The Basics of Water Birth

A water birth means at least part of your labor, delivery, or both happen while you’re in a birth 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.

In the U.S., some birthing centers and hospitals offer water births. Birthing centers are medical facilities that offer a more homelike setting than a hospital and more natural options for women having babies. The use of a birthing pool during the first stage of labor might:

  • Help ease pain
  • Keep you from needing anesthesia
  • Speed up your labor

The American College of Obstetricians and Gynecologists (ACOG), which sets guidelines for pregnancy and childbirth care in the U.S., says a water birth during the first stage of labor may have some benefits but delivering your baby underwater should be considered an experimental procedure with risks. The first stage is from when contractions start until your cervix is fully dilated.

Studies show water birth during stage one doesn’t improve your or your baby’s medical outcome.

A warm bath might help you relax and help you feel more in control. Floating in water helps you move around more easily than in bed, too.

Some science suggests that the water may lower chances of severe vaginal tearing. And it may improve blood flow to the uterus. But study results about these points aren’t clear.

Stage Two of Labor: Time to Exit the Tub

Things change during the second part of labor. That’s when your cervix is completely dilated and open and you start pushing until the baby is born.

Many doctors say there isn’t enough information to decide how safe or useful water birth is during this period.

Being out of the water for the second part of your labor makes it easier to move fast in case something goes wrong, ACOG spokesman Aaron Caughey, MD, says.

“If you have to do an emergency C-section, it would be foolhardy to risk an extra 4 or 5 minutes to move you out of the water,” says Caughey, chairman of the obstetrics and gynecology department at Oregon Health and Science University.

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Water Birth Risks

Here are some of the rare problems that could happen while water birthing:

  • 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.
  • Your baby could breathe in bath water.
  • Your baby could have seizures or not be able to breathe.

“It’s important to emphasize the ‘rare’ part. But these are the sorts of outcomes that are severe, like drowning,” says Jeffrey Ecker, MD, who co-wrote the ACOG committee's opinion on water births.

Are You a Good Water Birth Candidate?

Some factors may keep you out of the running for a water birth. You shouldn’t try it if:

  • You’re younger than 17 or older than 35.
  • You have complications like preeclampsia 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.

Water Birth Precautions to Take

If you’re thinking about a water birth, talk to your health care professional early in your pregnancy to find out if it’s a service the hospital provides. If so, who will manage your labor and delivery? You may need to find a midwife instead of an OB-GYN.

If it’s not done in a hospital near you, you may have to go to a birthing center or do it at home.

Regardless of where you decide to deliver, having a water birth means you should ask questions about how the labor and delivery are done. Things to look for:

  • You have an experienced health care professional to help you through the labor and delivery.
  • High standards are kept to ensure the tub is clean and well-maintained.
  • Proper infection control measures are in place.
  • You and your baby are being properly monitored while in the tub as required.
  • There’s a plan to get you out of the tub as soon your doctor, nurse, or midwife says it’s time.
  • The water temperature is well-regulated, usually between 97 to 100 F.
  • You drink water during the birth to avoid dehydration.

Getting into a warm bath too early might slow your labor.

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Water Birth Costs

If your water birth is done in a hospital, it usually costs same as a vaginal birth if it’s covered by insurance. You may be required to rent the tub, which may be an extra $200 to $400.

If you buy your own tub or pool for a home birth, it can range between $65 to $500 depending on how fancy you go.

The fees for a midwife or nurse-midwife for a water birth at home will be the same as a normal birth, ranging from $2,000 to $6,000.

If you’re having your water birth at a hospital or birthing center, the midwife’s fee is usually part of what you pay the facility. Birthing centers charge an average of about $2,300 per birth.

WebMD Medical Reference Reviewed by Nivin Todd, MD on September 24, 2014

Sources

SOURCES:

American Academy of Pediatrics, Pediatrics, March 2014.

American Association of Birth Centers.

American College of Nurse-Midwives.

American College of Nurse-Midwives: “Position Statement: Hydrotherapy During Labor and Birth.”

American College of Obstetricians and Gynecologists: “Immersion in Water During Labor and Delivery.”

News release, American College of Obstetricians and Gynecologists.

Aaron Caughey, MD, spokesperson, American College of Obstetricians and Gynecologists; professor and chairman, department of obstetrics and gynecology, Oregon Health and Science University; associate dean for women’s health research and policy, Oregon Health and Science University School of Medicine.

Jeffrey Ecker, MD, chairman, Committee on Obstetric Practice, American College of Obstetricians and Gynecologists; professor of obstetrics, gynecology, and reproductive biology, Harvard Medical School; director of obstetrical clinical research and quality assurance, Massachusetts General Hospital.

Nutter, E. Journal of Midwifery & Women’s Health, May 2014.

Oregon Health & Science University Center for Women’s Health.

Royal College of Midwives.

Jenna Shaw-Battista, PhD, certified nurse-midwife; associate education director, University of California, San Francisco.

University of Maryland Medical Center: “The Three Stages of Labor.”

Waterbirth International: “Waterbirth FAQ.”

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