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Water birth has garnered considerable attention in the last decade. There are numerous online resources for women thinking of giving birth in a tub or pool. And, although this practice is generally accepted among midwives, it’s not widely accepted by doctors. Is it because delivering in water could put your baby at risk of complications? How can you estimate the benefits versus the risk for you and your baby? Let’s review the basics about water birth. Hopefully, this article will help you decide if it’s right for you.
What is water birth?
A water birth means at least part of your labor, delivery, or both happen while you’re in a tub or pool filled with warm water. It can take place in a hospital, a birthing center, or at home. A doctor, nurse-midwife, or midwife helps you through it.
The potential benefits of water birth
Water birth during the first stages of childbirth (when contractions start until your cervix is fully dilated) may:
- Help ease pain
- Reduce the need for anesthesia 
- Decrease the duration of labor
- Give you a greater sense of control
- Conserve your energy
- Reduce perineal trauma 
- Reduce the likelihood of an episiotomy
I must point out that these potential benefits are based purely on anecdotal evidence, with no randomized controlled trials that would allow an evidence-based assessment of the safety and benefits of water births.
The potential risks of water birth
Babies don’t breathe in utero, they receive oxygen via the umbilical cord. Therefore, the American College of Obstetricians and Gynecologists (ACOG) cautions against water immersion during delivery. In the rare case your baby does take a breath underwater, it can cause potentially serious complications including drowning and meconium aspiration. Consequently, during the second stages of childbirth (when your cervix is completely dilated and you start pushing until the time your baby is born) you should exit the tub or pool. Your practitioner will most likely be monitoring your baby’s condition with an underwater Doppler device to make sure everything is all right. Why do I suggest you exit the water close to the final push? Think about it. In case something goes wrong and your baby’s birth becomes an emergency, every minute counts. It will be much easier for your practitioner to help you if you are out of the water. However, if you (with the support of your practitioner) decide to have an underwater delivery, your baby’s underwater entry should be limited to no more than a few seconds.
Water birth is also associated with rare potential risks that you should be aware of, even if they are unlikely you would experience them:
- You or your baby could get an infection
- The umbilical cord could snap before your baby comes out of the water
- Your baby’s body temperature could be too high or too low
When water birth is not for you?
Electronic fetal monitoring is not possible under water. Therefore, water birth is only an option if your pregnancy is low-risk . WebMD does not recommended water birth in the following cases:
- You’re younger than 17 or older than 35
- You have complications like pre-eclampsia or diabetes
- You’re having twins or multiples
- The baby is in the breech position
- The baby is premature
- You’re having a really big baby
- You need to be constantly monitored and it can’t be done in the tub
- You have an infection
Where you can have a water birth?
Most birthing centers and hospitals do not have birthing pools or Jacuzzis on-site. Some may help you rent one, after you get the necessary permission. Google where you can find the right equipment for your needs. There are several companies that rent comfortable birthing tubs equipped with a thermometer (the water should be between 95 and 100 degrees but no more than 101). Also, let your medical insurance company know about your plans as soon as you make them, since they may cover the cost of renting or buying water birth equipment. Of course, if you’re planning to deliver at home, you’re free to take advantage of your bathtub — or bring in a birthing tub that’s big enough for you and your birthing partner!
- Yinglin Liu, Yukun Liu, Xiuzhi Huang, Chuying Du, Jing Peng, Peixian Huang, Jianping Zhang (2014). A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery. BioMed Central.
- Garland, D (2000). Waterbirth: An Attitude to Care. Elsevier. ISBN 0750652020.
- Royal College of Midwives/Royal College of Obstetricians and Gynaecologists (2006). Immersion in water during labour and birth.