Labour and birth using water

You may be considering using a bath or birth pool for pain relief during the first stage of your labour or having a waterbirth.

This information is designed to help you make an informed choice for you and your baby.

The WA Womens and Newborns Health Network has developed statewide guidelines to enable midwives and doctors to provide care that is as safe as possible for healthy pregnant women choosing to use water during labour and/or birth.

Benefits for you and your baby

• Water immersion in a bath or a pool during the first stage of labour has been shown to:
  • decrease the need for pain relieving drugs
  • make the experience more enjoyable for women.
• Waterbirths are associated with low-risks for both the woman and baby when care is provided by midwives and/or doctors who follow best practice guidelines.

Exploring your choices

• Firstly find out if your maternity service offers the option of immersion in water for labour and/or birth.
• Write down what you would like in your birth plan.
• Talk to a midwife and/or doctor to find out more information, in particular:
  • whether there are any reasons why immersion in water is not advisable for you – the benefits and risks to you and your baby
  • details about when you would be required to leave the water.
• You will be asked to sign an agreement form if you choose to use water for your labour and/or birth.

Common concerns about using water for labour and/or birth

You and your baby may get too hot

If your body overheats your baby may also get too hot and this can cause the baby’s heart rate to increase.

You should feel comfortable in the water but not too hot.

Your midwife will check the water temperature regularly while you are in the water during labour and/or birth.

Your baby may develop an infection

There are strict guidelines for keeping the water clean during labour and for cleaning the bath or pool to minimise the possibility of infection.

Your baby may inhale water

If you choose to stay in the water to birth, your baby should be born under the water, then gently but immediately lifted out into the air.

Your baby’s head should then be kept above the water so that breathing can start and potential inhalation of water can be prevented.

Who can use water for labour and/or birth?

You and your baby must fit all of the following criteria to use a bath or pool for your labour and/or birth:

• be healthy with no complications of pregnancy
• be having only 1 baby who is presenting head first
• be at least 37 weeks pregnant
• not be a carrier of, or infected with, HIV, Hepatitis B or Hepatitis C virus
• not be excessively overweight
• not have broken your waters for longer than 18 – 24 hours (unless antibiotics have already been started)
• the colour of your broken waters must remain clear
• your baby’s heart rate must remain within the normal range
• you must not enter water until 4 hours after receiving an injection for pain relief.

Conditions for using water during your labour

• You must never be alone while immersed in the water.
• The midwife or doctor will advise you about the best time to enter the water, which is when labour is becoming stronger.
• The bath or pool must be filled with only pure tap water with no additives such as:
  • bath oils
  • gels
  • soaps
  • salt.
• When sitting in the bath or pool the water should reach the level of your breasts.
• You should feel comfortably warm.
• You can leave the water at any time.
• You must leave the water to urinate.
• You should keep well hydrated throughout labour to avoid dehydration.
• You must leave the water when advised to do so by the midwife and/or doctor.
• You cannot have an injection for pain relief or an epidural when in the water, but it is possible to use gas if desired.

If you choose to birth in water

• All the conditions for using water during labour must be met at all times.
• You must leave the water if the midwife or doctor is concerned about your wellbeing and safety.
• You must be assisted when you leave the water to avoid any injury to you or your baby.
• Your baby must be brought to the surface as soon as he/she is born and the head must then remain above the water at all times.
• The baby’s cord must not be cut under water.
• The baby must be kept warm after birth using skin-to-skin contact, drying the head and keeping the rest of the body under water.
• The baby must be removed from the water immediately if he/she needs help to breathe.
• You must leave the water for the delivery of the placenta after the baby is born unless you want to have a natural third stage.
• If you require stitches this procedure will be delayed for at least 1 hour after you leave the water.

More information

You may wish to seek out more information about the use of water for labour and/or birth which will help you to be fully prepared for the experience.

The Cochrane review (external site) provides a full overview of all the latest research and information.

If you have any further questions or require additional information please discuss the use of water during labour and/or birth with your midwife or doctor.

Remember

• Water immersion in a bath or a pool during the first stage of labour has been shown to decrease the need for pain relieving drugs.
• There are strict guidelines for keeping the water clean during labour.
• You must never be alone while immersed in the water.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.