Water birth: procedure, advantages and disadvantages

In a water birth in the narrower sense, the woman giving birth spends the entire time of the birth from the opening phase to the expulsion phase in the birthing pool. So the baby is born underwater. 30 percent of all pregnant women find this idea appealing. But only less than ten percent of all babies are actually born as part of a “real” water birth. Many women giving birth do not use the birthing pool for the entire period of birth, but only in individual phases and spend the rest of the time “on land”. Below you can read how being in the water affects the different phases of birth.

What does water birth mean in the three stages of birth?

• Beginning of the opening phase : Especially in the opening phase, many women giving birth use their own bathtub or a birthing tub in the clinic or in the birth center for a “test bath” to decide whether it is really going to start or whether it is just a matter of preparatory contractions and the birth is still a long time coming.
• Next in the opening phase : If the contractions are intensifying and with it the contraction of the muscles of the uterus, a bath can clearly help to relax. Because bathing can help to soften the circular muscles (responsible for the cervix) that then begin to contract. If a woman giving birth has particularly severe labor pains during this phase, many birth attendants advise getting out of the tub and giving birth in an environment that they can better control in the event of complications. After contractions, most women who give birth experience a short break. the cervixis then about five centimeters open and the effect of the water is now reversed. If before it was more of a soothing effect, now it tends to increase contractions. Especially in this phase, the baby has to put his head in the pelvic entrance. During this phase, women who are giving birth often help their baby to find its way into the pelvis more quickly by moving it outside of the birthing pool.
• Transition phase : At this stage of labor, the contractions become longer and more intense, because now the pain of the cervix dilatation is accompanied by the pressure of the baby on the tailbone. Now the woman giving birth can influence the length of the contractions through her position in the water. The water now has a particularly pain-relieving effect by making the pelvic floor and the birth canal more elastic. It is precisely in this phase that staying in the water shortens the birth the most.
• Expulsion phase : In the expulsion phase, the baby’s head must be pushed out through the birth canal. In this phase, too, the water makes the pelvic floor and the birth canal more elastic and softer. Most water births feel less of an urge to push with their abdominal muscles. The lower urge to press reduces the risk of a perineal tear.
• The baby is here : If the baby’s head is there, there is no need to rush, even with a water birth, because the baby continues to be cared for by the mother via the umbilical cord. With the next contractions, the rest of the baby’s body is also born. Even then there is no need to act, because the oxygen supply is via the umbilical cordpersists. Only when the baby is no longer in contact with the water does it take its first breaths. Until breathing works properly, the baby is supplied twice via the umbilical cord. Many women who give birth keep their baby in the tub and only let their little face look out of the water. So the baby can still enjoy the warmth of the water. The new mom puts the baby to her breast in the tub. The afterbirth also comes in the tub. However, if the placenta is there, obstetricians advise you to get out of the tub, because the resulting open wound surfaces could otherwise become inflamed more easily.

Benefits of a water birth

• The warm water relaxes the woman giving birth and gives her a feeling of security . The pain is felt less severely and breathing and pressing in the water requires less effort and is easier.
• Due to the greater relaxation of the muscles and the reduced urge to press, the probability of a perineal tear is significantly lower .
• Many midwives recommend the birth pool because it can shorten the actual labor time and reduce the need for pain medication.
• Above all, water birth offers a number of advantages for the baby. Because the warm element familiar from the womb reduces the stress of birth . The transition from the warm amniotic fluid to the “cold” world is made easier for him. Since the newborn is initially nourished by the umbilical cord, diving at birth is not a time crunch or exposes the baby to any risk, since it was not breathing in the amniotic fluid either.

Disadvantages of a water birth

• Unfortunately, water birth also comes with disadvantages. This means that an emergency that requires leaving the pelvis cannot be dealt with as quickly as with a delivery room birth .
• Epidural anesthesia (PDA) is also not possible .
• The perineum cannot be protected by the midwives to the same extent as in a delivery room birth.
• In addition, unfortunately, the same level of hygiene cannot be implemented with a water birth as with a conventional birth. This increases the risk of infection for mother, baby and staff. However, if you prepare accordingly, there is no need to worry. Midwives and doctors usually recommend further hygiene measures.
• If a woman giving birth decides to leave the tub during the course of the birth, this can be difficult and uncomfortable for her, especially in the advanced stages of the birth . Because she has to get out of the tub, dry herself and possibly be taken to another room for the rest of the birth process.

Requirements for a water birth

If there were complications during pregnancy, the child should not be born in the water. In the case of a water birth, quick action and intervention by the doctor and midwife are not so easy. In the case of premature babies, twins or babies who are in the breech position, it is therefore clearly better not to give birth in water. The following requirements should definitely be met:

• The 37th week of pregnancy must already have passed.
• The baby must lie “normally”, i.e. not in the breech position.
• You must not expect multiple births .
• There were no infections during pregnancy and you do not have any major previous illnesses.

Learn about the experiences of other birthers in our water birth story . You can find out more about your other birth options in our special “Birth”.