Vaginal birth

• Most women give birth through the vagina (birth canal).
• Labor occurs in three stages and feels unique to everyone.
• If you’re healthy, wait for labor to begin on its own.

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Water birth is when a woman gives birth in water. While water birth is gaining popularity with some women, there isn't enough research to know if it's safe. In fact, it may be harmful to some women and their babies. The trouble is that, like home birth, you don't know that water birth is safe for you and baby until after the baby is born and there've been no complications. Some women use warm water to help them deal with labor pain, but then come out of the birthing tub for a more traditional bed delivery. Others choose to experience all three stages of labor in water.

Whatever you decide, it's important you are cared for by someone who is medically trained in pregnancy and childbirth. This professional can be an obstetrician/gynecologist (OB/GYN), a family physician or a certified nurse-midwife. Not all health providers will perform a water birth. If you're considering a water birth, it's important to talk with your health provider.

What happens during a water birth
Water births can be done in a bathtub, hot tub (as long as the water temperature isn't too hot) or a special birthing tub. Some birthing tubs can be rented and may be covered by health insurance. Check with your insurance carrier to see if it will cover the rental and delivery cost of a birthing tub.

The water temperature should not be above 100 degrees Fahrenheit. High temperatures are dangerous for your baby. If your body temperature gets too high during pregnancy, it can cause your baby to be overheated and lead to very serious health complications for your baby. Also, high body temperature can cause your blood pressure to fall. As a result, your baby may get less oxygen and nutrition.

Most hospitals mainly offer traditional bed delivery. But some hospitals and birthing centers have policies and equipment for water births. When a water birth is done in a hospital setting, your baby should be monitored with special underwater equipment to ensure she is healthy and stable. You can also be given medications through an intravenous (IV) tube.

What to think about before you decide
If you're thinking about having a water birth at home, first consider whether water birth is a safe choice for you and your baby. Below are some pros and cons of water birth.

Water birth pros

• Some women find a water birth to be soothing and relaxing.
• Floating in water may help a woman feel lighter and lessen body weight.
• Warm water may help relax the perineum (area between the vagina and the rectum) and make the delivery easier.

Water birth cons

• Research is limited. We don't know if water births are safe for mom and baby.
• If the tub is not properly cleaned, it can lead to infection.
• The baby may gasp for his first breath while still underwater, causing him to inhale water.
• The umbilical cord may snap during water birth. This could lead to serious blood loss for the baby.

Preparing for water birth

• Make sure you're cared for by a professional who is medically trained in pregnancy and childbirth (an obstetrician/gynecologist, a family physician or a certified nurse-midwife).
• Ask your health provider if she is willing to participate in a water birth.
• Work with your provider to find out if water birth is okay for you.
• Contact your hospital or birthing center to see if they have a water birth facility.
• Stay hydrated and drink plenty of water.
• Be sure the water is at the right temperature (not too hot).
• If you're not planning to deliver in a hospital, have an emergency plan for taking you to the hospital in case something goes wrong.
• If you begin feeling unwell or are concerned about safety, ask someone to help you get out of the birthing tub.

When water birth isn't safe

• The baby's bottom or feet are facing down right before birth (breech position).
• The baby has his first bowel movement (meconium) while still in your uterus.
• You have preeclampsia or another health condition that makes water birth unsafe.
• You're in preterm labor.
• You have herpes (herpes can easily be passed to the baby in water).
• You're carrying more than one baby (twins, triplets or more).

July 2010