Your baby spends nine months floating in the warm, cozy comfort of amniotic fluid, so a water birth in a tub or birthing pool might seem like a natural way of welcoming her into the world.
But while laboring in water can be safe and soothing, delivering your baby underwater comes with risks. Here's what experts want you to know.
What is a water birth?
A water birth means spending at least part of your labor or delivery (or both) in a tub or birthing pool filled with warm water. Some moms find it helps them relax and better manage labor pain.
"It is a wonderful pain reliever and was so easy for me to relax in the tub," says What to Expect Community mom fourlittlarrows, about her two water births.
"Water immersion may decrease the need of an epidural in early labor (though I think having an epidural does not worsen outcomes)," says Sarah Gloria Obican, M.D., a board-certified OB/GYN who specializes in maternal fetal medicine and works as a physician at Tampa General Hospital in Florida and is a member of the What To Expect Medical Review Board. "Some women feel more empowered choosing an unmedicated birth,and water immersion may help."
Water birth is generally accepted by midwives but not widely practiced by doctors, who are concerned about potential risks.
The American College of Obstetricians and Gynecologists (ACOG) recommends laboring in water but delivering on land. "During the first stage of labor, water immersion has been found to lower pain scores without evidence of harm," the group states.
ACOG strongly cautions against water immersion during baby's delivery, however, since it can lead to potentially serious and even fatal conditions in newborns.
What are the benefits of a water birth?
Laboring in warm water — especially during the first stage, when contractions are building — may help:
- Decrease labor pain and your need for pain medication
- Shorten labor
- Give you a greater sense of control
- Conserve your energy
- Reduce the chance of tearing or needing an episiotomy
"Home waterbirth was my choice with my second, and it was AMAZING," says What to Expect Community member flokitten. "The water was so comforting, and I'd argue a better pain relief for me than an epidural."
"My body responds heavenly to water, and it eased the pain SO MUCH," agrees What to Expect Community mom lovinglittlesdaily. "So very doable."
Even if you decide not to stay in a birthing tub for long — whether it's because you're uncomfortable or your hospital doesn't allow it — you may find it's relaxing to begin labor in the water.
What are the risks of a water birth?
Laboring in water can be safe and soothing, but delivering your baby underwater comes with risks:
- Baby breathing while underwater. Since babies don't breathe in utero, in theory your baby shouldn't start breathing until she comes out of the water and into the air. But if your baby does happen to take a breath while she's submerged, it can cause potentially serious complications, including drowning andmeconium aspiration.
- Infection. There's also a risk of infections, including Legionnaires' disease, a rare but serious type of pneumonia linked to two newborns delivered in home bathtubs in 2016. Though more research needs to be done, the Centers for Disease Control and Prevention (CDC) cautions that Legionnaires' is a very real potential complication of water birth that parents need to consider.
- Tearing of the umbilical cord. This is called cord avulsion, and it happens more often with water births (when the baby is lifted from the water) but is still rare. If this happens, the cord needs to be clamped immediately.
Not all laboring moms are comfortable in a tub. You might know ahead of time that it's not for you, or you may discover while you're in labor that you want to be elsewhere.
"I had a home birth and was planning on a water birth but found the water more uncomfortable than just being on all fours on my bed," says What to Expect Community mom Genuinekimbygmailcom. "I needed the counter pressure techniques from my husband which he couldn't do very well in the birth tub. I say just do what feels best while you're in labor."
Who should not have a water birth?
Water birth is usually only an option if you've had a healthy, low-risk pregnancy. It's not recommended if you:
- Have a chronic medical condition (like high blood pressure or diabetes)
- Develop complications (such as preeclampsia or gestational diabetes)
- Are carrying multiples
- Have a breech baby
- Go into preterm labor
- Need continuous fetal monitoring (although some hospitals and birth centers have birthing pools with wireless, waterproof monitors that may be used to monitor your baby's heart rate continuously)
If you fall into one of these categories, your provider will likely recommend other safe comfort measures instead.
"I really wanted one for both births but first one was an induction with complications so didn't happen and the second birth happened quite fast and by the time the bath was full I was at pushing stage," says What to Expect Community mom mrsdone.
How to plan a water birth
While some birthing centers have birthing pools or Jacuzzis on-site, hospitals are less likely to be equipped to handle a water birth, though some are. Ask your provider about policies where you plan to give birth. If tubs are available, find out if there are fees or equipment you'll need to bring. If not, you may be able to rent or purchase a birthing pool.
If it's important to you to labor in water, advocacy groups like Waterbirth International may be able to negotiate permission from your hospital for you to bring in a purchased or rented birthing pool.
Of course, if you're planning a home birth, you're free to take advantage of your bathtub during the early stages of labor — or bring in a birthing tub that's big enough for you and your partner or coach. If you're using your tub, you'll want to have a thermometer on hand to keep track of the water temperature. (Birthing tubs come equipped with a thermometer.)
"I labored in a normal tub at the hospital and climbed out when I was 9 cm dilated, delivered 5 mins later in the bed," says What to Expect Community member raisinglittlegents. "It was so amazing, and I would recommend 10/10."
How much does a water birth cost?
The cost of a water birth can vary depending on where you have it and whether your hospital or birthing center offers it as an option. Hospitals and birthing centers that do have birthing pools may charge you a fee for using it, or they may not charge at all if they have the equipment on hand.
If you buy your own pool kit, you can usually do so for around $250 or so. And if you get a pool through your midwife, they may charge you a fee to rent it (how much will depend on the midwife).
If you do need to get your own equipment, let your insurance company know about your plans as soon as you make them, since it may cover the costs.
What happens when you go into labor during a water birth?
When you go into labor, call your practitioner, then fill up your tub and wait for them to arrive before getting in.
Have your partner adjust the water as necessary so the temperature remains between 95 and 100 degrees Fahrenheit and no higher than 101 degrees F (otherwise your body temperature could rise, causing the baby's heart rate to increase).
Have plenty of drinking water on hand, along with a few washcloths your coach can dampen with cold water to help cool off your face or neck. Your practitioner will monitor your baby's condition with an underwater Doppler device.
When it comes time to push, make sure you've already discussed your plan with your practitioner, as this is the most potentially dangerous part of a water birth, and pushing and delivering underwater is not advised by experts. Your partner can be in the tub or pool with you during the rest of labor to support you and then get out of the water when you're ready to push.
"I loved my water birth with my second and plan on doing one again for this baby. The warm water was great during transition, and I felt weightless which I think helped alleviate some of the pain of contractions as well," says What to Expect Community mom elletigre.
If you're considering a water birth, talk openly with your provider about your pregnancy risks, your birth preferences, and what's possible where you'll be delivering. With the right plan in place, you can enjoy the calming benefits of water while still ensuring a safe arrival for your little one.
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