Mother and Baby

How to have the best-ever water birth

Section: Labour & Birth

If you're contemplating a water birth, founder of the Positive Birth Movement Milli Hill explains everything you need to know, plus tips on making it the best ever! 

If you’re dreaming of your ideal birth and trawling Instagram for inspiration, you can’t have escaped the photos of the beaming woman in the birth pool, her partner behind her, their newborn in their arms, the fairy lights twinkling in the background.

They certainly make a water birth look like a positive birth experience, but is it for you? Years back, a water birth might have been viewed as something only for home birthers or seen as an alternative, but times have changed and for good reason.

Many birth centres and even obstetric units have birth pools now, and almost 10 per cent of UK babies have a ‘waterbirth’, which officially means they are born underwater. More women, around one in five, spend time during labour in water – be it in the shower, bath or birth pool – before giving birth but it’s not classed as a waterbirth unless you actually deliver in the water. 

Is water birth safe?

You may have seen some headlines about waterbirth but last year a Cochrane review found no increased risk to either mother or baby when having a water birth. There are basic safety rules to follow though, which your midwife can advise you on.

But how does a baby breathe underwater? 

One thing everyone wonders about is how baby breathes underwater – but your baby won’t take his first breath until he meets the air, due to something called the ‘dive reflex’. Until this first breath, he is still getting all the oxygen he needs from the placenta, just as he has throughout your pregnancy while ‘underwater’ in the amniotic fluid of your womb. This is why it’s important that the pool water is at least 18 inches deep, so that your baby can’t ‘surface’ before his whole body is born, and be stimulated to breathe.

What are the benefits of a water birth?

While you can reap all the relaxing benefits of water in your bath tub, an actual birthing pool offers so much more.

In a birth pool you’ll experience the weightless feeling and increased mobility that you might be familiar with from pregnant trips to the swimming pool, and this mobility enables you to more easily change positions during labour. We know that being in a bed on your back in labour can make birth more difficult – narrowing your pelvic opening and making you work against gravity – so it stands to reason that the birth pool will have the opposite effect, allowing you to find more upright positions that work for you. Many women who give birth in water do so kneeling or on all fours, using the sides of the pool or their partner for extra support.

Several studies have shown that women who choose waterbirth are less likely to want other forms of pain relief and more likely to report a positive experience of childbirth, perhaps because the freedom of movement and the soothing feeling of the warm water make labour feel more manageable.

Many women describe how the heat of the water ‘takes the edge off’ labour discomfort, just like a bath or a hot water bottle can soothe away other aches and pains. There’s also something about being in your own private space that makes you feel more protected in waterbirth, and this feeling of safety can have a powerful effect on your body. Being relaxed, feeling safe and having made a conscious choice to give birth naturally in water may all alter your perception of pain and increase your sense of power and resilience. Researchers have found that women who’ve had water births describe it as ‘relaxing’, ‘pleasurable’ and ‘fulfilling’, and that around 80 per cent of women would give birth this way again.

Read more: The six labour pain relief options explained

Apart from the increased comfort the water brings, there are other established advantages to water birth. Research has shown that being in the pool can reduce the length of the first stage of labour (the part when your cervix is dilating) by an average of 32 minutes. Other trials have found birth in water to be associated with lower rates of tearing and episiotomy, perhaps due to more upright birthing positions in the pool and because the water acts like a warm compress on the perineum – reminiscent of the age-old midwifery technique of hot towels and water to reduce tears.

Water birthers also have higher rates of normal vaginal birth, and better ‘Apgar’ scores for the baby, which is the way a baby’s condition at birth is measured. In fact, many people who have their baby in water are surprised by how peaceful their baby is – many water-born babies don’t cry but just calmly lock eyes with their mother. It’s an incredible moment.

Despite this, some women may find they don’t like being in the pool: if this happens to you, don’t worry, you can simply get out – you don’t have to stick to your birth plan. Or you may simply decide you’d like a change and to labour on dry land – again that’s OK. Out of the pool you can try different pain relief such as such as epidural or opioids – you can’t have these in the pool but you can have gas and air.

Why you may not be suitable...

