Water Birth: an Overview

A water birth refers to a birth where a woman labour’s or births in the water. Technically this can be in any form of water including natural bodies of water, but most usually in the shower, bath or speciality birthing pool. You can have a water birth both at home and in a hospital setting, but both require a level of planning. If you want to learn more about your different birthing options you can read my other blog post Birthing Options Perth to Mandurah, Western Australia - Mother Mother Doula

Hospital Water Births

Not all hospitals offer specialty birth tubs, but most will permit labouring women access to a shower. There are some strict policies and guidelines to adhere to if you're planning a hospital water birth. But even if you meet all the criteria your access to a birth pool on the day will be determined on availability and the presence of a water birth trained midwife. You can look into hiring your own birth pool to use within a hospital setting but this must be discussed with your care provider during your pregnancy. 

To be eligible to use a birth pool in a hospital setting you must (at minimum):

  • Be healthy with no medical or pregnancy complications. 
  • Be having only one baby who is presenting head first. 
  • Be at least 37 weeks pregnant. 
  • Not be a carrier of, or infected with, HIV, Hepatitis B or C virus. 
  • Not be excessively overweight at booking (note: this means you must have a pre-pregnancy BMI ≥18 and ≤35)
  • Your baby’s heart rate must remain within the normal range. 
  • You must not enter water until four hours after receiving an injection for pain relief.
  • (Labour-and-or-Birth-Using-Water.pdf)

Currently hospital water birth is offered at the following services:

Fiona Stanley: Family Birth Center

11 Robin Warren Drive, Murdoch, WA

Email: Fsh.FamilyBirthingCentre@health.wa.gov.au

Phone: 6152 9416

Website: Family Birthing Centre (health.wa.gov.au)

Family Birth Centre: King Edward Memorial Hospital for Women

374 Bagot Road, Subiaco, WA

Email: KEMH.FamilyBirthCentreReferrals@health.wa.gov.au

Phone: (08) 9340 1800

Website: King Edward Memorial Hospital - Family Birth Centre (health.wa.gov.au)

Home Water Births

When birthing at home the world is your oyster. As long as you and your care provider, usually a Privately Practising Midwife (PPM), are comfortable, you can give birth wherever you like. Some PPMs provide birth pool hire with their service, but most will require you to hire one independently. You will need to consider if your hot water system will last long enough to fill and reheat your pool, or for how long your shower will run hot. 

Photos By Sarah Del Borrello, Mother Mother Doula

Why are more women choosing to give birth in the water?

Water birth is becoming increasingly popular. Before birth photography and social media really took off we rarely saw birthing images outside of textbooks, and most of these images were of clinically managed births in hospital settings. Women and birth workers are often sharing beautiful birth photography images on social media and many of these are water births. Want to see some absolutely stunning water birth photos check out these Instagram accounts (@ambermay.birthphotography, @sarabresser.birthphotography, @catfancote.capturingbirth).

Not only is there an increase in women's awareness of this option there is also more and more research pointing to the benefits it holds. Water immersion during labour and birth has shown to:

  • Improve maternal pain tolerance 
  • Reduce the use of pharmaceutical pain relief 
  • Improve maternal satisfaction and feeling of control over the birth
  • Decrease the risk of a perineum tear 
  • Significantly decrease episiotomy use
  • Improve apgar scores

Reference: A retrospective comparison of water birth and conventional vaginal birth among women deemed to be low risk in a secondary level hospital in Australia (researchgate.net) & Water Immersion in Labour and Birth - SNSWLHD

Why Water Temperature is Important

It is important that the temperature of your bath, pool or shower remains consistent and similar to your body temperature (around 37.5 degrees), particularly as the baby is crowning and being birthed. Labouring in water that is too warm can cause both you and your babies bodies to overheat, which can cause an unwanted increase in babies heart rate. Labouring in water that is too cold will not provide the relaxation benefits of warm water, and babies who are born into water that is too cool may have the gasp reflex triggered too early (more on this in a moment). Your midwife will carefully monitor the temperature of the water during your labour. 

Why it’s safe and your baby won't drown

Usually during a water birth the baby is usually born completely immersed under water. For the previous 9 months the baby has been growing inside of the amniotic sack, surrounded by water-like amniotic fluid. As the baby moves through the birth canal and is squeezed out of the vagina so too is the amniotic fluid from their lungs. As the baby takes their first breath or makes their first cry the lungs expand to take in air/oxygen. This expansion and breath happens when the gasp reflex is triggered by the change in temperature from the mothers body to the outside temperature. Some mothers will instinctively blow on their babies faces to help them take that first breath. This is why water temperature is so important at the moment of birth. A baby who is born into cold water may have their gasp reflex triggered too early, which could cause water aspiration, this is extremely rare and these babies usually make a full recovery with medical support. This is where the fear and misconception of babies drowning in water comes from. They may (very rarely) aspirate water before their first breath, but just like the amniotic fluid that is in all babies lungs, they usually expel it and begin breathing either independently or with mild assistance. 

It is also important to note that as long as the placenta is attached to the mother, and the umbilical cord to the baby the infant still has a placental circulation system to rely on if needed. This is your babies built in respiratory support. As long as the cord is pulsating your baby is receiving oxygenated blood. You and your midwife can gauge this by feeling the cord pulsating which may last for 5 to 10-minutes (this is also why optimal cord clamping isn't about just waiting 2-minutes, it's about waiting until the pulsating stops and the cord is limp and white). For more info on optimal cord clamping visit Optimal cord clamping: what's the evidence? - Dr Sara Wickham

Photos By Sarah Del Borrello, Mother Mother Doula

What do I need to have a water birth?

Hospital water birth supplies: Hospitals that have fully equipt birthing pools wont require you to bring anything. If you are using a hospital's inflatable birth pool they should supply a liner for you to use to ensure hygiene. If they have a built-in tub you won't require a liner as the surfaces can be sanitised. However you may want to consider the following items to support your hospital water birth.

  • Mirror to see baby
  • A bather top if you prefer modesty 
  • Knee pads if birthing in the shower 

At home water birth supplies: let's assume that you need to supply everything, here's a detailed list of what you may want to include and some links of where you can get it.

  • Birth pool  (purchase outright Simply Birth from $407, for hire check your local facebook homebirth group pages)
  • Pool liner suitable for your pool
  • Electric air pump for inflating and deflating the birth pool (Ryobi Cordless Air Inflator and Deflator)
  • Patching kit (just incase)
  • Water thermometer 
  • 5-10 towels
  • Plastic tarp or liner to protect carpeted or wooden floors
  • Mesh scoop for removing debris from the pool
  • A reverse pump for draining the pool (Birth Pool Drainer)
  • Tap fitting/connector (make sure this fits in advance)
  • New food grade hose (for filling the pool)
  • Hot water urn if your hot water runs out quickly (you can hire these from catering companies)
  • A waterproof flashlight
  • Mirror

Above image is of me and my second baby, photo was taken by my Midwife.