Everything you Need to Know About Having a Water Birth

Pregnant woman
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Everything you need to know before taking the plunge with a water birth.

As an expectant mother, you may find yourself constantly asked about your birth plan. If you haven’t already made your decision, it could be time to start running through your options with your midwife. If you’ve thought about having a water birth, you might want to know a little more about what the process involves. We’ve got the low down on the pros, cons and whether a water birth would be right for you.

The benefits of a water birth

The decision to opt for a water birth is becoming increasingly common. Marina Fogle and Dr Chiara Hunt, founders of The Bump Class in South Kensington and Parsons Green, are among the advocates for this method. They place it at the top of their list for relaxation techniques during childbirth. “That’s right, not needles, not drugs – water can be a great help to women throughout their labours”. The Bump Class pioneers affirm that the majority of women find being in the bath in the early stages of labour helps to ease the intensity of contractions.

In this way, undergoing labour in a birthing pool has been described as nature’s epidural. It is encouraged by NHS UK. An organic way of relieving pain during childbirth. The pool promotes the release of hormones called endorphins, helping us to manage pain. 

As well as acting as pain relief, water births also have other benefits. The privacy offered by the water can serve as a tool to reduce anxiety and inhibitions. Add the benefit of lowering the mother’s blood pressure, without reducing placental blood flow. Buoyancy also plays a part. Women feel more mobile in water, and find it easier to get into good positions for labour.

Credit: Anthony Tran on Unsplash

Is a water birth right for me?

Traditionally this was a birth choice mainly reserved for low-risk pregnancy, but increasingly women with other conditions, such as previous caesarean, are being allowed to go through labour in water with careful monitoring of both mum and baby.

In some cases, water immersion may slow down the contractions. In these cases, the women are encouraged to leave the pool and mobilise to encourage the contraction frequency to increase. 

There have been some concerns about the baby inhaling water into its lungs, but the lungs aren’t inflated until the first breath is taken, and studies have shown little difference in the health of babies born in water in comparison to those in air. Rates of infection are also similar, and there’s no increase in the rates of those requiring special baby unit care.

Current NICE guidelines are that water immersion is a safe and useful tool in labour and should be offered to all women without contraindications, such as breech babies, multiple births, herpes, pre-term delivery and some chronic medical conditions.

Recovery after a natural birth is usually quicker, due to the relaxing effects of water which promote energy conservation during labour.

Does a water birth reduce tearing?

The studies around water births are mixed. Some groups cite that the risk of tearing is reduced because water causes the perineum to become more elastic and relaxed. Another study showed that the risk of third-degree tear was higher. However, this was related to a very fast pushing stage.

Therefore, slow breathing as the head is crowning is encouraged. Techniques such as perineal massage may also be used to try to reduce the risk of tearing in the second stage of labour.

What happens during a water birth? Are there any risks?

In the pool, the baby is monitored with an underwater doppler device. This measurement is taken every 5 to 15 minutes, depending on the phase of labour.

The best time to enter the water is usually after 5cm, when the contractions are coming every three minutes: this is when labour is established. Once in the pool, the temperature should be keep between 35-37˚C in the first stage of labour and 37-37.5˚C in the second stage.

If women become overheated, it can effect the baby’s heartbeat. Likewise, the water being too cool can cause complications in the baby such as hypothermia. Therefore, it’s important to have a qualified healthcare supervisor present. If there are any concerns about the mother’s observations or the baby’s heartbeat, she may be asked to leave the pool. 

An underwater mirror may be used to check if the head is visible. When the time is right, she’ll be asked to push. The practitioner will lift the baby out of the water on to her chest.

Some women may be asked to leave the pool for delivery of the placenta, particularly if they plan to keep it or extract stem cells.

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