  • You may not be able to have a water birth if you have a history of heavy bleeding during pregnancy
  • If you have a medical condition such as diabetes or epilepsy
  • If you go into labour prematurely (before 37 weeks)
  • You will only be allowed the option of gas and air as additional pain relief; so if you think you will need stronger pain-relieving drugs, you won’t be able to stay in the pool.

How to organise a water birth

If you are interested in having a waterbirth, the best way to maximise your chances of this happening is to have a home birth where you can hire, borrow, or buy your own inflatable birth pool. If you don’t want a home birth, speak to your midwife about accessing a pool in your area and check out which.co.uk/birth-choice to see if a water birth is an option near you. If there isn’t a pool available, you may even be able to negotiate bringing your own to the hospital – it’s always worth asking.

Read more: What are the pros and cons of a home birth

As well as practical issues of pool access, you might be told that can can’t have a waterbirth if you’re ‘high risk’ – for example, you may be expecting twins, have a high BMI, or be having an induction or a VBAC (Vaginal Birth After Caesarean). However, women in all of these circumstances and more have had waterbirths, so it’s worth talking to your care provider to ask them to consider your individual case. You can also contact AIMS, which supports women to get the birth they want.

Women who have had waterbirths tend to be evangelical about them, and I’m one of them: waterbirth for me was blissful and if I had another baby, I’d never do it any other way! It may seem a strange idea at first, but it’s really not complicated – you just get a pool, fill it with water and get in. If you have a baby before you get out, congratulations, you’ve had a waterbirth!

7 ways to enjoy your water birth even more

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1) Consider what to wear

Some women like to be naked in labour, but if you prefer to be covered up, then a bra top, vest top or bikini top are ideal for water birth. Your partner may wish to have some ‘swimwear’ handy too, in case they wish to jump in and join you!
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2) Choosing a pool 

For a home birth, you can buy a birth pool for around £100 to £150 however, a cheaper option is to borrow the pool – ask the person who runs your local antenatal class, or try asking on local social media pages. Then all you need is a new liner (around £30) plus the hose and tap connector (around £20), a pump to blow the pool up (around £10) and a pump to empty it (around £25, optional).

M&B recommends: ​Birth Pool, £132.91, birthpoolinabox.co.uk
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3) Have a trial run 

If you’re having a pool at home, it’s essential to have a trial run at blowing it up, filling it, and of course, having a test dip. In labour, deciding when to start filling the pool is the million-dollar question, but it’s best to err on the side of caution, especially if you have a water system where you have to reheat several tanks to fill a birth pool.
If you think you’re in labour, get your partner on the case because I’ve heard many stories of women who have given birth before the pool was ready to get in!
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4) Practise stepping in and out

Get in when you feel drawn to do so, but the best timing is when contractions are three or four every 10 minutes and labour is established. To make it easier to get in and out of your pool, either step sideways over the side – in labour this can actually flex your pelvis and help things progress – or sit on the side and swing your legs over.
You may also like to have a clean low stool next to the pool to help you get in and out, and if your pool doesn’t have a step to sit on, you may wish to use this in the water too.
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5) 'Accessorise' your pool 

Get an underwater thermometer – any kids’ bath thermometer will do – to ensure the water is at the safe temperature of 35 to 37 degrees. A small sieve can quickly remove any ‘debris’ from the water, while a clean bucket is useful to bail out colder water before topping up with warm.
Battery operated fairy lights can be placed between the liner and pool to make a lovely ‘glow’ in the water.
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6) Stock up on towels 

Keep plenty of towels handy – some old ones that can be put to use mopping up any spills around the pool, and several nice fluffy ones that you can wrap round you if you need to get out. You may need at least half a dozen if you get in and out several times.
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7) Relax!

Waterbirth can be made even more special by creating a calm, relaxing birth space. Keep lighting low and use tealights and fairylights, along with your favourite music, and discourage interruptions. Practice deep breathing or hypnobirthing as you float your way through contractions.

Are you planning a water birth? Let us know on Facebook or Twitter!

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  • Author: Milli Hill Milli Hill
  • Job Title: Freelance writer and founder of the Positive Birth Movement

Milli Hill is a freelance writer and the founder of the Positive Birth Movement. The mum of three is author of The Positive Birth Book: A New Approach to Pregnancy, Birth and the Early Weeks.

She writes tips and advice on how to have happier labour experiences.