Water for labour and birth

Patient Information Leaflet

The information in this leaflet is to help you make an informed decision about your birthing choices. If you need any further information, or have any questions that are not addressed here, please use the contact details at the end of the leaflet and speak to your midwife or obstetrician.

Introduction: ‘a gentle beginning for a new life’

Birth in water is an alternative way to give birth. More and more women are choosing to deliver their babies in water. Water can be an effective form of pain relief for women, and a gentler introduction to the world for babies. Remember your baby has been in fluid for the duration of your pregnancy.

For the majority of women, it is quite safe to use water for labour and/or birth. If, after reading this leaflet, you decide you would like to use a water birth pool in labour or to give birth to your baby in water, talk to your midwife who will advise you and give you time to ask questions and express your preferences for your baby’s birth.

What are the benefits of having a water birth?

There are several benefits to giving birth to your baby in the water:

• Labouring in water helps you adopt a wider variety of positions which will help you relax and improve your comfort. Being less tense has been proven to speed up labour.
• The water allows you to experience a ‘weightless’ feeling, and can reduce both your body’s production of stress related hormones and increase the body’s own pain relieving hormones.
• Many women find that the water allows them more control over their labour.
• Water can help the tissues of the perineum to stretch and relax. This is known to reduce the chance of having severe tears or the need for an episiotomy. This is a cut to the perineum that may be used to help deliver your baby in some circumstances.

What are the risks of having a water birth?

For healthy women with an uncomplicated full term pregnancy, complications are rare.

There are a few potential disadvantages to having your baby in the water or using the water birth pool during labour. These are listed below:

• You will not be able to use the water birth pool if you have an epidural for pain relief.
• You may become dehydrated if you have a water birth although this can be overcome if you drink plenty of non-fizzy fluids.

Will I be able to have a water birth?

We will do our very best to help you achieve your birth choice. However, it may not always be possible to have a water birth for a variety of reasons. These include medical reasons and the availability of the pool room.

There may be other reasons why you might be advised not to have a water birth. These include:

• If your pregnancy is less than 37 weeks (this is classed as premature labour).
• If your baby is breech (not in a head down position).
• Your body mass index (BMI) must be below 35 and above 18 for a waterbirth in the Midwifery Led Unit
• A maximum of 125kg for waterbirth in the built-in pool and a maximum of 93kg for the inflatable pool, both at the time of labour.
• You must be able to enter and leave the pool independently.
• If your baby is smaller than expected, detected when the midwife measures your abdomen and confirmed by ultrasound scan.
• If any of the checks carried out when you come to hospital in labour are found to be abnormal. These include your blood pressure, pulse, breathing rate, urine and temperature.
• If the baby has opened its bowels in your womb. This is referred to as meconium-stained amniotic fluid and could mean your baby is distressed.
• If your baby’s heartbeat is abnormal – it may be too fast or too slow.
• If you are having your labour induced and require a cannula for a hormone drip.

We have a new birth pool on delivery suite which is designed for women who are Consultant led and would like to have the option of a waterbirth. We have a wireless telemetry machine that can be used for continuous monitoring of your baby whilst in the pool.  A discussion prior to or at the time of birth with the multi-disciplinary team is advised and ongoing assessment of current condition completed.

There may be other reasons why you are advised by your midwife during labour to leave the water birth pool, for the safety of you or your baby.

Your community or hospital midwife or obstetrician will discuss with you if you are suitable to have a water birth during your pregnancy.

Useful things to help during your water birth

The following items are useful when having a water birth:

• Dressing gown
• Large bath towels
• Dextrose sweets or similar
• Inflatable pillow and float
• Plenty to drink (non-fizzy)
• A bikini or T shirt to wear whilst in the water birth pool – this is your choice.

What happens during the water birth?

Your midwife will make sure that all is well with you and your baby before you enter the pool. Your midwife will continue to check your temperature, blood pressure, breathing rate and pulse while you are in the pool.

Your baby’s heartbeat will be listened to under the water with a waterproof hand-held device called a Doppler. This device uses ultrasound waves. This means you can relax in the water and your midwife can listen to your baby’s heart rate without you having to get out of the water each time it is checked. If you are classed as high risk, a telemetry wireless monitor can be used to continuously monitor the baby and is suitable to be used in the water.

Water is a way of providing you with pain relief during your labour. You will also be able to use Entonox (gas and air) while you are in the water if you want to.

If you want further pain relief, you can have pethidine injections. However, if you have these, the midwife will ask you to leave the water birth pool as pethidine can make some women drowsy. Once the effects of pethidine have worn off, if you decide you would like to get back in the water birth pool, this may be an option.

You will be able to have two birthing partners with you while you are in labour and these must remain the same two people throughout your water birth.

The temperature of the water should be comfortable for you. To ensure you and your baby do not become too hot or too cold, it is recommended that the water temperature is between 35°C and 37°C in the first stage of labour and 37°C for the birth. The midwife will check your temperature, the water and the room temperature regularly.

Your midwife will encourage you to drink extra water throughout labour to prevent dehydration.

Why may I be asked to leave the water birth pool?

You may decide to leave the water birth pool at any time – this is your decision.

The midwife may ask you to leave the water birth pool in the following circumstances:

• Your baby opens its bowels before birth.
• You lose a lot of blood while you are in the pool.
• There is concern about your baby’s heartbeat.
• Your contractions slow down.
• Your labour does not progress as expected.
• You request pethidine or an epidural for further pain relief.

Your midwife will discuss these reasons with you.

You will also need to leave the pool to use the toilet.

What happens when my baby is born?

Once your baby is delivered, you will be given the choice of whether you, your birth partners or the midwife guides your baby to the surface of the water.

Do not worry: your baby will not swallow the water during this process. This is because the temperature of the water surrounding your baby in the womb will be similar to the temperature of the water in the water birth pool (approximately 37^oC). Your baby will take its first breathe only when he/she reaches the surface of the water and the cold air stimulates them to breathe.

Once your baby has been born, the head must not go back into the water in order to prevent them from inhaling water. Babies born in water tend to have their eyes open and be very calm. Sometimes, your baby may take a short time to become pink. This is because the birth has been very gentle and is normal.

You may deliver your placenta (afterbirth) in or out of the water birth pool. Your midwife will discuss this with you during labour.

We hope that we can help you to have the kind of birth that suits you.

Can I find out more?

You can find out more from the following websites:

• National Childbirth Trust (NCT) (2022) Water births and labouring in water: questions answered London: NCT.
• National Childbirth Trust (NCT) (2022) Planning for a water birth: 6 top tips. London: NCT.
• Royal College of Midwives (2012) Evidence Based Guidelines for Midwifery-Led Care in Labour: Immersion in Water for Labour and Birth. London: The Royal College of Midwives Trust – Immersion in water during labour and birth

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Maternity Documentation Group. Date reviewed: April 2025. Next review due: April 2028. Version: 4. DGH ref: DGH/PIL/00889