Water births have become increasingly popular over the past few decades as more women seek natural childbirth options. But are water births really all they’re hyped up to be? Let’s take a closer look at the pros and cons of giving birth in a tub.
What is a Water Birth?
A water birth refers to the process of laboring in a birthing pool or tub filled with warm water and giving birth underwater. The theory behind water births is that the water provides a soothing, womb-like environment for the baby to transition from the uterus into the world.
During a water birth, the mother enters the birthing tub in the later stages of labor, anywhere from 5-10 centimeters dilated. She remains in the tub for the delivery of the baby and immediately afterward. The baby is born underwater and brought to the surface within seconds.
Water births typically take place in a hospital birthing suite, birthing center, or at home with a midwife or doctor present. The birthing tub is specifically designed for water births with features like handrails, seats, and water jets.
The Potential Benefits of Water Births
Why might someone choose a water birth? There are several potential benefits that attract women to this birthing method:
- Pain relief – Being immersed in warm water can significantly reduce pain and discomfort during labor. The water helps the mother relax, which causes her body to release endorphins that act as natural painkillers.
- Mobility – The water makes it easier for the mother to change positions and stay upright, which facilitates the downward progression of the baby. Being upright also relies on gravity to move the baby through the birth canal.
- Less traumatic for baby – Proponents argue that a gentle water birth is less traumatic for babies than conventional births. The water eases the transition as they emerge from the warmth and comfort of the uterus.
- Promotes relaxation – The water creates a calming, spa-like environment for the laboring mother. This can reduce anxiety and allow the natural birthing instincts to take over.
- Less intervention – Women who use water for pain relief may be less likely to need epidural anesthesia or other interventions. This means less exposure to side effects from medications or procedures.
Overall, the main benefit of a water birth is providing a warm, tranquil environment that can facilitate a natural, low-intervention birth experience for the mother.
Potential Risks and Concerns with Water Births
Despite the purported benefits, water births also come with some risks and drawbacks to consider:
- Risk of infection – Babies delivered underwater are at an increased risk of infection, including Legionnaire’s disease and other waterborne illnesses. Proper cleaning procedures must be followed to disinfect the tub.
- Difficulty regulating body temperature – Babies born underwater may have a harder time transitioning to life outside the womb and regulating their body temperatures.
- Respiratory distress – Babies can inhale water into their lungs, causing potential breathing problems after birth. There are techniques to minimize this risk.
- Navel cord rupture – The umbilical cord can snap or rupture when the baby is brought to the surface too quickly.
- No pain medication – For mothers who want medicated pain relief, water births do not allow access to epidurals or other medications.
- Less monitoring – Continuous electronic fetal monitoring is difficult in a water birth, which limits the ability to detect fetal distress.
These risks are rare when proper protocols are followed, but they should still be considered by expectant mothers weighing their birthing options.
Studies on Water Birth Safety and Benefits
Numerous studies have looked at the safety of water births and potential benefits compared to conventional deliveries. Here is a summary of the research:
- A 2009 Cochrane review of 12 trials found no evidence of increased adverse effects for water births compared to conventional births.
- A 2015 study found water births reduced the use of epidurals and episiotomies compared to regular deliveries.
- Research shows water births result in similar Apgar scores and neonatal outcomes versus conventional births when proper protocols are followed.
- One study found a lower risk of severe perineal tears among women who had a water birth.
- Some studies show a reduction in labor time for women who spend the first stage of labor immersed in water.
Overall, the current research suggests water births are safe when done under proper medical supervision and sanitary conditions. The benefits seem most significant in terms of reduced interventions and medications.
Who Can Have a Water Birth?
Water births are an option for healthy women experiencing a low-risk pregnancy. Guidelines typically exclude the following candidates:
- Women with pregnancy complications like gestational diabetes or preeclampsia
- Women carrying more than one baby
- Babies in the breech position
- Women with active genital herpes sores
- Women with low-lying placenta (placenta previa)
- Women undergoing induction of labor
Women should discuss eligibility with their doctor or midwife early in pregnancy if planning a water birth. They will determine if it is safe based on the mother and baby’s health.
How to Prepare for a Water Birth
Women interested in a water birth should take these steps to prepare:
- Talk to your care provider and confirm the hospital or birthing center accommodates water births.
