Water can provide natural pain relief in labour and birth. Read more about birthing pools, having a bath while pregnant and using hot water bottles.
Warm water is often used by people to help them unwind and relax. A bath eases aches and pains, and a long soak at the end of a tiring day can be very relaxing. Water can provide pain relief during labour and birth in the same way.
What are the advantages of using water in labour?
Different research studies also show that, for the most part, labouring in water can have the following advantages:
- Women who have used water say they feel more in control during their labour, and are more satisfied with their birth experience.
- Women say they feel more relaxed, their contractions feel less painful and they use fewer pain-relieving drugs, such as pethidine or epidural.
- Labour is slightly shorter, and less likely to be speeded up with a drip of oxytocin.
In addition, one study found that having a water birth reduced chance of an episiotomy (a cut to increase the vaginal opening) or a tear to the vaginal area so less likely to need stitches. And that fewer babies needed admission to a special care baby unit after a water birth (bear in mind that if a baby or a woman appears at risk during labour or birth, she might be advised to leave the pool. This will affect the statistics).
Are there any disadvantages to using water in labour?
Although many thousands of women have now used water for their labour or birth, most of the research done so far has been on small numbers of women, so it’s not possible to make a full comparison between the safety of labour and birth in and out of water. As far as we can tell, there is no increased risk of a baby dying or being damaged as a result of their mum using water in labour. Nor is there any overall risk of a baby coming to harm through being born in water, although there have been a few cases where doctors think that a baby short of oxygen may have breathed in some water just after being born. In one or two instances, this sadly probably contributed to the baby dying.
One of the main concerns people had when women first started to use water in labour was that this would lead to more infections among both women and their babies. This has not turned out to be the case; probably because of the very strict rules about hygiene which hospitals and midwives adhere to, and careful preparation when the pool is used at home.
Can I use water in labour?
The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have said that: ‘All healthy women with uncomplicated pregnancies at term should have the option of water birth available to them and should be able to proceed to a water birth if they wish.’
You may find that your local unit or midwives impose more precise restrictions on your eligibility for a water birth. If you’re told that you’re not eligible to use water in labour, but you think that it’s the right choice for you, you can ask to speak to a consultant midwife or a senior obstetrician. If you make it clear that you accept responsibility for the decision to use water, they may be willing to record this in your notes and support you in your decision. The user reps on your local Maternity Services Liaison Committee may also be helpful.
About half the maternity units in the country have birth pools. If you plan to use water during labour and your local unit doesn’t have a pool, or you’re going to give birth at home, you will need to hire your own pool. Hire details are provided below or your local NCT branch may be able to put you in touch with someone local to you.
How do I use water in labour?
Birthing pools are bigger than standard baths – wider and at least two feet deep – so you can move easily and keep your tummy immersed in water. Many hospitals now have a water birth pool plumbed in, and portable water birth pools can be hired for use at home or in hospital.
You may want to investigate arranging to use a birth pool in labour, either at home or in a hospital or birth centre. If you know you don't want to or are unable to have your baby in water, you may still like to hire a small pool for using at home during late pregnancy and early labour. You can use a hired birthing pool to relax in during the last weeks of pregnancy. This can be especially useful if you find it difficult to sleep at night.
If you are interested in the idea of using water for pain relief but can't afford to hire or buy a birthing pool, you may still be able to relax in water in some of these ways:
- You can have a bath during pregnancy. Run a deep bath and use some blu-tack to block the overflow (you won't be able to move around as freely but this will give you a deeper bath).
- You can use an upturned plastic bucket or plastic chair to sit on under a shower.
- Warm water can be poured over you from a jug.
- A strong shower jet directed against the small of the back helps some women.
You can also use a hot water bottle to soothe pains. Just make sure to use warm water rather than boiling water.
Tips about using water in labour
In order for the use of water to be as safe and helpful as possible, take a look at our tips below.
- Don’t be in a hurry to get into the birth pool. The water will probably work better for you if you wait until your cervix is at least five centimetres dilated.
- Drink water freely while you’re in the pool according to your thirst.
- Keep the temperature of the water at or below 37ºC at all times. If you become overheated it may be detrimental to your baby's wellbeing.
- If your labour shows signs of slowing down, it may be beneficial to leave the pool; you can always get in again later.
During a water birth:
- Sometimes you may be asked to leave the pool during labour. This might be because of abnormal changes in the baby’s heart rate; meconium (baby’s poo) staining in your waters; or any bleeding from your vagina during labour.
- Once the baby has fully emerged from your body, bring the baby’s face to the surface as soon as possible after the birth so that it can breathe air freely.
- Most units have a policy of delivering the placenta out of the pool. This is because women sometimes feel faint during the third stage of labour and it may be difficult to get you out of the water if you feel unwell. You can always get back into a clean pool of water later if you wish.
These have not been proved by research, but are based on experience and an understanding of hormones during labour.
It’s your decision
If you’re not sure about using water in labour, it may help to speak to other women who have done so; you can ask your local NCT branch to put you in contact with someone.
You can change your mind about the use of water at any time. Some women who planned to have a water birth have found that when they got into the water in labour they didn’t like it. Other women have found they got in and out of the pool during labour according to how they felt. Many women love the feeling of being in water and stay in for the whole of their labour and even the birth.
NCT's helpline offers practical and emotional support in all areas of pregnancy and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about labour and life with a new baby.
The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have produced a joint statement on immersion in water in labour and birth.
A Guide to Water Birth, 12-minute video.