A water birth is a natural birth method where the baby is born in a warm birthing tub. Many women find it gentler and more relaxing than giving birth in a hospital bed. However, it’s not suitable for every pregnancy. Certain conditions must be met in order to minimise risks.
Overview of water births
In water births, the expectant mother gives birth to her child in a bathtub filled with water. A birth can take place entirely or partly in water. For many women in labour, a water birth is associated with less pain and stress than a conventional birth, as the warm water has a relaxing effect and usually shortens the duration of labour. For the baby, a water birth creates a smoother transition from the warmth of the uterus to the light of the world compared to a normal birth.
Requirements for a water birth
For a bathtub births, the following conditions must be met in order to minimise risks to the mother and child:
- The mother must be healthy
- The pregnancy must be risk-free and without complications
- No infections or bleeding can have occurred in late pregnancy
- A water birth is not recommended for multiple pregnancies
- The baby must not be in a breech position
Benefits of giving birth in water
Both the mother and the newborn can benefit from the positive effects of a water birth:
- The warm water can help to relax the tissues and muscles, thus reducing pain
- Water births often take less time
- Reduced risk of perineal tears or cuts
- Easier to change positions during delivery
Procedure for water births
The birthing tub is larger than a conventional bathtub and is equipped with different handles and supports so that the woman giving birth can always be in a comfortable and supported position. She is free to decide when she wants to enter the delivery tub and has the option of leaving at any time if she feels uncomfortable. The tub is filled up to approximately the height of the navel with water warmed to 34–36 degrees Celsius – no bath additives are used.
As soon as the pregnant woman is ready, the final preparations are made. In case of an emergency, the mother receives an infusion to allow a quick administration of medication. In addition, an enema is administered to empty the rectum and prevent the water from becoming contaminated by bowel movements.
Both the first and second stage of labour can take place in the water. The midwife guides the birth from the side of the bathtub, while an experienced team supports the mother at all times. The contractions and baby’s heartbeat are monitored with waterproof cardiotocographs to ensure that it is doing well throughout the labour. If the warm water leads to significant relaxation and the contractions subside, it may be helpful to briefly get up. The cooler surrounding air has a stimulating effect and can speed up the birthing process.
Shortly before and while the child’s head is exposed, the midwife carries out the perineal protection. The warm water makes the tissue more supple, so that a perineal incision is not necessary in most cases.
After birth, the baby is gently lifted out of the water and placed on the mother’s stomach. The first breastfeeding can also occur while in the birthing tub.
Preparation and precautions
- Birth planning: discussions are carried out with the midwife and doctors to determine whether a water birth is possible. If a water birth is an option, further wishes, needs and questions can be discussed as part of the birth planning.
- Preliminary examinations: as with a conventional birth, the usual preliminary examinations, including blood and ultrasound examinations, are carried out before a water birth. These are used to rule out infections and determine the baby’s position, among other things.
Aftercare and recovery
Immediately after birth
Immediately after birth, the baby is gently lifted out of the water and placed on the mother’s stomach. The first breastfeeding can also take place in the delivery bathtub. The mother is then washed and brought to bed, while the baby is cleaned, has the umbilical cord cut off and receives its first medical care. Afterwards, the baby is brought back to the mother. The afterbirth, i.e. the expulsion of the placenta and the foetal membranes, takes place in a quiet atmosphere directly in the room. Finally, the mother is carefully checked to determine whether there have been any birth injuries and whether medical treatment, such as a suture in the event of a perineal tear, is necessary.
The first few days after the birth
In the first few days after a bathtub delivery, rest and relaxation are particularly important; the body should be given enough time to recover. Physical hygiene requires special attention in the first few days – bathing should be avoided to prevent infections, while showering is possible without any problems. As with every birth, postpartum bleeding (lochia) occurs, which can last for several weeks.
Gentle postnatal exercises can be can be started at an early stage to support the body’s recovery. This strengthens the muscles and stabilises the pelvic floor.
Potential complications
The greatest challenge for water births is unpredictable emergencies that can pose a risk to both the mother and the child:
- Time-critical emergencies: although an experienced team is always on standby, the transfer from the pool can cost valuable time, which can be decisive in critical situations.
- Lack of a diving reflex: in rare cases, the baby’s diving reflex is missing, so that it could inhale water with the first breath.
- Risk of infection for the child: water contamination (e.g. from germs or stool flora from the mother) can lead to infections in the newborn.
- Risk of infection for the mother: the skin is weaker due to the prolonged stay in warm water, which can increase the risk of skin infections.
Questions about water births in hospitals
When is a water birth not recommended?
A bathtub birth is not an option for cases of multiple pregnancies, premature birth or if the child is in a breech position. It also cannot be carried out if there has been bleeding during pregnancy or if the woman or baby have an illness (e.g. fever, infection with hepatitis C, HIV).
What are the disadvantages of a water birth?
One disadvantage of a bathtub delivery is the risk of unforeseeable emergencies, in which the transfer from the water can cost precious time. In rare cases, the baby’s diving reflex is absent, which could cause it to inhale water. In addition, there is an increased risk of infection for the newborn due to possible water contamination, as well as for the mother, since the skin is more susceptible to infections due to the prolonged stay in warm water.
What about bowel movements during a water birth?
In order to empty the rectum and thus prevent the water from becoming contaminated by bowel movements, an enema is usually administered.
Is epidural anaesthesia possible for water births?
No, epidural anaesthesia is not possible for water births, as the anaesthetic would restrict the mother’s mobility and could increase the risk of infection. Epidural anaesthesia requires continuous medical monitoring and stable storage, which is not compatible with a water birth.
Which is better, a water birth or a conventional birth?
Choosing between a water birth and a traditional delivery in the delivery room depends not only on the medical requirements but also on the expectant mother’s individual preferences and health conditions. A water birth offers benefits such as pain relief and a shorter delivery period, but not every woman finds it more comfortable than a conventional birth.
Centers
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Maternity unit
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Maternity Unit
Schänisweg
CH-5001 Aarau