- Take a childbirth education class to learn techniques for laboring in water.
- Read up on water birth protocols and safety precautions.
- Have a support person present who is comfortable with water birth.
- Pack supplies like a bathing suit, pillows, essential oils, etc.
- Create a birthing plan outlining your preferences and contingencies.
- Consider renting or purchasing a birthing pool if delivering at home.
Proper preparation can help ensure a smooth, safe water birth process.
What Happens During a Water Birth?
If you choose to have a water birth, here is a general overview of what you can expect:
- Filling the tub – The birthing tub will be filled when you are 5-10cm dilated in active labor.
- Entering the water – You will undress from the waist down and enter the warm water (usually around 95-100F).
- Laboring in water – You’ll remain in the tub while contractions intensify and birth nears.
- Delivery – Squatting, kneeling, or reclining, you will go through involuntary pushing and give birth underwater.
- Bringing baby to surface – The midwife or doctor will immediately bring the baby up after the head is born.
- Clamping the cord – The navel cord is clamped and cut after it stops pulsating, while the baby is on your chest.
- Delivering the placenta – The placenta is typically delivered out of water, after leaving the tub with baby.
You may get out of the water anytime you wish if you become uncomfortable. Your care team will monitor you and baby closely throughout the process.
Transitioning the Baby After a Water Birth
When a baby is born underwater, these steps are taken to transition them to life outside the womb:
- The baby is brought to the surface within 10 seconds of delivery.
- Stimulation to breathe is done with gentle rubbing, not suctioning.
- The baby is placed directly skin-to-skin on the mother’s chest to stay warm.
- Monitoring breathing effort and heart rate closely.
- Oxygen may be provided if needed.
- Baby is dried off and head covered to prevent heat loss.
In most cases, babies adapt well to the water to air transition with proper support. However, transferring to a hospital may be needed if respiratory distress occurs.
Recovering From a Water Birth
The postpartum recovery period is similar after a water birth compared to a conventional birth. A few things to expect:
- Monitor temperature for possible hypothermia from water exposure.
- Observe incision sites for signs of infection if an episiotomy or tear occurred.
- Watch for breathing problems or respiratory infections.
- Expect typical postpartum bleeding and discomfort from vaginal soreness.
- Follow-up pediatric visit within 48 hours of discharge.
While recovering, get plenty of rest, stay hydrated, and don’t hesitate to seek medical help if any concerning symptoms arise.
Pros and Cons of Water Births
Here is a quick recap of the main advantages and disadvantages of giving birth underwater:
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Frequently Asked Questions
Is giving birth underwater safe?
Research shows water births are just as safe as conventional births for healthy, low-risk women when appropriate protocols are followed. There is no evidence of increased adverse effects for the mother or baby.
When should you enter the birthing tub?
It’s recommended to enter the tub when you are in active labor and at least 5-10 centimeters dilated. This helps avoid slowing or stalling labor in the early stages.
Can you deliver the placenta underwater?
Most experts advise delivering the placenta out of the water to allow for proper examination and monitoring. The placenta detaching underwater can increase blood loss risk.
Is the baby underwater when born?
Yes, the baby is fully underwater during delivery. They are immediately brought to the surface within seconds after being born.
Do doctors recommend water births?
Many doctors support water births for healthy, low-risk women who go into labor naturally. But preferences vary – discuss options with your provider early on.
Is a water birth more natural?
Water birth proponents believe it provides a gentler transition for the baby and facilitates a natural childbirth without medications. But “natural” means different things to different women.
Are water births messy?
The water contains vernix, blood, stool, and other fluids that come out during delivery. While it can be messy, many women feel more comfortable laboring in water.
The Bottom Line
Water births allow women to immerse themselves in warm water during labor and delivery. This method offers several potential benefits like pain relief, relaxation, and mobility in labor. However, water births also carry some risks that mothers should carefully consider before making a decision.
If you have a healthy, low-risk pregnancy and want to avoid medications, a water birth can be a safe alternative with proper medical support. But work closely with your doctor or midwife to determine if it is right for you.
While water births are not for everyone, they can empower many women to have a calm, natural childbirth on their own terms. If you decide a water birth aligns with your hopes for delivery, thoroughly prepare yourself for this special experience.