Hydrotherapy during birth, or more simply, “waterbirth”
has been gaining in popularity among parents since the
1970’s. Many parents find that labor and birth in water is
calming, gives them a sense of having their own space,
comfort, and pain relief as they labor. So what could it
mean for you?
FAQs
Can’t the baby drown?
Probably the most common question asked about
waterbirth is if they baby will drown if they’re born under
water. The short answer is “Not under normal
circumstances.” Humans have an instinct called the “dive
reflex.” When our heads are submerged, we instinctively
stop trying to inhale. Babies come preprogrammed not
to breathe when submerged, and they are still receiving
their oxygen and nutrients from their umbilical cord and
the parent’s placenta. Also, their lungs are already filled
with amniotic fluid that protects the lungs from the
water in the tub or pool. So once the baby is born, we
have a couple of moments to ensure that the umbilical
cord is not wrapped or twisted around the baby, and to
gently lift them above the water’s surface and to the
laboring parent’s chest. This allows for immediate skin-
to-skin contact which promotes the parent-child bonding
that is so vital in these moments, and also for
thermoregulation, in this case, keeping the baby warm
with the parent’s body temperature.
In some unusual events, a baby has been known to
attempt to breathe before they are brought to the
surface, and the birth team goes immediately into action
to assist a baby who has aspirated water, and will act
quickly to ensure baby starts breathing air on their own
as fast as possible. This practice has protocols and regular
drills to be prepared for one of these unusual events to
hone our response time for baby’s best care.
What about sanitation and infection?
Good question! There have been a few events in the past
10-15 years of babies getting sick from water-borne
germs that can cause serious outcomes. These are
preventable. Following protocols from the EPA, the CDC,
state health departments, new scientific studies and
health bulletins are the ways this practice informs
disinfection and sanitizing techniques for keeping our
center’s birthing tub and plumbing clean and free from
disease-causing microbes. We also keep a set of
protocols and instructions for portable home-birth tubs,
and take the time to go over protocols with home-birth
clients and partners so that we can all work together to
facilitate home-waterbirth in the best, safest conditions.
What if I have GBS (Group Beta Strep)?
When a person learns that they have GBS during the last
weeks of pregnancy, they generally get a crash course in
the possible risks to their baby of giving birth with an
active Vertical GBS colonization (when GBS is going up
into the birth canal). Whether or not one can have water-
labor and –birth are of great concern to many people!
The first thing that will happen if you test positive for GBS
in this practice will be our request that you immediately
begin a protocol, with written instructions that we will
provide to you, to begin the process of clearing GBS out
of your birth canal. After two weeks on this protocol,
should you agree to it, we will ask to retest your GBS
status.
Also, during labor we can offer you IV antibiotics at
intervals recommended by national and state standards
of care.
Perhaps most important of all, it has been scientifically
proven that babies born to people with active GBS
colonization are less likely to develop infection from GBS
than those born out of water. Although the reason for
this is still a matter of speculation, the numbers from
study groups are definitive. GBS infection is less likely in
waterbirth than in dry-land birth.
What health concerns could prevent my having a
waterbirth?
There are some conditions that exclude some people
from waterbirth.
 Less than 37 weeks along
 Breech presentation*
 Twin birth*
 Parent temperature is more than 100.4°F
 Excessive vaginal bleeding
 Untreated blood or skin infection
 Any medicine given by injection to the spine
 Inexperienced or fearful attendant
*These may be possible depending on state regulations and your
attendant’s experience with waterbirth, breech and twin births.
What benefits are there for the parent?
The benefit that is mentioned most often is experiencing
less pain during labor. Just because you don’t have an
epidural or other spinal medication doesn’t mean that a
natural birth is without pain management! Other
benefits include:
 Lower blood pressure during labor (this helps
baby too!)
 Less need for chemical pain relief
 Lesser production of stress hormones
 Less need for episiotomies (cuts made with
scissors around the birth canal)
 More relaxed pelvic floor
 More freedom and ability to move about
 Relief for back and hips from buoyancy
 Reduces stress
 Promotes relaxation
 Reduces distraction from other others
 Can aid in shortening labor
 Often shortens pushing phase
 Often helps parents to feel they have greater
privacy and security
What about for the baby?
Waterbirth benefits the baby, too. Some of these are:
 Fewer incidents of transfer to hospital or NICU
care following birth center or home waterbirth
 Birth into a more relaxed atmosphere
 Anything that benefits the parent’s physical
condition is beneficial for baby’s physical
condition. (Lesser BP, stress hormones, etc…)
What’s the difference between home waterbirth and at
the birth center?
If you opt to have a waterbirth at home, there will be
some differences compared to a waterbirth at the birth
center. For one, you and your partner or support
person/people will be responsible for ensuring that you
set up and fill the portable birth tub properly. Some
partners and support people really appreciate having
something constructive to do in early labor, as many feel
like there is nothing they can do to support the laboring
parent. Of course, you are assuming the risk of property
damage from water and/or the weight of the tub, so
keep this in mind. If you’re renting you will need to check
with your landlord to see if they will allow this in their
rental property or you could be held liable by your
landlord for any damages. Also, you will have to purchase
several items NEW from our practice only (at cost, no
markup) for use during your labor and birth: two to three
tub liners, a filling hose, a hose adapter, a floating
thermometer, and a submersible pump for emptying the
tub, and a new hose for emptying. We’re picky about
these items so we are better able to protect you and your
baby from any possible infection. Previously used items
will not be allowed for the safety of you and your baby.
You will also be responsible for cleaning the tub initially
after emptying it. Your midwife team will sanitize the tub
once it is returned to the practice, and we ask that your
partner or support people return the tub to the practice
within seven days of its use; we may have to move that
time up depending on the needs of other clients for use
of the tub.
Other differences are being in your own space which
many parents find they prefer. Also, being in your own
bed, and not having to travel from the birth center to
your home after the birth are often times seen as
preferable situations for both the parents and the baby.
For those concerned about the baby’s personal biome,
oftentimes a home waterbirth is preferred over a birth
center waterbirth.
Any other questions? Check out the following sheet of
references and recommended reading from around the
web. And please feel free to ask your midwife team!
We’re here for you!
 References
Evidence Based Birth.com. (2018, March 20). The evidence on: Waterbirth. Retrieved from
https://evidencebasedbirth.com/waterbirth/
Mamanatural.com. (2018, August 21). Is a water birth right for you? Retrieved from https://www.mamanatural.com/water-birth/
MIDIRS Midwifery Digest. (2015, June). Ovid: Water birth safety and suggestions for new guidelines. Retrieved from
http://ovidsp.tx.ovid.com/sp-
3.31.1b/ovidweb.cgi?&S=FIKMFPNEJPDDJGCPNCEKKFOBFEKFAA00&Link+Set=jb.search.29%7c1%7csl_10
Nutter, E., Shaw-Battista, J., & Marowitz, A. (2014). Waterbirth fundamentals for clinicians. Journal of Midwifery & Women's
Health, 59(3), 350-354. doi:10.1111/jmwh.12193
OnClipart.com. (n.d.). blue-water-art-illustration-ocean-splash-clipart-612_412.jpg [illustration]. Retrieved from
https://img.onclipart.com/blue-water-splash-vector-art-illustration-ocean-splash-clipart-612_412.jpg

Recommended Reading:
https://evidencebasedbirth.com/waterbirth/

https://www.mamanatural.com/water-birth/

https://waterbirth.org/

https://www.parents.com/pregnancy/giving-birth/vaginal/5-myths-about-water-births/

https://www.babycenter.com/2_live-birth-water-birth_3658855.bc (video)