During a water birth, a mother chooses to give birth in a birthing pool full of warm

water. This can ease labor pain for a mother. However, there is also some evidence
that delivering in water can increase a baby’s risk of breathing in water. If you're
considering a water birth, make sure you know as much information as possible
before you decide if this birthing strategy is right for you.

Part1
Learning about the Process

1 Know why some women choose water births. During a water birth, a baby is
delivered in a birthing pool filled with lukewarm water. Deciding on a birth plan is a
highly personal choice. There are a variety of reasons women choose water births
over conventional methods. Know the rationale behind water births before deciding
to undergo the procedure yourself.

A baby spends nine months floating in an amniotic sac filled with
fluids. Many women and doctors believe the transition from womb to world is
easier on a child if they're submerged in water before being exposed to the open
air.[1] However, there is no research to support this and this is only opinion.

For many women, water births can be less painful. Women who spend
time in water during labor request pain-relieving drugs roughly half as much as
women who use conventional methods.[2]

Tearing of the perineum, the area between the vagina and anus, is
common during birth. Warm water can soften these tissues, making them more
malleable as the baby passes through. Tearing and damage may be less likely
during water births.[3]

For many women, warm water can feel soothing and reduce stress
during labor. Warm water has also been known to stimulate the body's release of
endorphins, a feel-good hormone.[4]

Your weight is supported by water, making it easier to sit upright
during delivery. This allows your pelvis to open to pass the baby during birth.[5]

2 Decide if you will give birth in a hospital or at home. A water birth can be
performed in a hospital setting or at home. Depending on your preference, there are
special considerations for each method.

If you decide to give birth in a hospital, you need to make sure the
hospital is able and willing to accommodate a water birth. Many hospitals either
have policies prohibiting water births or do not have the proper resources for water
births.[6] If you want to go the hospital route, you should make sure a water birth is
allowed in your chosen hospital and with your OB/GYN or midwife. You may
have to switch hospitals or doctors if you're set on a water birth and your doctor
cannot provide one.

The majority of water births are done at home or at birthing centers
due to the inability of many hospitals to accommodate water births. [7] As you will
not be in a hospital setting, you will have to rent or borrow equipment, such as a
birthing pool, yourself. You will also need to hire a doula or midwife to help you
through the birthing process.[8]
3 Be aware of the risk factors. Certain risk factors mean you're more likely to
undergo complications during birth. A water birth, especially one outside a hospital
setting, may not be viable if you have any of the following conditions.

Chronic, long term medical conditions like diabetes, high blood
pressure, herpes, and epilepsy.[9]

Mothers who are very overweight.[10]

A history of heavy bleeding during pregnancy or birth.[11]

Premature labor.[12]

Pregnancy complications such as preeclampsia and gestational
diabetes.[13]

Preterm labor, defined as going into labor two weeks before your due
[14]
date.

Part2
Having a Water Birth at the Hospital
1 Find a hospital that allows water births. As stated, not all hospitals allow water
births. Before you plan your water birth, make sure your hospital, doctor, midwife,
and nurses understand your wishes and are willing to accommodate you.

Talk to your doctor or midwife about your desire for a water birth.
They should be able to tell you straight away if this is allowed in the hospital
you're giving birth in and whether they're willing to aid with a water birth. You
may have to switch doctors or hospitals before you find a hospital willing to
accommodate your birth plan.

Waterbirth International, an organization that advocates for the right to
water births worldwide, may be able to negotiate between you and your hospital if
you're having trouble getting clearance for a water birth.[15]

Waterbirth International also provides a directory online of hospitals
and birthing centers that allow water births. You can search through their listings
to find providers in your area.

Go in with questions. You should ask your doctor, midwife, and nurses
all about water births and their professional opinions and experiences with the
process. Any concerns you have about the process should be voiced with a medical
professional before you settle on a birth plan.[16]
2 Secure a birthing pool. Not all hospitals provide birthing pools. Make sure you
secure access to a pool before going into labor.

About half of all hospitals have birthing pools. However, even if your
hospital does have a pool this does not necessarily mean you can use it. It could be
in use by another patient or need to be cleaned. It's also possible the hospital might
not have water birth experienced doctors or midwives on staff when you go into
labor.[17]

If your hospital does not have a birthing pool ready when you go into
labor, you could transfer to another hospital in your area or opt to have the baby at
home.[18]

Birthing pools can also be rented or purchased. If you're bringing your
own equipment into the hospital, you need approval beforehand. The hospital will
need to make sure they have a room ready to accommodate your birthing pool and
the ability to transport it to the hospital when you go into labor. Ideally, a pool
should be rented out for 4 to 6 weeks, leaving a 2 to 3 week time period before and
after your due date.[19]
3 Have a backup plan. As your birth progresses, certain factors may arise that mean
a water birth is no longer possible. You should have an alternative birthing plan in
place in the event the water birth falls through during labor.

