Water births

Water birth is the process of giving birth in water using a deep bath or birthing pool. Being in water during labour is shown to help with pain as well as being more relaxing and soothing than being out of water. The water can help to support your weight, making it easier to move around and feel more in control during labour.

Can I have a water birth?

Having a water birth is an option for you if you have had a low risk pregnancy and your midwife or obstetric doctor believes it is safe for you and your baby. You can talk to them about it at any of your antenatal appointments.

You may not be able to have a water birth if:

• Your baby is breech
• You are having twins or triplets
• Your baby is pre-term (under 37 weeks)
• Your baby has passed meconium before or during labour
• You have active Herpes
• You have pre-eclampsia
• You have an infection
• You have a high temperature in labour
• You are bleeding
• Your baby needs continuous monitoring via CTG machine
• Your waters have been broken for over 24 hours
• You have had a previous caesarean section
• Your labour is induced
• You are at high risk of having birth difficulties.

You will probably be advised not to have a water birth if you have any of the risk factors above because it may be difficult to get you out of the pool safely in an emergency. If you have an infection, you may be at risk of passing it onto your baby in the water.

If you are at high risk of bleeding, being in the pool can be dangerous because it is difficult to measure how much blood has been lost in the water.

What are the advantages of water birth?

• The warm water can help to relax, soothe and comfort you
• The support of the water means you can try different positions and move more freely
• When upright in the water, gravity will help move the baby down towards the birth canal
  
• Being in water can lower your blood pressure and reduce feelings of anxiety, making your body more able to release endorphins, which can help ease pain
• The water can help to improve back pain and the feeling of pressure, especially when you are fully dilated
• Being in the pool during labour and birth can be a “cosy” experience, making you feel safe
• The water can help your perineum stretch gradually as the baby’s head is being born, reducing the risk of injury.

Are there any disadvantages of having a water birth?

• You will not be able to have some pain-relief options. For example, you cannot have any opiates, such as pethidine, for at least six hours before you get into the pool, and you cannot have an epidural
• You will be unable to use a Tens machine
• Your contractions may slow down or get weaker, especially if you go in the pool too soon
• If the pool water is too cool at birth, your baby is at risk of hypothermia. But your midwife will check the water temperature regularly. If your baby’s temperature is low, skin to skin contact with you and warm towels will help
• You might need to leave the pool if there is a complication.

Can my baby drown if I give birth in water?

Many women wonder whether there is a risk of their baby drowning if they give birth in water but it is very unlikely to happen.

Babies do not need to breathe when they are in the womb because they get oxygen from the blood that comes from their mum through the placenta. When they are born in water, their body behaves as if they are still in the womb until they take their first breath of air, at which point their lungs open up. As a baby comes from water (in the womb) into water (in the birth pool), the lungs are not open and no water can enter.

After your baby is born in the water, you and your midwife will bring them to the surface slowly. Your baby will only be under water for a short time and won’t take a breath until they are out of the water.

Your baby is only at risk:

• If their head is brought above the water and brought down again
• If their oxygen supply from the placenta is affected
• If their temperature changes suddenly

What should I wear for my water birth?

You can wear what feels comfortable for you, keeping in mind that you will be in what is essentially a large bath.  Many women choose to wear a bikini or tankini. Others choose to just wear a bra. You can wear a t-shirt or vest top if you want to be a little more covered. It can be twisted up and tucked into the neck if it’s very long. Some women prefer to be naked.

What other pain relief can I have in the water?

Water is sometimes referred to as ‘nature’s epidural’ or ‘aquadural’, because of the support and pressure it gives you. However, if you need a little extra, it is common to use gas and air (Entonox) while you are in the birth pool.

The Entonox tubing is waterproof so this can be used in the pool too.

How do I deliver the placenta if I have a water birth?

Your midwife is likely to ask you to get out of the pool to deliver the placenta because gravity can be helpful in the third stage of labour. It also makes it easier to help you in case of an emergency, as some new mums can feel faint after birth, or during the third stage of labour. If you do suddenly feel lightheaded, it may be difficult to get you out of the pool quickly and safely.

When might I need to get out of the pool?

• If the midwife sees meconium (when the baby does a poo whilst still inside)
• If you start to bleed heavily from the vagina
• Your labour becomes abnormal, changes in your temperature or blood pressure for example
• If the baby’s heart rate changes
• To go to the toilet (you can leave and return)
• For your midwife to examine you to check your progress
• If your labour slows down or if your contractions get weaker
• To deliver the placenta.