How to prepare for a water birth
What is a water birth?
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.
Ask your midwife if any of the above apply to you.
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.
'I was surprised by how warm it was in the water, and so nice and relaxing! They were able to check the baby’s heartbeat while I was inside the pool. I hadn’t eaten so they even made me some toast and my mum had to feed me while I was in the birth pool.' Jade (read her full story)
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.
'When I had my water birth, I was in the pool from about 12.30pm until 3pm but unfortunately my contractions slowed down a bit, so I had to get out of the pool and finish off labour on the bed.'Jade (read her full story)
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.
Your midwife will be careful to make sure this does not happen.
Where can I have a water birth?
- At home, with a hired birthing pool
- In a birth centre
- On the labour ward.
Find out more about where you can give birth.
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.
Whatever you feel comfortable with wearing on your top half is fine.
It is best to take your bottom half off so that the midwife can see what is happening as you approach birth. However, if you wish to leave your pants on until that stage, that is fine too.
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.
Find out more about pain relief during labour.
Can I have optimal / delayed cord clamping if I give birth in the water?
Delayed cord clamping (DCC) has become very normal. Most birth centres, labour wards and home birth teams will try to do DDC for every birth. This is because holding off from cutting the cord until the blood from the placenta has stopped going into your baby can increase your baby’s iron levels and the amount of stem cells they have, which will help with their growth and immune system. Although many centres practise DCC as normal, you can add this to your birth plan just in case your hospital does not.
The only reason DCC would not happen is if you or your baby are suddenly unwell just after birth. If the baby is slow to breathe, or you are bleeding more heavily than normal, the midwife may need to cut the cord earlier than usual.
Your and your baby’s safety during and after a water birth is very important and this will always take priority.
Find out more about delayed cord clamping.
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.
Most hospitals, birth centres and home birth teams have a policy on how the placenta should delivered, and most of these are on a bed, toilet, birth stool or floor mat for your safety. Please ask your midwife about this policy.
Find out more about the third stage of labour.
Can I have the injection to deliver the placenta more quickly?
You can be given an oxytocin injection to speed up the delivery of the placenta in the pool. Your thigh or bottom will need to be slightly raised out of the water for this to happen. You will then need to leave the pool within a few minutes to deliver the placenta.
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.
Can I change my mind about having a water birth?
Yes. Even if it is in your birth plan, if you decide you don’t want to get into the pool then you don’t have to.
If you get in the birth pool and don’t like it, you can get out again.
Do not be worried about changing your mind. Midwives are happy to support you as long as you and the baby are safe.
'I’m so glad I went for a water birth and would definitely recommend it! If I have another baby in a few years, which I hope to do, I'm really hoping the birthing pool is available for me to use again!' Jade (read her full story)
- NICE (2007) Intrapartum Care: care of healthy women and their babies, National Institute for Health and Care Excellence, London, England
- RCOG/RCM (2006) Joint Statement no 1: Immersion in Water During Labour and Birth, Royal College of Obstetricians & Gynaecologists and Royal college of Midwives, London, England
- Davies, R; Davis, D; Pearce, M; Wong, N. (2015) The effect of waterbirth on neonatal mortality and morbidity: a systematic review and meta-analysis. Database of Systematic Reviews and Implementation Reports. 13 (10), 180-231
- MIDIRS (2008) The use of water during childbirth. Informed choice leaflet for professionals, MIDRIS, Bristol, England
- Richmond H (2003) Women’s experience of waterbirth. Practising Midwife 6: 26-31
- NICE (2014) Intrapartum care for healthy women and babies Clinical guideline [CG190], National Institute for Health and Care Excellence, London, England
- Harper B. 2014. Birth, bath, and beyond: the science and safety of water immersion during labor and birth. J Perinatal Ed 23(3):124-134. www.ncbi.nlm.nih.gov [Accessed January 2017]
- Cunningham E. 2016. Is water birth natural for the fetus? MIDIRS Midwifery Digest 26(1): 55-63