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A variety of birthing options are available today. Depending on your preference and the health of you and your baby, you may choose to deliver in the hospital, at a birthing center, or at home. Beyond location, more and more women are choosing water births as the way their babies enter the world.

During a water birth, you’ll be submerged in water, usually in a stationary or inflatable tub, and you’ll birth your baby in the water. You may also choose to labor in water and deliver out of the water. This may be a good option if you want the benefits of hydrotherapy, along with the benefits of delivering in a hospital. Ask your hospital beforehand if they allow women to labor in water.

Read on to learn more about the benefits, risks, and logistics of water births.

Water births have become more popular over the last several decades. The American College of Obstetricians and Gynecologists recognize certain benefits, but they don’t recommend laboring in water beyond the first stage of labor, leading up to when the cervix is fully dilated. They also do not recommend delivering in water.

According to ACOG, immersion in water in the first stage of labor may help shorten the duration of labor. Laboring in water may also decrease your need for epidurals or other spinal pain relief.

One small study revealed that women who labor in water may also have a lower cesarean section rate (13.2 percent versus 32.9 percent). Not only that, but women who have water births reported less stress incontinence 42 days after delivery than those who delivered on land, 6.1 percent versus 25.5 percent, respectively. Larger scale studies are needed to confirm these findings.

Women who birth in water also report higher birth satisfaction. Michelle O. delivered her daughter in a stationary, warm-water delivery tub at a birthing center in 2012. She says “the warmth of the water, the weightlessness, gave me room to escape without disconnecting. Giving my daughter a gentle start earthside as I brought her up to my chest from the still water was a moment I will always treasure.”

Overall, ACOG recommends that laboring in water be offered to women who are between 37 weeks to 41 weeks, 6 days gestation. There are other guidelines, including having a low-risk pregnancy, clear amniotic fluid, and baby in head-down position.

Water births may not be recommended for women who are in preterm labor or who have had two or more previous cesarean section deliveries.

In addition, water birthing may not be recommended if you have any of the following complications or symptoms:

While rare, babies born in water may acquire infections or other diseases. Legionnaires’ disease, for example, is caused by inhaling (aspirating) droplets of water that contain Legionella bacteria. It’s a severe and sometimes fatal disease that causes fever, cough, and pneumonia, among other issues.

Other risks include:

  • trouble regulating baby’s body temperature
  • chance of umbilical cord damage
  • respiratory distress for baby
  • asphyxia and seizures

Are water births safe with multiples?

You may or may not be a good candidate for a water birth if you’re carrying twins or higher order multiples. These pregnancies do have a higher risk of premature birth and other issues that may need closer monitoring during labor and delivery.

Communicate your desires to have a water birth with your healthcare provider to discuss your individual risks and birth plan.

Consider touring local hospitals and birthing centers to find out more about their water birthing options. Some hospitals will allow you to labor in the tub but then require you to deliver on the hospital bed. Others may allow you to go through all stages of labor in the tub. A few may have additional rules and practices in place. Gather as much information as you can so there are no surprises when you arrive.

Supplies for home water birth

If you choose a home water birth, there are options for how to get a tub. You may rent or buy one yourself. Sometimes midwives will supply a tub, dropping it off at your home later in your third trimester.

Regardless, you’ll want to prepare in advance to know where you’ll place the tub. The weight usually isn’t an issue in most homes, but if you’re concerned, consider placing it on the first floor level.

You’ll need a number of supplies to clean and heat the pool. For example, you may choose to use a hygienic birth pool liner, especially if you’re renting or borrowing a tub. You’ll also want a fishnet or strainer to scoop out solid materials during birth.

Other supplies:

  • new garden hose that is long enough to reach your tub
  • adapter to attach the hose to a sink
  • a jug of bleach for cleaning
  • 2 to 3 pounds each of sea salt and Epsom salts
  • tarp to protect your floor
  • more plastic sheeting to cover a cleaned tub
  • towels
  • floating thermometer
  • pots for boiling water as backup heating

You also need access to a hot water tank. In fact, you may need to turn your water heater to its highest setting to ensure you’ll have enough hot water throughout your labor. You should aim to keep the birthing tub temperature between 97 and 100° F (36.1 and 37.8°C).

It may seem like a lot of preparation, but your midwife will help guide you along the way. The key is to get your tub as clean and comfortable as possible.

What happens during labor and delivery?

While you’re in the tub, you may see a variety of colors and textures as you make your way closer to delivery. These sights are likely normal and include such things as mucus, bloody show, and feces. Your midwife or helper will clean them out with the net.

After delivery, your midwife will likely take care of you and your baby first. Then while you’re recovering, your midwife or helper will empty the tub into your toilet using a pump. The liner will also be thrown away. The tub should be wiped down with bleach before storage or return.

Q:

Can I use the tub in my bathroom for my water birth, or do I need to rent or buy a special tub?

A:

A home bathtub can be used for water immersion during labor and/or delivery if cleanliness is ensured. Because the risks of not only water immersion, but also home-based labor and delivery, are involved, this process should be discussed in detail with your obstetrician or midwife so that you can be informed of all your options.

Many hospital units are equipped with tubs in their labor suites, which can be used when your doctor or midwife feels it’s safe for both you and your baby. This option provides you with expert care during the labor, delivery, and postpartum process as many unforeseen complications can easily arise, while allowing you the option for water immersion if you desire.

Holly Ernst, PA-CAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

A water birth in a hospital setting may cost the same as a vaginal birth. In many cases, most or part of a hospital birth is covered by your health insurance. Without insurance, a vaginal birth at a hospital in the United States may cost anywhere between $5,000 and $10,000, though costs vary by location and facility.

Home-birth costs can range depending on your location, but are generally lower than hospital costs. Personal finance site Money Crashers shares that a home birth may cost anywhere between $1,500 and $5,000. Home births are most often not covered by insurance. When choosing your midwife, ask for a full breakdown of the expected costs and when payment will be due before you agree to use their services.

Some midwives offer tubs as part of their services. If not, the cost to rent or buy a birthing tub also ranges depending on where you live and the options you choose. A basic tub with liner may cost under $300 to purchase. Rental costs are around the same price. You’ll also need other supplies, so plan accordingly.

Some insurance carriers may reimburse birth pool costs. Call ahead to find out your coverage. Water Birth International explains that it’s important to express that the tub is for pain management when inquiring about coverage.

For more information about water births, consider chatting with an obstetrician or midwife to find out the range of options in your specific area. Again, some hospitals offer water births while others allow you to labor in the tub and deliver on dry land.

Here are some resources for additional information or finding a midwife:

You may also reach out to friends or family who have had previous water births to learn more about their experiences. What’s most important is choosing a birthing plan that’s right for you and your baby.

If you’re planning a water birth, it’s also a good idea to come up with a backup plan in case you have complications as your pregnancy progresses, or during labor.

There isn’t enough formal evidence to support the benefits or risks of labor and delivery while submerged in water. Much of what you will read is anecdotal. More research is needed to assess the benefits for both mother and baby.

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