Pros and cons of a water birth

Possible Benefits of a Water Birth

• Warm water relaxes the body so that you have less stress and more endorphins (natural painkillers) are produced. It also lowers blood pressure and heart rate, and the relaxing effect of water also reduces stress for the baby.
• Giving birth under water is supposed to ease the pain somewhat.

Figures from the Study Centre for Perinatal Epidemiology (SPE) show that seven out of ten Flemish women receive an epidural during their delivery. In maternity wards that offer the opportunity to give birth under water, this would only be the case for two out of ten. It could of course also be that women who opt for a water birth opt for a more natural and less technical approach to childbirth. Or that women who opt for an epidural prefer not to give birth under water.

• In water you can move more easily. In addition, the water supports the weight of the baby and thus reduces back and/or other pain.
• Often a faster dilation, a smoother labor and delivery.
• Water makes the perineal tissues more supple, which reduces the risk of tears and episiotomy.
• Birth in water makes the transition to the outside world less abrupt for the baby.
• Babies born in water often have better Apgar scores.

Possible disadvantages of a water birth

• Taking a bath too early can reduce the effectiveness of your contractions.
• You are more likely to have a genital infection or postpartum bleeding.
• The chance of the baby contracting infections is also slightly greater.
• There is a small risk that the baby will start breathing on its own too early, causing it to swallow water.
• There is also a small risk of the umbilical cord breaking as the baby is carried to the surface of the water.

A water birth in the hospital

Although many hospitals are equipped for water births, there are also many maternity hospitals where only the labor can take place under water and not the actual birth. So inquire in advance.

A water birth at home

The midwife who will assist you must have sufficient experience with underwater births. A regular bath is usually not suitable, because it is difficult to disinfect 100%, and a plastic toy bath is also not sufficient. You will therefore normally have to rent a special 'pool' or birthing pool. The midwife can help you with this. The bath is a lot bigger than a regular bath (about 1.80 by 1.50m) and has a special cover for single use.

Precautions when using a labor and/or delivery pool

• The quality of the bath water is super important. It must be germ-free water, in a germ-free bath. Regularly a sample check of the bath water is necessary.
• Because bathing can slow down contractions, it is better to wait until you have regular, strong contractions.
• The temperature of the bath water should be 37-38°C. Bath water that is too warm can be harmful to the baby.
• To ensure the safety of the baby, heart sounds should be checked regularly.
• As optimal prenatal preparation for a water birth, some maternity clinics organize special classes led by a physiotherapist and/or midwife.

When is a water birth not recommended?

A water birth is only possible for healthy women with an uncomplicated and full-term pregnancy (+ 37 weeks). Underwater labor and birth is in any case not recommended for:

• pelvic stenosis
• abnormal position of the baby (e.g. breech position)
• premature birth (< 37 weeks) and/or growth retardation in the baby
• multiple pregnancy
• scar from a previous caesarean section
• preeclampsia
• placental problems (placental abruption, placenta previa, etc.)
• need for intensive control/monitoring of the mother (for example if there is meconium in the amniotic fluid)
• premature rupture of the membranes (or more than 18 hours before actual delivery);
• a difficult birth in the past (e.g. with severe blood loss)
• if the mother has a fever (over 38°C), diarrhea, an infection (urinary tract infection, active herpes, HIV, hepatitis B or C, etc.), diabetes, epilepsy, a physical disability, etc.

If there are complications during labor (e.g. abnormal blood loss, increase in blood pressure, abnormal heart rate of the fetus, etc.) you should immediately leave the bath and give birth “on dry land.” The afterbirth will take place out of the bath anyway.

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