Water births: everything you need to know


by Milli Hill |

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.

What is a water birth?

Quite simply, a water birth involves giving birth in water, whether that's a deep bath or birthing pool.

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 water birth unless you actually deliver in the water.

Is it safe to have a water birth?

​​'Water births are just as safe as a birth out of water,’ says Alessandra D’Angelo, Quality and Standards Advisor, Royal College of Midwives.

‘Some women choose to birth their baby in the pool, others choose to labour in the pool but then come out to birth their baby. The choice will be up to you.’

Where can I have a water birth?

Water births can be done at home or in a midwife-led maternity unit, either within a hospital or a freestanding unit away from a hospital. Some maternity units will do water births in obstetric-led units too, but this is where most women with risk factors for complications during birth will have their babies.

‘In a midwife-led unit or hospital they will often have dedicated rooms with a specialist large bath where you can give birth, or to get into to help relieve labour pains,’ says Alessandra.

‘If you are giving birth at home, it is still possible to have a water birth by hiring an inflatable pool. Your midwife will take your temperature from time to time just to make sure you are not getting too hot. You don’t have to stay in the water all the time and can get in and out as it suits you. Just make sure you have someone to help you in and out such as your partner just in case you feel a little wobbly.’

Can I have a water birth?

‘Most women can have a water birth if you are having a low-risk pregnancy and birth without any complications, and most maternity units offer them,’ says Alessandra.

If this is something you are interested in pursuing or finding out more about, you should speak with your midwife or doctor.

‘For women with symptoms or a positive COVID-19 result, we recommend an individual discussion with your midwife. You may be advised against waterbirth in these circumstances, to keep you and everyone around you safe.’

Why you might not be able to have a water birth​

  • If you have a history of heavy bleeding during pregnancy

  • If your baby is breech

  • If your waters have been broken for over 24 hours

  • If you are induced

  • If you have previously had a C-section

  • If you have a medical condition such as diabetes or epilepsy

  • If you go into labour prematurely (before 37 weeks)

  • If you have an infection

  • If you are having twins or triplets

  • 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 does a baby breathe underwater?

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 having a water birth?

While you can reap all the relaxing benefits of water in your bathtub, 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 water birth 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 water birth, 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.

  • 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.

What are the disadvantages of having a water birth

  • 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.

  • You can't have certain pain-relief options such as an epidural. You can't have opioids for at least six hours before you get into the pool. However, you can have gas and air.

  • You will not be able to use a Tens machine.

  • If there is a complication for whatever reason, you may need to leave the pool.

  • Labouring in water can sometimes slow down contractions, however if this happens you can come out of the water and go back in at a later stage.

How to organise a water birth

If you are interested in having a water birth, 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. If there isn’t a pool available, you may even be able to negotiate to bring 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 water birth 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 water births, 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.

4 ways to enjoy your water birth even more

Alessandra shares four tips below on how to make your water birth an even more enjoyable experience.

  1. If you are at home, make sure the room is a comfortable temperature for when you and your baby come out of the water.  You might also want some of your favourite relaxing music on to help you relax during the birth. Many maternity units can also play your music as well in your water birthing room.

  2. You might also need a jug to pour water over the bump or back, and something to pad the floor of the pool, or to lean on in the water or over the side of the pool.

  3. Think about what you might wear. Some women prefer to be naked when having a water birth, others might have briefs on until they are in labour and maybe a loose t-shirt or bikini top. Make sure you have dry clothes and towels for when you get out of the water.

  4. It is advisable to put a plastic sheet of some kind under the pool to catch any water splashes. If you are having a water birth at home you will need to hire a pool as the NHS don’t provide them, so do look at the cost of the pool hire if giving birth at home. NHS maternity units have special baths for water births.

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