How to Prepare for a Home Waterbirth

Are you thinking about having a water birth? Find out about the advantages and things to consider when planning to labor or give birth in the water.

What is a water birth?

Water birth is the process of giving birth in water using a deep bath or birthing pool (depth of water is key and you’ll see why). Being in water during labour is shown to help with pain as well as being more relaxing and soothing than being out of water (https://evidencebasedbirth.com/waterbirth/). The water helps to support your weight, making it easier to move around and feel more in control during labour, it also relieves pressure. I’ve also included resources at the end of this blog post. 

Can I have a water birth?

Having a water birth is an option for you if you have had a low risk pregnancy and your midwife believes it is safe for you and your baby. You can talk to them about it at any of your antenatal appointments.

What are the advantages of water birth?

  • The warm water can help to relax, soothe and comfort you.
  • The support of the water means you can try different positions and move more freely.
  • When upright in the water, gravity will help move the baby down towards the birth canal.
  • Being in water can lower your blood pressure and reduce feelings of anxiety, making your body more able to release endorphins, which can help ease pain.
  • The water can help to improve back pain and the feeling of pressure, especially when you are fully dilated.
  • Being in the pool during labour and birth can be a “cosy” experience, making you feel safe.
  • The water can help your perineum stretch gradually as the baby’s head is being born, reducing the risk of injury.

Are there any disadvantages of having a water birth?

  • If you’ve been using the TENS machine that’s going to need to be removed before you enter the water.
  • Your contractions may slow down or get weaker, especially if you go in the pool too soon (your midwife will discuss this with you and help you with timing pool entry).
  • If the pool water is too cool at birth, your baby is at risk of hypothermia. But your midwife will check the water temperature regularly and I provide a floating thermometer. If your baby’s temperature is low, skin to skin contact with you and warm towels will help (Towels left on a heat pad during the labor or given a quick heat through in the dryer does the trick).
  • You might need to leave the pool if there’s reason to monitor baby more closely or if your labor has slowed down as a result of you submersing yourself. 

Can my baby drown or inhale water if I give birth in the Pool?

Many birthers and their partner’s wonder whether there is a risk of their baby drowning if they give birth in water but it is very unlikely to happen.

Babies do not need to breathe when they are in the womb because they get oxygen from the blood that comes from their parent through the placenta. When they are born in water, their body behaves as if they are still in the womb until they take their first breath of air, at which point their lungs open up. As a baby comes from an amniotic sac filled with water in the womb into warm water (in the birth pool), the lungs are not open and no water can enter.

After your baby is born in the water, you and /or your midwife will bring them to the surface slowly. Your baby will only be under water for a short time and won’t take a breath until they are out of the water. 

Your baby is only at risk:

  • if their head is brought above the water and brought down again (hence why deep birth pools are key)
  • if their oxygen supply from the placenta is affected
  • if their temperature changes suddenly.

Your midwife will be careful to monitor the above during your labor and birth. 

Where can I have a water birth?

  • At home with a hired birthing pool or if you have a deep tub. 
  • In a birth centre ( we do not currently have a birth centre in Victoria and VGH has showers but not birth tubs)

What should I wear for my water birth?

Silk Negligee? ….all jokes aside-you can wear what feels comfortable for you, keeping in mind that you will be in what is essentially a large bath.  Many birthers choose to wear a bikini, tankini or loose fitting sports bra. You can wear a t-shirt or tank top if you want a tad more coverage. Some birthers prefer to be naked. 

Whatever you feel comfortable with wearing on your top half is fine.

It is best to take your bottom half off so that the midwife can see what is happening as you approach birth. However, if you wish to leave your unders on until that stage, that is your right.

What other pain relief can I have in the water?

Water is sometimes referred to as ‘nature’s epidural’ or ‘aquadural’, because of the support and pressure relief it gives you. There would need to be some space of time after you’ve had intramuscular morphine or the like before you could enter the pool. In other places a birther can have gas and air ( entonox or nitrous oxide) while in the water but this is not available currently in Victoria. Most birthers find the combo of water, reassurance, breathing, massage and vocal toning are helpful pain relief. 

Can I have delayed cord clamping if I give birth in the water?

Delayed cord clamping or DCC has become the standard of care in Canada. Most birth centers, labour wards and homebirth teams will try to do DCC for every birth. This is because holding off from cutting the cord until the blood from the placenta has stopped flowing into your baby can increase your baby’s iron levels and the amount of stem cells they have, which will help with their growth and immune system. Although many centers practice DCC as normal, you can add this to your birth plan to reinforce your wishes.

The only reason DCC would not happen is if you or your baby are suddenly unwell just after birth. If the baby is slow to breathe, or you are bleeding more heavily than normal, the midwife may need to cut the cord earlier than usual.

You and your baby’s safety during and after a water birth is very important and this will always take priority.

How do I deliver the placenta if I have a water birth?

Your midwife is likely to ask you to get out of the pool to deliver the placenta because gravity can be helpful in the third stage of labour. It also makes it easier to help you in case of an emergency, as some new mums can feel faint after birth, or during the third stage of labour. If you do suddenly feel lightheaded, it may be difficult to get you out of the pool quickly and safely.

Most hospitals, birth centres and midwife colleges have a policy on how the placenta should delivered, and most of these are on a bed, toilet, birth stool or floor mat for your safety. Please ask your midwife about the third stage of labor.

Some Logistics: 

In addition to what I bring in your water birth kit you will also want to have:

  • Towels, LOTS OF THEM. Dark colored is preferred. Some folks just sanitize towels they pickup second hand to save money.
  • A tarp or plastic drop sheet for under the pool ( when I have these in stock I bring them for you, just ask)
  • A Robe or amazing blanket for when you get out of the pool. Again, dark colored is good if you cant get to the laundry soon after labor/birth.
  • Large pots to keep water simmering in in case you want a quick, warm water top up but don’t have enough heat in the hot water tank (usually this isn’t a problem).

 

More helpful Resources

The short version of the evidence: https://www.ontariomidwives.ca/water-birth 

Systematic Reviews: https://www.cochrane.org/CD000111/PREG_immersion-water-labour-and-birth

U.S based but relevant:

1- https://evidencebasedbirth.com/waterbirth/ 

2-https://evidencebasedbirth.com/water-immersion-during-labor-for-pain-relief/

3-https://evidencebasedbirth.com/real-life-stories-waterbirth/

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