A water birth is when a woman gives birth in a tub or pool of water instead of on dry land. Women may choose water birth as a method of pain coping, relaxation and for easier birthing. Water birth has even been called “the natural epidural”!
In this post we will cover all things water birth – the benefits, warnings, tips and tricks. Let’s get started!
Water Birth 101: Benefits, Warnings, Tips and Tricks
How Does Water Birth Help with Pain?
Water birth can be very helpful with coping through the pains and discomforts of labor. I’ve even heard people describe it as a natural epidural.
When I was pregnant with my first I had very high expectations for the tub. Unfortunately, I did not find it to help much with my back labor, despite submerging my whole body during a contraction. 😉
However, during my second childbirth I did not have back labor and used a tub in my home and it was amazing! The water eased the weight of gravity off my body relieving pressure and it also allowed me to change positions easily.
Also, the warmth of the water soothed and relaxed my body making each contraction just a little bit easier.
Where Does a Water Birth Take Place?
Believe it or not, water births happen everywhere – at home, birth centers and some hospitals. I’ve even seen “free birthers” give birth in streams.
However, not everyone birthing at a hospital can have a water birth. Water births are strictly for those women having an unmedicated birth. However, if a woman waits to receive pain medications for late active labor or transition, she can still benefit from a water birth earlier on.
Also, not every hospital allows water births. In my area there are no hospitals that allow for water birth (but I’ve seen water births accidentally happen these hospitals haha).
What Kind of Tub Should I Buy for a Water Birth?
In a perfect world all women should purchase or have access to a pool that is made specifically for birth. The depth of these birth pools are absolutely perfect, they have plenty of room to move around and change positions, have handles to grip, and are very sturdy. They’re worth it! Also, if you re-sell your pool you’ll be able to recoup a significant portion of the cost.
If you’re looking for a sturdy birth pool, I highly recommend using Waterbirth Solutions. I’ve used them twice with great success. Excellent products and amazing customer service.
However, not all families can afford a birth pool, but still deserve a water birth. The next best thing is an inexpensive kiddie pool affectionately called the “fishy pool” and for $30 it’s an amazing next best thing. In the photo below my doula client is rocking her labor in and out of her “fishy pool”.
PS – A regular house tub will work in a pinch for very slender and mobile pregnant women. I wouldn’t really recommend it, if the water does not cover the belly, but I’ve seen it done!
What Should I Bring for a Water Birth?
If you are having a water birth in a hospital or a birth center, most things will be supplied for you so there isn’t much extra you should bring. See below for some possible ideas and suggestions.
What Do I Need to Buy for a Water Birth?
If you are having a home water birth the following things will need to be purchased.
- Extra Towels – If you’re anything like me, getting in and out of the tub repeatedly, you’ll need lots of dry towels!
- Air Pump – An air pump is absolutely necessary to save someone the time and energy to blow up a birth pool by hand. I’ve often seen women be unable to have a waterbirth because 1) things were progressing rapidly and 2) the birth pool was taking a long time to setup.
- Drinking Water (Lead Free) Hose – Most hoses contain lead. Buy a lead free hose to fill the tub, please!
- Faucet to Hose Adapter – Don’t forget this! To hook up a hose to your kitchen faucet, you’ll need an adapter.
- Drain Pump – After a water birth many parents wonder how to empty the birth pool. PLEASE! Buy an inexpensive water pump. It’ll make your life easy. You’ll thank me later.
- Floating Bath Thermometer – A bath thermometer is very helpful to ensure the water temperature stays close to the laboring mother’s temperature as much as possible.
Optional Water Birth Purchases:
- 2 Large Pots – If your birth pool doesn’t have its own heater, a birth attendant will need remove water from the pool and replace it with heated water from the stove top. If you have a huge hot water tank, or a tankless hot water heater this is likely not needed.
- Small Stool – A small stool may be helpful to assist shorter mamas as they get in and out of the tub. Also, some mamas have enjoyed having a stool in the tub to sit on.
- Water Filter – Many parents install a water filter to remove chlorine and other water contaminants before filling the birth tub. There are many effective water filters on the market, but a simple faucet adapter and filter like this one may work just fine.
- Birth Pool Liner – If you buy a fishy pool for $30, you won’t need a birth pool liner. But if you buy an actual birth pool, especially if you have plans to resell, you will need a birth pool liner. Buy the liner from a birth pool retailer like Waterbirth Solutions.
