Water immersion as pain relief during labor is a popular option for women around the world.

You might be thinking you’d like to give birth in the water but have some concerns it might not be possible or safe for you.

Is water birth dangerous? Rather than worry, read on, as we take a look at the common fears and concerns and put them to rest with the facts.

What happens during a water birth?

Water immersion for labor and birth is so incredibly simple. The woman submerges herself up to breast level in water that’s been warmed to body temperature.

This ensures the mother receives all the benefits of water birth as well as making it safe for her and her baby.

Can a baby drown in water birth?

With a low-risk pregnancy and a healthy baby, there’s no increased risk your newborn will drown underwater.

A baby born underwater is supplied with oxygen from the placenta, via the umbilical cord.

Being born isn’t the single trigger for an infant to start breathing. Human beings are born with what’s known as a dive reflex. This prevents them from taking a breath until receptors in the face sense a change in water temperature and environment.

There are many things that happen when breathing is triggered:

The shunts in the heart are closed
Fetal circulation turns to newborn circulation
The lungs start to work
The umbilical cord is stretched, causing the umbilical arteries to close down.

You can read How Does A Baby Breathe During Water Birth? for more information.

Any change of temperature, very low oxygen levels, or high levels of carbon dioxide will trigger the gasp reflex and the newborn will start breathing, even underwater.

That is why it’s important to bring the infant to the surface quickly, to prevent him from inhaling water and drowning.

If the mother wants to stand up or lift her pelvis out of the water, she will need to remain that way.

How is a baby monitored during water birth?

Monitoring the fetal heart rate is important, to make sure babies are coping with the stress of labor, especially during the pushing stage.

Changes to the fetal heart rate can indicate potential problems with your baby. Your care provider will usually check every 30 minutes in labor, and every 5 minutes, or after each contraction during the second stage.

If you are laboring in a birthing pool, accurate monitoring is done with a waterproof Doppler. This can be placed on your belly to allow the care provider to listen to your baby’s heartbeat while you stay in the tub.

Is water birth dangerous at home?

In water birth at home, the risks are decreased if you’re supported by two trained midwives with all the correct equipment. In fact, birth at home is actually safer than in the hospital.

In Australia and many other countries around the world, two midwives must attend all home births. This allows mothers and babies to be monitored and cared for properly.

Equipment used for home births includes:

Doppler
Resuscitation equipment for mother and baby
Medication
Pool and pool liner
Birth kit, including medical supplies, gloves, cord clamps, etc.

Water birth at home gives you the advantage of being in your own environment, not needing to move during labor, and having your chosen support team.

Is water birth safe in the hospital or birthing centers?

Many hospitals have redesigned birth rooms and their facilities to include a private birthing pool or a tub, so women can labor and have their babies there.

If there is a limited number of birthing pools in your hospital, however, or the birthing tub is already in use, you might not have access. Staff in many hospitals and birthing centers are trained to support and help women to give birth in water.

In many places, though, there are still restrictions placed on labor and water births. For example, they might be restricted to those who are low risk and under a certain body mass index (BMI).

There’s not a lot of evidence to support these restrictions. With more training of care providers, water birth can be accessible and safe for all mothers in the hospital.

Will my baby get an infection from the water?

Many parents are concerned about infections, especially in a hospital setting or birthing center, where birthing pools are used again and again.

There are strict protocols in place that require proper cleaning of all equipment between and during births to lower the risk of infection.

Wearing protective equipment, such as gloves and goggles, reduces contact with body fluids.

A study of almost 9000 women who labored or birthed in the water, found less than 1% of their babies had any suspected infections. Lab tests performed on the newborns showed no signs of infection after birth.

What happens if you poop during water birth?

Most women will poop during labor, no matter where they’re actually giving birth. This is normal and your midwife is very good at making sure you aren’t even aware of it.

