Expert Advice

Water Births —The Latest Evidence

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Babies live in water before they’re born, and breathe through their umbilical cord. Increasing numbers of people think the transition to an air environment is easier if baby is first born into water. More and more midwives and obstetricians believe water births help reduce labor stress, which can reduce complications for both baby and mom.

Are water births safe?

The scientific evidence says, Yes, they are!

Evidence-Based Birth is a website run by Rebecca Dekker, PhD, RN. Here’s what she has to say about the latest research: 

According to available evidence[1],[2],[3],[4],[5], babies born in water are as healthy at birth as babies born directly into an air environment.

Water birth babies and air birth babies have no differences in

The largest study conducted on water births was done with low-risk women in China in 2015. 

Those women had:

  • Fewer severe perineal tears
  • Shorter labors (an average of about 50 minutes shorter)
  • Less pain

And water births at home—attended by midwives—had

  • Fewer postpartum transfers to hospital
  • Fewer hospital admissions within 6 weeks
  • Reduced need for episiotomies

Water births help ease pain for Mom and transition for baby

According to American Pregnancy Association, there are many water birth advantages for both mom and baby:

For Mom

  • Warm water is soothing, comforting, relaxing.
  • In the later stages of labor, water has shown to increase the woman’s energy.
  • The effect of buoyancy allows free movement and new positioning.
  • Buoyancy promotes better uterine contractions and improved blood circulation, less pain for mother, and more oxygen for baby.
  • Immersion in water often helps lower high blood pressure caused by anxiety.
  • Water seems to reduce mom’s stress-related hormones and produce endorphins (pain-inhibitors).
  • Water causes the perineum to become more elastic and relaxed, reducing the severity of tearing and need for an episiotomy and stitches.
  • Laboring women relax more physically and mentally, increasing ability to focus on the birth process.
  • Water provides a greater sense of privacy, can reduce inhibitions, anxiety, and fears.

For baby

  • Provides an environment similar to the amniotic sac.
  • Eases the stress of birth, thus increasing reassurance and sense of security.

For about the last 30 years, water births have been a popular birth choice with few negative outcomes.

Most women laboring or delivering in water are low-risk—each one needs to decide if the benefits outweigh the risks for her and her baby.

What are the risks?

  • Possible breath intake. Babies usually don’t take their first breath until they are exposed to air. And though the Royal College of Obstetrician and Gynecologists is 95% confident that water births are safe, there is a small chance baby will breathe while still in the water, especially if it is experiencing stress in the birth canal.
  • Small chance the umbilical cord could snap as baby is lifted onto mom’s chest, but this can be prevented by taking care to support the cord as baby is lifted.

The most important outcome of any birth is a safe and healthy Mom and Baby

Water births are not for everyone:

  • If you have Herpes: Herpes transfers easily in water—talk about this with your care provider
  • If your baby is breech: Breech births can be done in water, but talk this over with your care provider
  • If you have been diagnosed with one of the following: excessive bleeding or maternal infection
  • If you are having multiples: Successful water births with twins have been done all over the world, so discuss this with your care provider
  • If preterm labor is expected: If a baby is pre-term (two weeks or more prior to due date), water birth is not recommended.
  • If there is severe meconium: Mild to moderate meconium is fairly normal, and your care provider can manage it or else help you out of the tub. Meconium usually washes off the face of the baby and even comes out of the nose and mouth while the baby is still under water.
  • If you have toxemia or preeclampsia: Thoroughly discuss this risk with your health care provider.

Deciding to have a water birth means planning ahead

  • Notify your birth attendant that this is your preference for labor and birth
  • List water birth on your final birth plan listed on your hospital bag checklist
  • Check facilities (birthing centers) near you or plan for a home birth. Can you have a water birth at your local hospital?
  • Stay low risk—the majority of women successfully having water births are low-risk. Diet, exercise, and stress all contribute to your risk status, but your personal health is the biggest factor.
  • Get logistics in order—How does this birth preference fit into your home environment? Where can you rent a tub? And how does it fit into your living room (the usual place temporary tubs are placed)? What do you need to protect your floor?
  • Who will set up and fill the tub? Many tubs take hours to fill and even more time to heat the water to 97 degrees F, so at the first signs of true labor (as compared to Braxton-Hicks contractions) or shortly before your due date, it’s time to fill and heat the tub.
  • What supplies do you need next to the tub? You’ll need to drink WATER and stay hydrated so you don’t overheat. What about clothing or slip-on shoes or non-slip rugs?

Understanding the benefits and risks, working with a care provider who supports this birth choice, and staying healthy prepares everyone to welcome your new baby as she swims into your world.







To learn more about birth choices, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.

This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.

Published: May 18, 2017 | By SP Turgon, Certified Labor Doula  Reviewed by: The Best Ever Baby Expert Team | Last reviewed: May, 2017


Sabriga TurgonWater Births —The Latest Evidence

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  • Julius Wither Amberfield - December 18, 2017 reply

    It was really nice how you said that a majority of women who prefer water birth are low risk, however, diet, exercise, stress, and overall health contribute to the risk status, so it’s best to be prepared and aware. I’ll be sure to let my sister know about that because she’s three months pregnant, and I have the strangest feeling that she’s interested in water birth. At least, it’s a good idea to know what she needs to know in order to make sure that the baby is delivered properly. Thanks a lot!

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