- Water Skimmer – Totally optional, but some find a “debris net” helpful to remove any mucus or other bodily products. 😉
- Vinyl Table Cloth – Place a vinyl flannel backed table cloth upside down underneath the birth pool. When mom steps out she won’t slip but won’t get the floor wet either. It’s a perfect solution!
What Should I Wear for a Water Birth?
In early labor and in the early portions of active labor, most women are not laboring in the tub. At this point wear whatever is most comfortable! In the photo below I wore a birthing skirt and shirt made just for birth.
Pretty Pushers and also Baby Be Mine make comfortable clothing for birth and immediate postpartum.
Check out this super soft and comfortable dress by Baby Be Mine!! I could totally see myself wearing this in early labor, but also those first few weeks postpartum. WAY cuter than sweatpants. 😉
Active Labor and Beyond
Once active labor has begun, many women choose to labor with no clothes during their water birth. Some women prefer a bathing suit top or a sports bra. Any of these options would work just fine!
How to Prepare for a Water Birth?
In my experience, parents prepare for a water birth effectively when they set up the pool before labor begins. This way they learn about the pool, how it works, how to blow it up, how to hook up the hoses before they actually need it, etc.
Often after a birth pool trial run, parents may realize they don’t have everything they need. Maybe the hose isn’t long enough to reach the tub, they don’t have the correct faucet adapter, their hot water heater is very small, etc.
Once the kinks have been worked out, there’s no need to keep the pool set up. After a trial run, empty the pool of its water. DO NOT KEEP THE TUB FILLED BEFORE LABOR BEGINS. It is a drowning hazard but also the water will begin to grow bacteria – not a good place for a baby to be born!
What Temperature Should the Water Be for a Water Birth?
The temperature of a birth pool should be very close to the laboring mother’s body temperature – 98.6 degrees. Too hot of water could put the baby in distress (this happened to me at my first birth) but it can also increase the risk of postpartum hemorrhage.
As wonderful as scalding hot water may feel on the back, don’t heat the water warmer than mom’s body temperature. If back pain or back labor is an issue, consider other natural remedies for back labor.
When Should I Fill the Tub?
Just because you’re experiencing signs of labor, doesn’t mean you should start filling the tub. However, active labor is a good time to begin filling the tub. To learn more about the signs, symptoms and how to cope through active labor head on over here.
If the birthing tub isn’t self-heated, be prepared for this process to take awhile. If the hot water heater is large or tankless, you may be able to fill the tub in one go. However, for those with small hot water heaters this may take longer. If this is you, filling the tub earlier rather than later may be wise.
Check out my post The Doula’s Guide to the Stages of Labor to immediately recognize the signposts of the first stage of labor and will fill the tub at the right time. I’ve seen so many people wait until transition to fill the tub and it ended up being too late. Yikes!
When Should I Get in the Tub?
A good time to get in the tub is when a woman is in active labor (when contractions are around 3-5 minutes apart and the cervix is dilated to 6 cm).
Sometimes if a woman gets in a tub too early, it may cause her labor to weaken or stall. If this happens, either 1) enjoy the break while it lasts or 2) get out on land for awhile. Generally speaking, however, the further a woman is into her labor progress, the harder it is to disrupt with something like a tub.
However, each woman and labor is different so use your best judgement. Sometimes if contractions are very close together, but the cervix isn’t dilating – the warmth of the tub may cause the body to relax and the cervix to open.
When Should I Get out of the Tub?
Many women wonder when to get IN the tub, but also wonder when to get OUT. Here are some ideas when getting out of the tub may be helpful or needed.
- Maternal diarrhea
- Meconium in the amniotic fluid
- During the pushing stage
- The water is too hot or cold
- Contractions have spaced out and labor has stalled
- Fetal monitoring
- To resolve shoulder dystocia
- To resolve postpartum hemorrhage
- Delivery of the placenta
Does a Water Birth Reduce Tearing?
Many people think that water birth reduces tearing. And for some, that may be true. However, there was a recent article put out that showed an increase in genital tract damage with water birth.
For more information on how to prevent tearing, check out my MUST READ article about how to prevent tearing.
Why Are Water Birth Babies Blue?
After witnessing a handful of water births, some will notice that water birth babies are more likely to be born a little bit more blue than their counterparts.
However, this doesn’t happen all of the time. See the photos below of my water birth – Eden wasn’t blue at all!
Nevertheless, some water birth babies ARE born blue. Why is that?