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There’s been some concern about the risk of infection in babies born in water. However, as the study mentioned above shows, infection rates are low. Bacteria from mothers is less likely to be a problem as babies are already being exposed via the placenta.

In fact, babies should first be exposed to bacteria from their own mother. This helps colonize the newborn’s own gut with healthy bacteria and primes the baby’s immune system.

In the birthing pool or tub, the dilution effect of the water reduces the exposure to any harmful bacteria.

When is a water birth not recommended?

Although you might have your heart set on giving birth in a pool, there are times when it’s not recommended, for safety reasons.

Blood loss

Previous excessive bleeding could mean you have an increased risk of further bleeding complications. It can be difficult to assess blood loss in a birthing pool, which is a reason why some obstetricians and gynecologists do not recommend water birth in those cases.

For more information be sure to read Postpartum Haemorrhage – How To Help Prevent It, Naturally.

Meconium

Meconium is your baby’s first poo or bowel movement. Babies will sometimes pass meconium if they are in distress before birth or during labor. It’s possible for babies to inhale the meconium into their lungs (meconium aspiration).

If meconium is seen, the woman will be asked to leave the tub or birthing pool to prevent meconium aspiration.

Please read Meconium In Amniotic Fluid – Is It Dangerous? for more information.

Nuchal cord

Nuchal cord occurs when the umbilical cord is wrapped around the baby’s neck. Usually, this doesn’t cause complications but sometimes the cord can be very tight.

This might be a reason why you are asked to stand up, so your care provider can help your baby be born safely.

You might wish to read this wonderful article Nuchal Cord – 9 Facts About A Cord Around Baby’s Neck.

Breech position

In the past, a baby in the breech position was often the reason for a more controlled birth or even for an automatic c-section.

Today, some practitioners recognize the benefits for a breech baby of being born in water.

Babies won’t take a breath until they are out of the water, no matter which way they’re born.

The temperature of the water keeps baby’s body and umbilical cord warm. The buoyancy will also support the baby’s body while the head is born.

Shoulder dystocia

Most hospitals will ask mothers having a suspected large baby to leave birthing tubs. This is because a baby becoming stuck (shoulder dystocia) is considered an obstetric or midwifery emergency.

Being in the water, however, can allow mothers to change position more easily, such as lunging, going on hands and knees, or standing with one foot on the edge of the birthing pool.

Prematurity

Babies under 37 weeks gestation need special care and attention and for this reason, water birth isn’t considered safe for premature babies.

The American Academy of Pediatrics notes babies who are compromised, including preterm infants, are more likely to have a compromised dive reflex and could potentially inhale water.

Are water births less painful?

Water can relieve pain in labor in a number of ways. Women instinctively feel a sense of safety, privacy, and calmness in warmed water, and this reduces fear and tension.

Warmth and buoyancy increase women’s ability to go with their bodies and the contractions, rather than fight the pain. More endorphins are released, too, which helps to reduce pain as the cervix dilates.

The smiles and the inner peace that mothers display are unmistakable as they relax into a tub of warm water. The sounds say it, too; it’s the ‘Ahhhh’ effect.

Please read 13 Natural Pain Relief Options For Labour for more information.

Why are water births better?

Water births aren’t for everyone but they increase the chance of you having a positive childbirth experience.

Many women fear tearing in labor and birth; water birth also offers protection against this.

The water temperature allows the perineum – the area between the anus and vagina – to soften and stretch to allow your baby to be born.

As the baby’s head crowns, the water also offers support for the perineum and reduces the chances of tearing.

Water also allows the mother choices. She can move into the position she feels most comfortable in as she pushes out her baby.

Most women don’t want to be on their back, as this increases their pain. In water, they’re more likely to be in an upright position.

Care providers can observe a woman laboring in water but are less likely to interfere. They can take a hands-off approach, leaving the woman in full control.

If you would like more information about water birth, please read:

Across Asia Pacific, BellyBelly recommends Simply Birth for the best quality, medical-grade birth pools, and birth supplies.