Water Birth Basics for Mothers & Babies

Are you considering using a birthing tub as part of your birth plan? It’s definitely worth researching and discussing with your labor and delivery team. Giving birth in a warm water tub can be a gentler way for you to give birth – and for your baby to enter their new environment.

Perhaps even more importantly, scores of women who’ve labored or given birth in a birthing tub report increased relaxation and physical comfort and may also benefit from a reduced need for pain medication or medical interventions. That said, there are certain times when a water birth isn’t recommended or requires extra planning and attention, which we’ve also outlined below.

Birthing Tubs & Water Births: What Are They?

Birthing tubs are available in hospitals, birthing centers, and for women who opt to give birth at home. These tubs are specially designed to accommodate a full-term mother in multiple positions.

They are just high enough to keep the woman comfortably submerged to a seated, chest-level position, with comfortable sides she can rest against between contractions. Once she’s through the transition phase of active labor and ready to push, the sides also allow the OB or midwife, along with her selected support team, to reach in and help her in whatever way she needs.

This may range from holding a water bottle for her to sip on, bathing the forehead with a cool cloth, or helping to support her body to the actual delivery of the baby.

Benefits of Water Births

There are multiple benefits to spending part – or all – of your labor in the water. A laboring mother’s feelings of safety, comfort, and the ability to relax whenever possible directly correlate to a reduction in medical interventions. So, you won’t be surprised to read that many of the same benefits associated with a midwife-assisted birth are also associated with laboring in a birthing tub.

In 2021, the British Journal of O&G published research concluding, “Waterbirth was associated with improved or no difference in outcomes.” Some of these and other research and clinical observations provided to the APA include:
● The relaxing, soothing, and comforting ambiance of warm water, which can lower blood pressure.
● Increased relaxation results in increased production of stress-relieving hormones and endorphins, which reduce pain and discomfort.
● Physical relief is provided by the water’s more “weightless” buoyancy, allowing for more effortless, mother-directed movements than outside the tub.
● Warm water increases blood flow, oxygenating the entire body – including uterine muscles.
● Subsequently, studies have shown lower amounts of fetal heart rate concerns with water immersion
● Effects of the soothing warm water make for softer and more relaxed perineum tissues, reducing the risk of tearing or the need for an episiotomy or stitches (U of Michigan concluded, “…women in the water group sustain fewer first and second-degree tears”).
● Increased privacy afforded by the water can help women feel less inhibited and more able to focus on the labor/birthing process.

The more relaxed you are, the less stressful the experience is for your baby, which is a major benefit.

Are there risks with giving birth in a tub?

One of the biggest fears for women and partners considering a water birth is that the baby will choke or inhale water. This is an understandable fear, but it’s a highly minimal risk. Babies don’t take breaths immediately after leaving the birth canal. Their umbilical cord is still connected and provides them with oxygen, so they don’t have the urge to take a breath.

Since the baby leaves a warm, amniotic sac – and enters a similar warm, water environment – they don’t have the instinct to breathe until they’re lifted gently up and out of the water and placed in their mother’s arms. By that point, their airways are water-free, and their first breaths result in a gulp of fresh air.

Plan carefully or opt out of a water birth if..

There are some scenarios where we advise against using a birthing tub or work with you to craft a different birthing plan that accommodates any risks. For example, we typically advise against water births if you:
● Have a high-risk pregnancy (gestational diabetes, pre-eclampsia, toxemia, macrosomia, intrauterine growth restriction, etc.)
● Experience pre-term labor by two or more weeks.
● Have herpes or other infections.
● If there are signs of heavy amounts of meconium in the birthing fluid while laboring in the tub, we’ll help you out and continue with your labor outside the water.
● Have a multiples pregnancy.
● Are giving birth to a baby in the breech position.

Healthy, low-risk pregnancies can have it all.

Laboring in a birthing tub doesn’t mean you have to give birth in the water. Some women use the tub for all of its beneficial, relaxing properties during labor and then opt to get out and deliver their baby in bed, on a birthing stool, on all fours, or whatever position feels safest and most comfortable for them.

If you’re interested in using a birthing tub, let’s talk about it at your next appointment. We’d rather you have the tub ready to go and decide not to use it than to have you forgo the tub option – and then regret not having it ready for you.

Have questions about creating a birth plan that includes a water birth? Your Northwest Women’s Clinic labor and delivery team is here to help in any way we can. Give us a call at 503-416-9922 and we’ll work through the options with you.