How To Have A Waterbirth

4,000 babies will be born underwater this year. Will your little one be among them? If you’re considering a water birth, read on to find out what you need to know before you sink into that birthing tub.
By Sarah Wassner Flynn

Weightless. Gentle. Luxurious. Such words are rarely used to describe childbirth, but that’s just how many women recount their experience of bringing babies into the world via water birth, or the process of laboring and, sometimes, delivering in a tub of warm water. And it’s a growing trend among moms-to-be, as illustrated in the 2006 documentary The Business of Being Born, in which former talk show host Ricki Lake shares the birth of her son in her own bathtub. Here’s more about why many women are eschewing stark delivery rooms for tubs filled with warm water, as well as how to decide whether a water birth is right for you. 

Though water births can be traced back to the ancient Egyptians, the concept was all but obscure in the United States until about thirty years ago. Today, up to 4,000 women a year opt for either water births or hydrotherapy (laboring in a tub or a shower, then delivering their baby out of the water). Experts say that immersing yourself in warm water definitely has its benefits:  “Water births and hydrotherapy are very helpful in allowing the woman to relax and cope more efficiently,” says Dr. Jo Anne Davis, a certified nurse-midwife and faculty member of the Midwifery Program at the New York University College of Nursing. She has overseen over 200 water births and touts the process as a way to speed up labor, reduce the intensity of contractions, and stretch the perineum, thus reducing the likelihood of tears, episiotomies, and painful stitches.

Just ask Laura Robinson, a mother of two from California who gave birth to her second child, a daughter, in a tub set up in her living room. She says the buoyancy of water reduced her anxiety and allowed her to have the freedom to continuously shift positions throughout her two-hour labor until she found a comfy spot. "You’re much more comfortable and can move around more easily. I wound up delivering on all fours in the tub,” she says. “Plus, the heat of the water helps to ease the pain immensely.” 

While more than 300 hospitals nationwide and countless birthing centers offer tubs in which to stage a water birth, at-home deliveries with a midwife are always an option. Some, like Robinson, set up rented tubs designed specifically for water births or even kiddie pools in their bedroom or living room. Others, like Lake, choose the comforts of their own bathtub. “It’s a matter of practicality. A pool is roomier and can be placed where the midwife or doula can easily access the woman. Some women love their tubs, but then again, a bathroom can be cramped,” says Davis. “I always find that inflatable toddler pools are great for water births, and inexpensive, too.”

Whether it’s a rental or a kiddie pool, a midwife will fill the tub with warm tap water (approximately 100 degrees Fahrenheit, similar to the temperature of amniotic fluid), about two- to three-feet deep. The woman will then enter the water when she’s officially in “active labor”, or at least four centimeters dilated. Any earlier, and the process may be hindered. “Research shows that getting in a tub too early can actually slow the labor down,” says Davis. “That’s why the provider must be vigilant about monitoring both the mother and the baby to determine when it’s time to get in the water, and, if necessary, out.” 

While water births and hydrotherapy are generally considered extremely safe, there are some risks involved. According to the American Pregnancy Association, there may be a chance of water embolism, which is when water enters the mother’s blood stream. Water aspiration, although very rare, may also occur if the baby is experiencing stress in the birth canal or the umbilical cord becomes kinked or twisted, causing the baby may gasp for air and possibly inhaling water into the lungs.

Additionally, water births present a bit of a practical challenge when supporting the baby’s transition to breathing from underwater to it can be difficult to control the emergence of the baby underwater. “But similar complications arise with ‘air births’, too. If something is going awry, we’ll recommend leaving the tub immediately,” she says, advising that, as with any births, moms should always expect the unexpected. “Birth is an instinctual process that works best when not over thought or over programmed. Instead of getting overly attached to any given approach, we just let it unfold naturally and carefully,” says Davis. 

The first way of determining whether to water birth is to ask yourself if you’re truly ready to go au naturale. “Women who are motivated to have a physiological birth, or one where they choose to work with the process rather than override it with medication are more likely to consider this approach helpful,” says Davis. She suggests that if you tend to relax with long soaks in the tub or feel especially refreshed after a shower, then you’ll fare well with either a water birth or with hydrotherapy.

However, if you have herpes or complications like maternal infections, toxemia, and preeclampsia, or if your baby is breech, you will probably be advised against a water birth—talk to your OBGYN or midwife about these factors. And, as Robinson warns, “It’s not for the faint of heart. It is a full-blown commitment and not easy, but it’s also very rewarding and empowering. My daughter is just as proud of her water birth as I am.”

For more information on water births and where to seek out a water birthing center near you, visit the American Pregnancy Association   and Waterbirth International.

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