Water Births Are Amazing, But It’s Important To Know The Risks

I have never given birth, but I watched my partner labor and deliver three babies. The human body is an incredible thing, and so is the pregnant person’s spirit and mental toughness. Because holy shit, childbirth really is next level.

My first child was positioned sunny side up, or posterior, so my partner had nearly 24 hours of excruciating back labor as my daughter’s head pressed against her back and tailbone instead of her stomach. To relieve some of the pressure and pain, the obstetrician recommended laboring in the bathtub in the delivery room.

My partner was skeptical because a water birth or any water treatment was not in her birth plan. But that heated tub was the only thing that offered any relief. So into the tub she went.

Water is a natural soother, and water births can be amazing for both the birthing parent and the baby. But it’s important to know the risks too.

My partner instantly relaxed once she settled into the hot water. Even though I was not the one with a baby trying to escape my body, my partner was visibly more comfortable in the water than out.

The buoyancy reduced the weight she was carrying and allowed her to move more easily so she could reposition herself in ways that felt more comfortable. Water’s buoyancy also improves blood circulation, which means more oxygen for the uterine muscles and the baby, and water births can reduce pain and anxiety for the person in labor, which allows for a more focused birth. Bonus.

Water births can also make the delivery more comfortable as well. Water causes the “perineum to become more elastic and relaxed, reducing the incidence and severity of tearing and the need for an episiotomy and stitches,” according to the American Pregnancy Association. Dear God, why don’t more people sit in a pool of water before attempting to push a baby out of their vagina? Take all the reduced tearing you can get.

Even though water births are a wonderful option for some people and can have numerous benefits, there are still risks involved.

Water births can be particularly risky if they are done at home. According to the American College of Obstetricians and Gynecologists (ACOG), a home birth carries a risk of neonatal death two to three times higher than babies born in a hospital.

One of the biggest risks for water births is infection. Even with proper cleaning protocols, there are more bacteria in birthing tubs than on birthing beds. And even the most sterile water and tub will naturally become contaminated as soon as anyone gets into the tub. Let’s just say water births are not clean births. Trust me — I saw this first hand. Blood, urine, and feces quickly turn sterile water into a breeding ground for bacterial infections that could be inhaled by the baby in certain situations.

I affectionately called this water “birthing stew.”

And speaking of poop, if a baby has their first bowel movement before they are born, the meconium in the amniotic fluid creates respiratory problems if it gets caught in the baby’s airways. If the amniotic sac breaks in a tub full of water, the midwife or doctor may not have seen that there was meconium in the fluid.

Babies have a “dive reflex” that instinctively closes their airway and prevents them from breathing in water, but if the baby’s head breaks the surface of the water before the rest of their body, the dive reflex is negated and there is a chance the baby will ingest poop water. Yup, lots of poop happens during childbirth.

Recently two babies in Arizona contracted Legionnaires’ disease—a serious and potentially life-threatening form of pneumonia—after their water births. In one case, the tub had been cleaned, but tap water had been used to fill it, and it’s suspected that the Legionella bacteria had been in the plumbing system. The other case involved a rented Jacuzzi tub that had been sitting at 98 degrees for a week. Anyway, this ready-to-go heated tub created the perfect petri dish for bacteria to grow, and days after the birth, the baby spiked a fever and it was confirmed that Legionella was found in the baby’s lungs.

(Side note: Anyone else picture a frat party or movies like Old School when Will Farrell went streaking when they read the words “Jacuzzi tub?” Just me? Okay then, I digress.)

Another risk of water births is a tear in the umbilical cord. Because a baby is brought quickly to the surface to facilitate breathing, there is a chance that the cord can snap. Dr. Weix, a Texas OB-GYN says, “A snapped umbilical cord can be life-threatening, as the fetus can bleed freely until it is stopped. It is usually easily managed by clamping the cord. It leads more often to neonatal anemia than anything else.”

Folks have a lot to consider when it’s time for baby to make their way into the world, and there are plenty of professionals ready to give their opinion on the how and why of labor and delivery. Joseph R. Wax, the chair of the ACOG Committee on Obstetric Practice, stated that the opinion of the ACOG is that laboring in water could be beneficial, but recommends that delivery happen outside of the tub.

“Immersion in water during the first stage of labor may offer some benefits: It may shorten labor and is associated with a decreased use of epidurals,” Wax said. “However, it is important to differentiate between laboring in water and delivering in water. There is no evidence to support delivering a baby in water has benefits to the baby.”

There are risks with any birth, of course, and creating a birth plan is a very personal process for many. It’s best to consult with your doctor or other medical professional to be sure you are all comfortable with the plan, and aware of the pros and cons of each scenario.

Make a plan that feels right to you, but be ready change that plan at the last minute. The ultimate goal is to keep the parent and baby safe at all times.