Water births - all you need to know

Find out all you need to know about having a water birth in our comprehensive guide that includes information on the benefits and potential problems.

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Water births are becoming an increasingly popular option as many women find them more relaxing and less stressful than a traditional labour. To help you decide whether this is something you might want to incorporate in your birthing experience here's our comprehensive guide to giving birth in water:

What are the benefits of a water birth?

While not a suitable option for everyone, many women find that a water birth gives them a more enjoyable labour and delivery; reported benefits include:

• Being submerged in warm water can help you to relax and feel in control of your body by reducing some of the discomfort and tension associated with a birth 'on land', making for a less stressful birth experience for you and your baby.
  
  
• Many believe that water births help you better cope with contractions and research has shown that fewer women require additional pain relief or medical intervention with this type of birth.
  
  
• Water births are also said to reduce the likelihood that you will tear or need an episiotomy as the water helps to soften your skin so that you are better able to accommodate your baby's head.
  
  
• During a water birth you will have a qualified midwife with you at all times and as the mere presence of another women during labour is said to reduce the need for additional pain relief and intervention this in itself could mean you have a more pleasurable birthing experience.
  
  
• As the water supports your body it is easier to move from position to position when you are in the birthing pool and this can help to make you more comfortable and your contractions more effective, potentially making for a shorter labour.
  
  
• Many believe that being born into water is less 'traumatic' for baby as they enter a warm, wet environment similar to that which they are used to in the womb before being introduced into the 'real world'.

What are the potential problems of having a water birth?

While there is very little conclusive research into the safety of water births, the general consensus is that they pose no additional harm to mother or baby than that associated with a regular birth out of the water. Having said that there are some points to consider:

• To ensure the health of mother and baby it's recommended that the water in the birthing pool is maintained somewhere between 36 and 37 degrees, however your midwife should keep an eye on this for you. The birthing room should also be kept to a comfortable temperature.
  
  
• It's important not to overfill the birthing pool and the 'ideal' depth is where the water covers your tummy completely and reaches just under your bust when you sit back on your heels.
  
  
• There is a slightly increased risk of a snapped umbilical cord during a water birth however, will proper monitoring this should not pose too much of a health risk.
  
  
• There is potential to be disappointed with your water birthing experience if it did not provide the pain relief that you had hoped for or if you require further pain relief that you had not planned.
  
  
• You may be concerned about the risk of infection however all maternity units have strict cleanliness standards that they must adhere to and any birthing pool will have been cleaned thoroughly so this risk is minimal.

How do I use a birthing pool?

It's possible to remain in the birthing pool throughout your entire labour and for the birth however you are free to get in and out as you please. Some hospitals will recommend that you don't enter the water until you are 5cm dilated as for some women the soothing effects of the warm water can actually slow the progression of labour. Additionally, others will ask you to leave the water for the birth itself.

You should stay in the birthing pool for as long as you feel comfortable doing so although you will need to get out to use the bathroom at regular intervals. It's much easier to move around and adopt different positions while you are in the water and squatting, kneeling or lying out flat either on your side, tummy or front (gripping onto the sides and using a waterproof pillow for support) are all good positions to try.

When writing your birth plan you should mention whether you would prefer to be in the pool by yourself or whether you would like your partner or midwife to accompany you (some hospitals will have a policy on this so it's important to check first).

When its time for your baby to be born your midwife will make sure that you are positioned so that your baby's head is completely under water during the delivery. This is because your baby will not start breathing until they feel the air on their skin as they are still receiving oxygen from the placenta. Once your baby's body is delivered your midwife will pick your baby up and place him or her straight on your chest so that their head is held out of the water and their body is submerged against yours.

Don't be surprised if your baby doesn't start crying right away, water birth babies often appear more serene for their first few moments of life. This is thought to be because they have enjoyed a more gradual introduction to the world.

Most hospitals will have a policy that dictates whether you will be able to deliver the placenta while in the water (some prefer you to do this out of the water so that they can monitor how much blood you lose), otherwise its entirely up to you whether you choose to do this or not.

How will my baby be monitored?

It's a requirement that a midwife stays with you at all times during a water birth and they will use a water proof doppler to monitor your baby's heartbeat at increasingly regular intervals as your labour progresses. They will also monitor your temperature and heartbeat and if deemed necessary may also give you an internal exam. If your midwife becomes concerned about how your labour is progressing at any stage she will simply ask you to leave the birth pool so that she can carry out further checks.

Can I use other forms of pain relief?

While being submerged in warm water will help to relieve some of the discomfort associated with labour you may find that you need some additional pain relief to help you cope as your contractions become more intense.

Gas and air (Entonox) is suitable for use during a water birth as it provides some pain relief without making you drowsy so it is safe to use while you are submerged in the birthing pool. Massage is a good option for everyone and aromatherapy is used by some although this will need a little forward planning as you will need to consult a qualified aromatherapist and check with your maternity department as to whether aromatherapy oils can be used in the pool.

Stronger forms of pain relief such as Pethidine or an Epidural will not be administered during a water birth as they can limit your mobility and make you drowsy so are not safe for use in water. However, if you change your mind part way through and do feel that you need further pain relief, as long as you agree to come out of the water completely for the remainder of your labour, your midwife may make these options available.

Additionally, Tens is not a compatible form of pain relief for use during a water birth as it is electrically powered and therefore cannot be used with water.

Can I eat and drink during a water birth?

Whether you're in the water or not it's incredibly important to drink plenty of fluids during your labour as you will need to keep yourself hydrated. Ask your birth partner to keep a glass of soft drink in close reach so that you can take a sip whenever you feel you need to; a bendy straw can come in useful here.

As for food, in principle there is nothing wrong with eating during a water birth (as long as it's nothing to heavy) as the extra calories you consume will help you cope with the demands of labour. However, some maternity units do not allow you to eat in their maternity / water birth suits so it's important to find this out in advance.

What should I wear for a water birth?

While many women feel comfortable being completely naked during their water birth others don't feel as confident at least when they first use the pool. In this case wearing a sports style bra, baggy t-shirt or tankini style top may make you feel more at ease. You should also have a warm dressing gown, large towel or sarong to hand to help you keep warm if you need to leave the pool for a break or to go to the toilet.

Will I be able to have a water birth?

Providing that your local hospital has the resources to accommodate a water birth when you go into labour and you have discuss it well in advance with your midwife you should be able to enjoy a water birth. However, there are some circumstances when a water birth is not thought a suitable option so as to protect your own and your baby's health these include:

• If you are having twins or multiple babies
  
  
• If your baby is premature
  
  
• If you have a chronic illness such as diabetes or heart problems
  
  
• If you have very high blood pressure or pre-eclampsia
  
  
• If your baby is in a breech position
  
  
• If you have experienced bleeding during the final weeks of your pregnancy
  
  
• If you have previously had a c-section
  
  
• If you have been induced

How can I find out more about having a water birth?

If having a water birth is an option that you would like to consider the best person to talk to is your midwife. They will be able to give you more information about the maternity services available at your local hospital and the resources that are likely to be available to accomodate a water birth either here or in the privacy of your own home. Your midwife will also be the best person to advise you on the suitability of a water birth on the basis of your health and your pregnancy.

Have you chosen to have a water birth or have you had one in the past? Whether you have any questions, advice or experience that you would like to share with others, why not visit the AskBaby forums for a chat with other parents-to-be?