“What initiates the breath in the newborn? As soon as the newborn senses a change in the environment from the water into the air, a complex chain of chemical, hormonal and physical responses initiate the baby’s first breath. Water born babies are slower to initiate this response because their whole body is exposed to the air at the same time, not just the caput or head as in a dry birth. Many midwives report that water babies stay a little bit bluer longer, but their tone and alertness are just fine. It has even been suggested that water born babies be given the first APGAR scoring at one minute thirty seconds, not at one minute, because of this adjustment.” (SOURCE: Barbara Harper, my trusted water birth guru)
Can I Have a Water Birth If My Water Has Broken?
“Some hospitals still restrict a woman from laboring in the water if her membranes are ruptured. Based on the current and past literature, this is absurd. No evidence exists of increased infectious morbidity with or without ruptured membranes for women who labor and/or birth in water. “
“Laboring mothers have an advantage when the baby is descending and moving out—nothing is moving up and in. Things that we put into laboring vaginas may cause infections, such as probes, fingers, AmnihooksTM, scalp hooks and so on.” (SOURCE: Barbara Harper, my trusted water birth guru)
Remember, your vagina is not a vacuum cleaner!
What Do I Do After the Baby Is Born?
As soon as the baby is born, turn off all fans so that air is not blowing on anybody. Baby is completely wet, so a fan circulating would chill baby rather quickly.
In the pictures below you can see the mad dash to turn off the fans. What was working during transition and pushing does not necessarily work for immediate postpartum.
Also, if baby blankets are used keep them dry and out of the water as much as possible. When blankets get wet they keep baby wet and may make him too cold.
Just as in any birth, there is a wide range of normal responses to what just happened. Sometimes mothers are exhausted and in shock, and similarly to baby, need a minute to acclimate to what just happened.
However some mothers respond quite differently! Some mothers are very lucid and immediately filled with euphoria.
If desired, mothers may initiate breastfeeding while still in the tub OR wait until in bed and dried off. Whatever makes most sense for mom and baby.
Eventually, in the first 2 ish hours after birth, a care provider will assess baby. With a water birth, and like most other births, this can be done with mom nearby.
Water Birth Delivery of Placenta
At some point the placenta (the unsung hero) will need to be delivered. This can be done in the birth pool but many women and care providers prefer this on dry land.
For my water birth I got up and walked over to my bed to deliver the placenta. I had lots of help navigating getting out of the pool while holding my baby. She was still attached to her umbilical cord (and the placenta was still attached)!
Once I got to my bed and my midwife assessed me, I delivered the placenta quickly. After that we wrapped it in a chux pad so we could wait to cut the cord until everybody was ready to do it. See that bowl sitting next to me? It contains my placenta.
When the time was right, we cut the cord and assessed my itty bitty placenta.
How Do I Clean up After a Water Birth?
In my opinion it’s important to remove the birthing pool water ASAP, especially if there are other children in the home. This is where the handy dandy water pump comes in handy. In a matter of minutes the pool will be empty!
Simply attach the water pump to a hose and empty the water out the window or in a nearby sink or shower/tub. The liner will have kept the birth pool clean so once the water is out, simply remove the liner for a clean and dry tub. Amazing!
After the tub is empty, dry and clean simply let the air out of the tub. Refer to your tub’s manual for a more detailed description of disassembly.
Water Birth 101: Benefits, Warnings, Tips and Tricks
Whew! If you read this whole thing not only are you awesome, but you’re a waterbirth pro! In this post we covered the ins and outs, benefits, warnings, tips and tricks of all things water birth. Water birth is a beautiful and wonderful option for birthing mothers. I dream of a day where water birth is an option for all women who want one!
If you liked what you read, would you please leave me a comment? I’d love to know what you thought.
Also, if you have any other insights, tips and tricks let me know! Leave a comment, especially if you’re Barbara Harper, and let me know what you think. 😉
Saturday 17th of September 2022
I’m curious about the positions used in a tub. I’ve had an unassisted unmedicated Birth before but having a water birth any day now. I usually see women in tubs birthing in a note sitting/reclined position which kinda reminds me of how you might be in a bed. Wondering how easy other positions like on hands and knees or squatting would be if even possible in water?
Sunday 18th of September 2022
Kneeling is easy, or kneeling but with one leg out to the side. Squatting is easy too. Everything is a bit easier in the water!
Sunday 6th of June 2021
Just wanted to say this article is still circulating and helpful to homebirth mama's in 2021! Looking forward to my first homebirth in November of this year.
Tuesday 15th of June 2021
YES! That's so great! Thank you for letting me know and best wishes for your homebirth! You're going to do great. :)
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