Water birth: how it works, benefits and who it isn’t suitable for

Many people find a warm pool takes the edge off contractions. Here’s what water can and can’t do, and what to know before you plan on it.

Labouring in water and giving birth in water

You can use a bath or birth pool just for labour, or stay in for the birth too. Tommy’s describes a water birth as labouring and/or giving birth in water, using a deep bath or birthing pool. You can get in and out as you like.

What it can do

The NHS says water helps you relax and can make contractions feel less painful. Tommy’s says the warm water can relax, soothe and comfort you, supports your body so it is easier to move, and may ease back pain. NCT describes labouring in water as a recognised pain management tool, and says generally water births are safe for both parent and baby. It says the largest recent UK study found babies born in water did not need more extra care after birth than babies born out of water.

Things to know

Pain relief: epidurals aren’t possible in the pool and TENS can’t be used in it. Tommy’s says opiates such as pethidine can’t be given for about 2 to 3 hours before you get in.
Temperature: the NHS says the water is kept at a comfortable temperature, but not above 37.5C, and your own temperature is checked.
Cord: NCT says the umbilical cord snapping before it is clamped is more common in water births, about 1 in 100 compared with about 1 in 300 out of water. Your baby is gently lifted to the surface by a parent, birth partner or midwife, slowly, to reduce this, and the cord is clamped straight away if it happens.
Getting out: you can get out any time. Your midwife may ask you to get out if there is heavy bleeding, changes in your baby’s heart rate, meconium (your baby’s first poo) in the water, a raised temperature, or if labour slows.

Who may be advised against it

Tommy’s says guidance generally advises against it if you have a breech baby, twins or triplets, a premature baby (under 37 weeks), meconium before or during labour, active herpes, pre-eclampsia, an infection, a high temperature in labour, bleeding, waters broken for over 24 hours, or an induction drip. Local guidance varies. If you carry group B strep, you may still be able to use a pool if you are offered antibiotics. NCT says a hospital or birth centre should explain the reasons if they discourage a water birth, and discuss alternatives such as using water in labour without giving birth in it.

Availability

A pool may not be free if the unit is busy, and you usually can’t reserve one. Ask your midwife about your local unit. Bleeding is harder to measure in water, so you may be asked to get out for the birth if you’re bleeding heavily. See where to give birth.

Questions people ask

Can I have a water birth if I’m being induced?

Tommy’s lists an induction drip among reasons a pool may not be advised. The NHS says induction doesn’t restrict your pain relief options, including water, so ask your midwife what applies to you.

Is a water birth safe for my baby?

NCT says water births are generally safe for both parent and baby, and the largest recent UK study found no extra need for care after birth.

What if I want to get out?

You can get out at any time, and get back in later.

Will I be able to use gas and air in the pool?

The NHS pain relief page lists water and gas and air as separate options. Ask your unit what it allows.