The pros and cons of water birth (2024)

What are the pros of labouring in water?

Relaxation

The relaxing effect of water, with its support and warmth, can help you through your labour. Your contractions may lose their rhythm if you become tense. This means your labour may stop and start without moving on. Being bathed in water may help you go with your contractions, so that they are less stressful for you and your baby (Cluett and Burns 2009).

Being relaxed also helps you to breathe calmly. It means you're less likely to take short, shallow breaths, which can make the pain of contractions worse.

Privacy and control

Once you're immersed in the warm waters of the pool, you're in your own world and can labour undisturbed. If the lights are dimmed and the room is quiet the effect will be heightened. It may help you to feel more in control of your body.

Buoyancy

The water buoys you up and makes you feel lighter. It's easy for you to move about, so you can make yourself comfortable. The best position for you is likely to be one that helps your baby move most easily through your pelvis. A useful rule of thumb is to keep your knees lower than your hips.

Coping with pain

Being in warm water can make it easier for you to cope with the pain of contractions (Cluett and Burns 2009). It's just the same as having a bath to soothe a stomach ache or backache. If you want strong pain relief, such as Demerol or an epidural, you'll have to leave the pool. If it is available, you can use gas and air, which is a mild pain reliever, while you are in the water.

Having a birth supporter with you

You should not be left alone while you are in a birth pool. This means that either your midwife or your labour partner should be with you at all times.

Satisfaction with your labour

Using a birth pool for labour is often such a positive experience that many women want to use one again when they have their next baby (Cluett and Burns 2009).

What are the pros of giving birth in water?

Working with gravity

Getting into a comfortable upright position may be easier if you are using a birth pool, particularly if you have a physical disability. Being upright gives you the advantage of working with gravity as your baby is born.

It may be easier to push your baby out in the water than in air (Cluett and Burns 2009). You'll be supported by the water and can use the sides of the pool for extra support.

Peaceful birth for your baby

Champions of water birth believe that the transition to the outside world is less traumatic for babies who are born in water.

The idea is that the warm waters of the pool will feel like the waters of your uterus (womb) to your baby. Babies born in water are often calm, and cry less than babies born in air.

Satisfaction with the birth

Women who have water births generally say they have had a positive experience. They say a water birth is particularly helpful when it comes to the pushing stage (Cluett and Burns 2009).

What are the cons of labouring in water?

Infection

There may be a risk of infection in a birth pool. Hospitals and companies that rent birth pools have strict rules about cleaning pools after each water birth. They do regular checks to ensure that the pool is left hygienic after each use.

There is some controversy about whether or not a woman whose waters are broken and is GBS positive should be allowed to labour in water. Check with your midwife or doctor for the latest recommendations. They will help you assess whether the birth pool is best for you.

Unpleasant environment

You may feel uncomfortable about accidentally opening your bowels as your baby enters the world. The idea of the midwife having to sieve debris out of the water to keep it clean may be unpleasant to you. But remember that midwives are quite used to this. You need not worry on their account.

Disappointment with pain relief

You may find that being in a birth pool does not make contractions less painful. If your plan was to spend most of your labour in water, it could be demoralizing to have to get out so that you can have drugs, such as an epidural, for pain relief.

Monitoring and emergencies

You may have to stay out of the pool if your labour develops complications or if you need to be continuously monitored. Having to get out of the water and change the course of your labour may be upsetting for you. You will be asked to leave the pool if:

• monitoring your baby's heartbeat shows that there is a problem
• your labour is progressing very slowly
• you start bleeding during labour
• your blood pressure goes up
• your baby's first poo (meconium) is detected in your waters
• the pool water gets very dirty
• you feel faint or drowsy

If you are having your water birth in hospital, you may find there restrictions on how you can use the pool. See our article on planning your water birth for more information.

Most water births go smoothly, but if an emergency does arise, it may take time to get you out of the pool and it may be difficult for your midwife to assess how much blood you are losing in the water. Even so, midwives are trained to deal with emergencies. They'll have ways of getting you out as quickly as possible, and getting you the help you need.

What are the cons of giving birth in water?

Infection

As you push out your baby, you may open your bowels. This is entirely normal, and debris will be quickly cleaned out by your midwife. But it does introduce the risk of infection, in particular pneumonia, in your newborn. (McCloghry 2003).

Baby starting to breathe under water

You may be worried that your baby will inhale water with his first breath if he is born in a birth pool. However, healthy babies have way of protecting themselves, called a "dive reflex". They instinctively close their airway, stopping them from breathing in water (Harper 2000; Johnson 1996 cited Cluett and Burns 2009).

Your midwife will also monitor your baby during your labour to make sure he's getting enough oxygen. There is no evidence that babies born in water suffer from breathing problems any more than babies born in air (Cluett and Burns 2009).

Experts believe that babies are only at risk of inhaling water if:

• they are startled during the birth so that they try to breathe air
• their head is brought to the surface before the rest of their body is born, overriding their dive reflex
• their oxygen supply via the placenta is affected in some way (Garland 2000)

Your midwife will know she needs to be "hands off" as your baby is being born, so that she doesn't interfere with his dive reflex. She'll guide you to make sure you don't bring your baby's head to the surface before the rest of his body is born.

Risk to the umbilical cord

The way water births happen means your baby will be brought quickly to the surface, head first. This will enable him to start breathing as soon as possible. Because of this swift movement, there have been a few cases where the umbilical cord has snapped (Gilbert and Tookey 1999; Cro and Preston 2002).

A snapped cord is not a life-threatening emergency for a properly trained midwife. But midwives and mothers are now advised to take care not to pull on the cord as they gently lift the baby from the water, just in case the cord is shorter than normal (Anderson 2000).