All About Water Births

What is a water birth?

A water birth is when a woman gives birth while submerged in water, with her abdomen completely covered. It’s not to be confused with ‘water immersion’, which is when a mum only uses the birth pool for pain relief in the early stages of labour, before leaving the water for the actual birth. Water birthing is sometimes referred to as hydro birthing.

The benefits of a water birth

According to The Australian College of Midwives there are many benefits for immersion in water during labour and birth. Here are some of the pros for water birth.

Reduced need for pain relief

The weightlessness associated with being in water can help relieve pressure from around the body and during a water-birth labour women are less likely to need pain killers or an epidural. (Women can’t actually have epidurals during a water birth but they can have pain relief gas.)

Research also shows that when giving birth in water, women experience:

• Reduced rates of postpartum bleeding

• Reduced rates of episiotomy

• And a higher likelihood on an intact perineum 

Reduced stress for the baby

Water births have been associated with a lower risk of perineal trauma –  the water softens the skin around the perineum, relieving pressure on the pelvic floor muscles and decreasing the chance of tearing. That means there may be less need for interventions and an assisted delivery. Warm water also promotes increased blood circulation and oxygenation of the blood, providing better circulation for the baby at birth.

Positive emotions for mum during labour

The pleasurable sensations associated with being in water – such as warmth and buoyancy – may elevate the release of endorphins and facilitate relaxation. This may helps keep mum calm.

Who’s suitable for water births?

A water childbirth won’t be for every woman. You need to talk to your doctor or midwife about whether or not your pregnancy is safe for a water birth. These are the general requirements you’ll need to meet.

• You’re at full term: You need to be at least 37 weeks pregnant

• You’ve had a low-risk pregnancy: Neither you nor the baby have health concerns

• You’re only carrying one baby: Women carrying twins or more are not eligible for water births

• Your baby is head-down: Breech or sideways positions aren’t safe for a water birth

• You have clear amniotic fluid: Your waters aren’t stained or discoloured

• You’re mobile: You need to be able to get in and out of the pool safely by yourself or with support

You also need to be cared for continuously by a midwife trained and experienced in water births.

Risks and safety considerations for water birth

While the advantages of water birth are well known, you always have to consider the risks. While there’s no evidence that water births pose an additional risk to labour, there are some of the common concerns that you should speak to your doctor about.

• Infection There’s a slight risk of postpartum uterine infections but maintaining proper water temperature and sterile conditions can minimise these risks. 

• Baby swallowing water Babies have several protective features that stop them breathing in the womb and underwater. In rare cases, though, a distressed baby may gasp before being lifted out of the water. This is why water birth is recommended only for low-risk pregnancies with continuous midwifery care.

• Medical intervention could take longer If you have your baby at home, you will be further from a medical setting in case of emergencies.

• You or your baby overheating Your midwife will regularly monitor your body temperature and the temperature of the water to make sure both are at an acceptable level. The water should be 35-37°C. If your temperature gets too high, you may be asked to step out of the water. You will also need to take frequent small sips of water to stay hydrated.

How to prepare for a water birth

If you’re considering a water birth – here’s what to do next.

Consult with your healthcare provider 

Start by talking to your GP and obstetrician about your birthing options. You’ll also need to find a birthing team – specific training is required for infection control and management of emergencies for women in water.

Choose a location

Do your research on the different options available.

• Hospital: Not all hospitals offer water births and the ones that do have different policies and guidelines. Start by reaching out to hospitals in your area.

• Birth centres: These are often attached to hospitals and can offer a more relaxed birthing environment. Not all birthing centres offer water births so do your research and look into their emergency protocols, as well. 

• Home birth: The regulations around having a water birth at home vary from state to state. For example in some states you need to live within 30 minutes via ambulance to a maternity hospital, while in others you need multiple midwives available. Look into the laws in your state before going down this path. 

Arrange birthing pool & supplies

Home water births need a lot of equipment, which you’ll need to organise following the advice of your midwife. The type of equipment you’ll need includes a birthing pool, a hose, a thermometer and disposable pool liners. You’ll also need to clear a space in your house for the pool, allowing ample room to walk around it.

Learn birthing positions in water

Birthing positions for a water birth are different to a dry birth. The buoyancy of water makes it easier to get into more upright positions like squatting, kneeling or leaning forward. You might also be in the pool with your partner supporting you. 

Factors to consider for water birth

By now, you’ll be starting to form a view on whether a water birth is for you or not. Make sure you consider these factors:

• Is your pregnancy low-risk?

• Have you discussed water birth pros and cons with your doctor?

• Do you have a team trained in water births?

• Where do you want to have the water birth?

• Have you considered the risk factors?