If you need to induce labor, you may not be able to undergo a water
birth. It depends on your individual circumstances and the reasons for inducing
labor. The medications used to induce can sometimes cause the baby stress. The
baby will need to be monitored throughout the process of labor and this is not
possible during a water birth.[20]

If your baby is in the breech position, a caesarian section is needed to
assure a safe delivery. A water birth will not be possible.[21]

If your blood pressure goes up, you may be asked to leave the pool.[22]

If your baby's first excrement (called meconium) is detected in the
water, you may have to leave the pool to prevent meconium aspiration.[23]

If you go into preterm labor, which means going into labor more than
three weeks before your due date, you will probably not be allowed to have a
water birth due to the increased risk for complications for you and your baby.[24]

You should have an alternative birth plan available so, in the event of
any of the above complications, you can still maintain some choice and control
over your birth.

Part3
Having a Water Birth at Home
1 Choose a midwife. If you're going to give birth at home, you should have a trained
midwife present during your labor. A variety of directories online can help you seek
out midwives in your area. If you know other mothers who underwent home or water
births, you can ask them where they found their midwives.

Have a variety of questions ready to ask the midwife you choose. Ask
them what experience they have with water births, what their specific training is,
and what services they provide for you and your baby. Make sure you know your
midwife's availability. Do they work with assistants? Will they be able to assure
availability during your birth and, if not, what would happen?[25]

Know what equipment will be provided and what equipment you
should be prepared to invest in yourself.[26]

Make sure your midwife knows as much about your personal and
medical history as possible. Tell them about any past pregnancies, any spiritual or
religious practices that are important to your birthing process, and any concerns
you have regarding home births.[27]
2 Select a birthing pool. If you're giving birth at home, you need to have a birthing
tub present in your home.

Your midwife can help you in the selection process and direct you to
companies that rent out or sell birthing pools.[28]

A variety of factors should be considered when you're purchasing a
birthing pool. How much space do you have for the pool? What room are you
giving birth in and, if it's on an upper floor, is the floor strong enough to hold the
pool's weight?[29]

Some pools have filtration and heating systems that allow you to have
the pool set up before labor. This might be a good investment as you can have the
pool set up and ready to go. You and your birthing partner will not have to undergo
the stress of filling the pool while you're in labor.[30]
3 Fill up the pool and call your midwife as soon as labor starts. When you notice
the early signs of labor, you need to alert your midwife and fill up your birthing pool
in preparation for delivery.

You should have a thermometer on hand to monitor the water's
temperature. It should be between 99 and 100 degrees, but no more than 101. Your
birthing partner or partners should be prepared to monitor water temperature
throughout your labor.[31]

Have damp cloths on hand, as well as drinking water, to cool yourself
off if you grow uncomfortably hot during labor.[32]

Make sure your hot water supply at home is adequate to fill the entire
pool and have a plan as to where to dispose of the water after birth.[33]
4 Be prepared for emergencies. As you're delivering at home rather than a hospital,
you need to be extra prepared for potential complications during birth. Make sure you
have a plan in effect for any emergencies.


Know how to get out of the pool safely. It can take awhile to get out of
a birthing pool during labor. Your midwife should know how to assist during this
situation.[34]

Have emergency contact numbers ready and do not hesitate to call 911
and request an ambulance if major complications occur.

Your midwife should have equipment to monitor the baby's heartbeat
and other vital signs during labor. If they notice anything concerning they should
have a plan in place, which they've gone over with you ahead of time, on how to
proceed with labor.

As with a hospital birth, certain complications may arise that make a
water birth impossible. You should have an alternative plan in place in the event of
breech births, preterm labor, increased blood pressure, and other potential birthing
issues.

Part4

Knowing what to Expect

1 Get into an upright position. One of the supposed advantages of a water birth is
that it supports your body and allows you to easily position yourself upright. This can
be a more comfortable birthing position for many women as opposed to giving birth
on one's back.

You will sit upright during labor and the late stages of pushing during
birth. The water supports your weight and allows you to more easily maneuver
your body in a comfortable position.[35]

Some evidence suggests pushing the baby out is easier in water than it
is in air, and the upright position increases the opening of the pelvis during birth.[36]

Many women are concerned the upright position will cause them to
accidentally release their bowels. While this can occur, it rarely causes
complications and many women do not notice. A midwife or doctor can easily
remove any excrement from the water.[37]
2 Know how the experience affects your baby. While we cannot know for sure how
babies feel during birth, many advocates for water birth believe the experience is less
traumatic.

The warm waters will ideally mimic the atmosphere or your uterus,
easing the intensity of the baby's transition into the world.[38]

While many worry babies will inhale water, most babies will not take
their first breaths until they're lifted safely out of the water. Babies are usually only
at risk of breathing underwater if their head is brought to the surface before the
rest of the body is born or if there was an issue with oxygen levels in the placenta
during labor.[39]
3 Plan for your baby's first breath. A baby's first breath is one of the most stressful
events of a water birth as mothers and doctors worry about a baby breathing
underwater. However, with proper precautions and protocol your baby should take his
first breath safely above the surface.

A baby should be brought to the surface shortly after the final push.
The baby should be submerged for no more than a few minutes. Depending on
your plan, either your birth partner or your midwife/doctor will bring the baby to
the surface of the water.[40]

When the umbilical cord or placenta tear, the baby is no longer
supplied with oxygen. Make sure your baby is above the surface of the water
before this occurs.[41]

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