy and are looking into whether water birth is right for you and your baby, we’ve listed everything you need to know about this medication-free method and the pros and cons to help you decide.

What is a Water Birth?

Water birth is the process of being immersed in a birth pool or tub filled with warm water while laboring or when delivering your baby; though, you may be able to perform both in water depending on where you give birth.¹

Typically, mommas-to-be remain in water throughout the first stage of labor when contractions are persistent, then relocate to a bed to give birth. If moms can remain in the water for delivery, their baby is born underwater, and they can continue receiving oxygen through the umbilical cord. Within five to 10 seconds, the newborn is gently brought to the surface to take their first breath of air.^2,3,4

Providing mothers with a more natural option to labor, water birth can help ease the pain of labor without medication and anesthetics (say goodbye to epidurals!) and keep mothers relaxed and less anxious. Women can also move and shift their bodies in the tub more easily than in a bed, giving them more control while laboring.⁵

For some mommas, a water birth means their little ones can be born in a less stressful environment. They believe the water will be a less disruptive experience, as it may feel familiar to their new baby since they spent nine months surrounded by amniotic fluid. Once they arrive, the hope is their bundle of joy should feel calmer.⁶

Where Can I Have a Water Birth?

Since OB-GYNs don’t widely practice water births in the U.S., they’re offered mainly by midwives independent from hospitals. They are commonly performed at home births or in a birthing center — a free-standing facility that provides a comfortable, home-like setting.⁷

While not all birthing centers offer the same amenities, most have private rooms with a queen or double bed, a rocking chair or reclining seat, a private bathroom and standing shower, a tub, Bluetooth speakers (to play soothing tunes, of course) and even some décor with motivational messages.

Although limited, some hospitals in the U.S. have the proper staffing and facilities to accommodate water births, but they may be challenging to find. Less than 10% of hospitals offer it as an option for labor and delivery. Many avoid it entirely due to higher liabilities associated with water births.^5,8

What are the Benefits?

Moms searching for natural pain management, relief from the typical pangs of childbirth, mobility during labor, and flexibility throughout delivery may find their holy grail in water births. Additional benefits of water immersion (also known as hydrotherapy) backed by the American Pregnancy Association include the following:⁶

• Induces relaxation: Floating in warm water helps moms feel less tense and allows their muscles to relax since they don’t have to support their bodies fully. One study found that laboring in water also reduces hormones that cause stress and the fight or flight response, allowing the body to trigger necessary endorphins that block pain.⁹
• Reduces the need for medication: When labor pains start to alleviate, women can better handle the aches that do come on, eliminating the need to rely on medication and painkillers.¹⁰
• Can help shorten labor: Yep, that’s right. Water births can help shorten the duration of labor’s first, second, and third stages. This may result from women feeling more physically and mentally relaxed when in water.¹¹
• Freedom to move as needed: Thanks to the buoyancy of the water, pregnant moms can move freely in a birth pool to find positions that work for them — hello, lower back relief!⁸
• Lowers your blood pressure: Just as taking a warm bath after a long day helps you forget your day’s worries, hydrotherapy can provide the same feel-good feelings. Hydrotherapy may help lower blood pressure and decrease feelings of anxiety. This allows your mind to clear and focus better on the birth process rather than your concerns.¹²
• Lessens the chance of an episiotomy: Researchers found that the rate of episiotomies was significantly lower in water births than in deliveries performed in bed. At the same time, the number of perineal tears in the study was similar.¹³

What are the Risks?

Until more data can be provided, some medical experts advise against water births. Here are several risks the American College of Obstetricians and Gynecologists (ACOG) and other experts recommend moms to be aware of:^5,14

• Chance for infection: It’s common in childbirth for women’s bowels to move and bodily fluids (like blood) to release. Women sitting directly in the tub water may be more susceptible to infection from bacteria or viruses that come with feces or fluids. Babies can also be at risk if they swallow contaminated water. While unlikely, this would occur if their oxygen supply from the placenta is compromised. Research is mixed regarding infection risk.^15,16,17
• Tear in umbilical cord: As with a traditional birth, the umbilical cord could snap as a newborn is brought to the surface, which can cause blood loss in the baby.⁶
• Drowning or inhaling water: If the umbilical cord gets wrapped around the baby’s neck or twisted, there’s a slight chance they may gasp for air and inhale water. However, this is rare, as babies typically only inhale once exposed to air. A 2004 study lists near-drowning and drowning as water birth complications parents should be aware of.¹⁸
• Fetal distress: It’s best to ensure the water a little one is born into maintains a temperature of about 98 degrees Fahrenheit. If the temperature is too hot, your baby’s heart could spike; if the water is too cold, it could cause distress.⁴

How to Improve Your Chances of a Water Birth

The good news is water births don’t pose increased harm to newborns when compared to land births or births that happen out of the water and in a bed, according to findings from Oregon State University. Of the 6,500 U.S.-based water births examined, infants were no more likely to be transferred or admitted to a hospital after birth or be hospitalized within the first six weeks of life after a water birth.¹⁹

Although the study presents findings that can help ease mom’s worries, it’s best to proceed cautiously to ensure a water birth is your best and safest option. Here are some factors that can pose a danger to you:¹

• Age: If you’re younger than 17 or older than 35
• Health concerns: If your baby is premature or in a breech position, or if you have an infection, are diabetic, or were diagnosed with preeclampsia, a high blood pressure disorder that occurs in pregnancy.²⁰
• You have more than one bun in the oven: If you’re having twins or multiples.
• You’re high risk: If you have to be constantly monitored, which cannot be done in a tub.

Ensuring a Safe Water Birth

Even if you don’t check off the “at-risk” boxes, there are still a few things to consider when having a water birth to keep you and your baby safe:

• Conduct thorough research on your preferred birthing center to ensure they meet the regulations and standards laid out by the American Association of Birth Centers, such as proper infection control measures.²¹
• Drink plenty of water to avoid dehydration.
• Ask your midwife to check the water temperature, ensuring it stays between 97 and 100 degrees Fahrenheit.
• Ensure you understand the plan for if and when you need to move from the tub. For instance, if you decide midway through labor that you’d prefer to finish your labor and delivery in bed, ask your midwife what will happen in advance so you feel confident and comfortable if you change your mind.
• Discuss with your midwife and birthing center how emergencies are handled — the more you know, the more relaxed you’ll feel during delivery.

It’s essential to take precautions if you proceed with a water birth. Talk with your physician or midwife to see if you’re an ideal candidate for a water birth before moving forward, and base your decision on your comfort levels and your baby’s health.

Resources

1. https://www.webmd.com/9j7g

2. https://www.mayoclinic.org/20046545

3. https://www.nct.org.uk/lbdtw

4. https://www.ohsu.edu/whwb

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210671/

6. https://americanpregnancy.org/hplbwb

7. https://www.unlv.edu/news/release/research-brief

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8972863/

9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940223/

10. https://pubmed.ncbi.nlm.nih.gov/10971083/

11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983243/

12. https://www.health.harvard.edu/hhbs

13. https://pubmed.ncbi.nlm.nih.gov/17440268/

14. https://www.acog.org/ccgco

15. https://pubmed.ncbi.nlm.nih.gov/17272934/

16. https://www.sciencedirect.com/S0301211506005148

17. https://europepmc.org/article/med/12708093

18. https://pubmed.ncbi.nlm.nih.gov/15167820/

19. https://www.sciencedaily.com/01/160121190918.htm

20. https://www.mayoclinic.org/syc-20355745

21. https://www.birthcenters.org/bcs1