Background

Water birth is the practice of undergoing labor or delivery while immersed in warm water. The water birthing tub may be used only for the first stage of labor (from the onset of contractions to the point where the cervix is fully dilated or open) or it may be used throughout labor and delivery. Water birth is a type of hydrotherapy, or balneotherapy, which uses immersion in water to reduce pain or to treat an illness.

Birthing tubs are available at many hospitals that provide water birth as an option to their obstetric patients. For home births, birthing tubs can be rented or purchased. It is recommended that a professional attendant with training in water birth be present during labor and delivery involving birthing tubs.

The Royal College of Obstetrics and Gynaecology (RCOG) in the United Kingdom stated that water birth should be an option that women should have available to them for giving birth, provided that the professionals assisting them are familiar with the technique and that the equipment is handled and maintained properly.

Some pediatricians and others have argued that water birth has been promoted by midwives and some physicians as a way to counter the "medicalization" of childbirth and return "empowerment" and "autonomy" to women. They recommend that informed consent be obtained by the practitioner and that expecting mothers and their families be informed of potential adverse outcomes that have been reported.

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Effectiveness Effectiveness definitions

INSUFFICIENT RELIABLE EVIDENCE TO RATE

Labor pain. Preliminary clinical research suggests that using water birth may reduce use of pain-control measures during the first stage of child labor. Using water birth compared to conventional methods of childbirth did not result in difference in the rates of Cesarean sections, damage or tears around the vagina, complications, or infections in the mother or the newborn.

More evidence is needed to rate water births for this use.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Dosing & administration

Adverse effects

General: Rare reports of excessive absorption of water, drowning/near-drowning have been reported with water births.

Pulmonary/Respiratory: There was a case of an infant that was birthed with the water birth technique, acquiring pneumonia due to Legionnaires' disease and dying.

Neurologic/CNS: There was a case of an infant being birthed with the water birth technique that experienced a lowered serum sodium level, which resulted in encephalopathy and seizures.

Interactions with pharmaceuticals

None known.

Interactions with herbs & supplements

None known.

Interactions with foods

None known.

Interactions with lab tests

Interactions with diseases

INFECTIONS: Water birth is contraindicated if the mother has an infection such as a herpes infection.

Mechanism of action

One theory about the benefits of water birth put forth by advocates is that the baby has been in the water of the amniotic sac for nine months and that birth into a similar environment may be gentler for the baby and lessen the stress of the mother as well. Many practitioners believe that reducing the stress of the mother during labor and delivery decreases the potential for complications for the baby.

The water provides buoyancy, and in theory, relieves weight pressure, not only where the mother's body rests on the tub, but also for the abdominal organs. This may promote better uterine contractions, blood circulation, and oxygenation for both the uterus and the fetus, according to advocacy groups, such as the American Pregnancy Association and Waterbirth International. These same groups also assert that immersion in water may help to lower high blood pressure in the mother and to reduce stress-related hormones, which may allow the mother to produce more pain-relieving endorphin hormones. There is a lack of published research that confirms these conjectures.

The water may theoretically relax the muscles of the floor of the abdomen (the perineum) so that there is a reduction in the tearing of the skin around the vagina, a reduction in the need for an intentional incision (episiotomy), and a reduction in the need for stitches.