Labor and Giving Birth in Water
Risks and Benefits
A must-read list of risks and benefits of labor and giving birth in water.
In order to make an informed choice about any birth option, a woman needs to investigate the risks and benefits of that option and apply them to her own situation.
Benefits of Labor and Giving Birth in Water
1. Reduces Perception of Pain
Research has shown that, during the first stage of labour, immersion in water significantly reduces women's perception of pain and the use of epidural/spinal analgesia for pain relief. Immersion in water during the second stage of labour increased women's reported satisfaction with pushing.1
Climbing into a warm bath automatically causes one to relax ("the ahh effect") and stimulates the production of hormones, oxytocin and vasopressin, which will reduce the perception of pain and facilitate progress in labor.2
Being calm will also help a woman in labor to breathe more easily and this will improve oxygenation of the uterus and also help to reduce her sense of pain.
2. Safe Pain Relief Method
Water is a natural pain reliever and is therefore safer than other medical interventions, such as pethidine, epidural analgesia etc.
3. Greater Comfort and Mobility
Once in the birth pool, a woman has freedom to move and position herself to ease the baby's descent through the birth canal. Her body is bouyant and there is less pressure on the abdomen, which will facilitate effective contractions. Gravity can help the baby's descent through the birth canal.
4. Greater Privacy and Control
Once a woman is immersed in water she has greater control over her birth and there is less opportunity for others to interfere with her body. A woman feels safe and secure when laboring and giving birth in water and she can assume greater responsibility for her birth experience. Women report that the water intensifies their connection with the baby. They are more aware of the baby's movement and progress through the birth canal.3
5. Water May Speed Up Cervical Dilation and Progress in Labor
Immersion in water can help to speed up progress in a slow labor. The cervix may suddenly dilate rapidly once a laboring woman is in warm water.
6. Reduced Perineal Trauma
Research shows that the episiotomy rate for giving birth in water is zero!4,5 The combination of being upright, having the mother in a good physiological position to birth her baby, giving her the freedom of control and not telling her to push when her body is not indicating it, all contribute to better perineal outcomes.3
7. Helps Women Focus on Labor
Once relaxed in a bath of warm water a woman is more likely to calm down and focus on what is happening to her body.
8. Greater Involvement of the Partner
Some men are reluctant to participate if they believe their partner is going to be experiencing pain, stress or trauma. When a man knows that his partner is relaxed and comfortable he is more likely to participate and take an active role in supporting her during labor and birth.
9. Enhanced Family Bonding
When a man has participated in a labor and birth, the relationship between him and his partner is enhanced. He is also more likely to experience greater bonding and attachment with the newborn. When a woman has had a positive birth experience, bonding and attachment between her and her partner as well as the newborn is also enhanced.
10. Sense of Satisfaction
Women who have used water during labor enjoyed such positive experiences that they express the desire to do the same again with subsequent births. Women who had water births felt empowered. In one survey of a thousand women, only one woman said she would not repeat the water birth experience and her reason was the she was "done" having babies as this had been her 7th birth!3
11. Gentle, Peaceful Birth for Baby
Advocates of giving birth in water believe that the transition to the outside world is less traumatic for babies who are born in water.
Babies born in water are reported to be calm, and cry less than babies born in air. Many psychologists believe that gentle birth experiences have a life-long effect on the person, while trauma or violence at birth can result in violence in adults.
Waterbirth is more a philosophy of non-intervention than a method or way to give birth. - Barbara Harper
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Risks of Labor and Giving Birth in Water
1. Infection
There is a perceived risk of infection in a birth pool, especially if a woman opens her bowels during the birth. However this is a normal occurence and the debris can be removed. Although it does contaminate the water, birth in air is not sterile either and babies are exposed to the same contamination during a birth out of water.6
There is also no risk of infection from mother to baby of viruses such as HIV or hepatitis.3Research has not shown any difference in rates of infection between giving birth in water or in air.1
2. Monitoring and Emergencies
A woman may not be able to labor or birth in water if there are any perceived complications or risk such as
- labour is progressing very slowly. Immersion sometimes slows labor if used too early.
- abnormal bleeding during labour
- an increase in the woman's blood pressure
- the pool water gets very soiled
- the woman feels faint or drowsy
- abnormalities in the baby's heart rate
3. Perceived Risk of Inhalation of Water
Research shows that babies do not inhale while under the water. A mechanism known as the "dive reflex" causes a baby to instinctively close the airway and prevent her from breathing in water. (Harper 2000; Johnson 1996 cited Cluett and Burns 2009).
There is no evidence that babies born in water suffer from breathing problems any more than babies born in air1. In an estimate of over 150,000 waterbirths worldwide between 1985 and 1999, there were are no valid reports of infant deaths due to water aspiration or inhalation.3
4. Risk to the Umbilical Cord
Care should be taken when lifting the baby from the water not to damage the umbilical cord. Although this is not a life-threatening emergency for a properly trained midwife, it is an unnecessary complication that should be avoided.
Download a copy of the 9 page article,Waterbirth Basics, with all the inside info on water birth, written by Barbara Harper, RN, the "Billy Graham" of Water Birth International, by signing up for our Pregnancy and Giving Birth NEWS.
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References for Giving Birth in Water
1. Cluett ER, Burns E. 2009. Immersion in water in labour and birth. Cochrane Database of Systematic Reviews Issue 2. Art No: CD000111.
2. Katz, V., et al. (1990, Feb.). A comparison of bed rest and immersion for treating the edema of pregnancy. Obstet and Gynecol 75 (2): 147-51.
3. Harper, B. Waterbirth Basics (sign up for free download)
4. Burn, E., Greenish, K. (1993). Water Birth. Pooling information. Nursing Times 89 (8): 47-9.
5. Garland, D., Jones, K. (1997, June). Ibid.
6. McCloghry K. 2003. Edgware Birth Centre: A waterbirth experience. Brit J Midwifery 11(5):314-6
7. Garland D. 2000. Waterbirth: An attitude to care. London: Books for Midwives
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