woman in water birth

Knowing what to expect when you’re in labour and using a birthing pool could help you feel prepared. Here’s what happens during a water birth…

Many women find having a bath or shower very comfortable in pregnancy, and this feeling of relaxation in water can continue in labour. What’s not to love about it – it’s warm and you’re buoyant so you can move more easily into any position that suits you. Being in the water also increases the chance of respectful midwifery care, and women say it improves their experience (Lewis et al, 2018).

But what about the potential for mess? When might you need to get out? And what will the midwife be doing? Here we answer your questions…

When should I get in the pool?

The great thing is that there’s no should about it – you can feel free to get in and out as you wish. There’s no evidence that the timing of when you get into the pool makes much difference.  You might be a little wobbly on your feet so a birth partner should help you as you get into and out of the pool.

How can my birth partner help?

Here’s your chance to get waited on. While in the pool, it’s a good idea to have your partner offer you drinks frequently, to make sure you stay hydrated. Your partner can even join you in the pool if you like.

What will my midwife do?

The midwife’s role in a water birth is the same as with a land birth. That is, they will monitor you and your baby during labour and birth.

You can decide if you are willing to get out of the pool at any point for internal checks. Try not to worry though, the midwife will have equipment to check all is well while you’re in the water too. They’ll have waterproof equipment to monitor the baby’s heartbeat and a mirror to check the baby as they emerge. They’ll also check both your temperature and the pool’s hourly, to make sure you’re comfortable (NICE, 2014)

Midwives are trained in how to use water for labour and birth, and each NHS trust will have its own guidance for use of their pools (RCM, 2012).  This guidance will include measures to check the quality of the water reaching the pool, protocols for cleaning the pool and infection control procedures (RCM, 2012; NICE, 2014).

What temperature will the birthing pool be?

The midwife will keep an eye on the temperature, and will let you know if it’s getting too hot (NICE, 2014). The water temperature should not be above 37.5°C (NICE, 2014).

What if I want to get out?

Sometimes women feel their labour has slowed and want to get out of the pool to walk around until it starts again. You can do that and return to the pool if you want. Whatever the case, you’ll want warm dry clothes to make sure you don’t get too cold.

You might want to get out to use the toilet, or get extra pain relief, or because you simply don’t find it comfortable. Some women prefer to get out of the pool and birth the baby on dry land.

What’s the longest time I can spend in the water?

Your time in the pool during labour should not be restricted. There is no evidence to say it’s an advantage to limit how long you stay in the pool when you’re labouring (RCM, 2012).

Will my midwife suggest I get out of the water?

Your midwife might ask you to get out of the water for a vaginal examination to assess progress. You can accept or decline.

If the midwife becomes concerned about you or your baby’s wellbeing, she might suggest getting out of the water. This might include if you develop a high temperature, pulse, or blood pressure or are bleeding from the vagina. Concerns about the baby would include changes in the baby’s heart rate or meconium (baby’s poo) in the water.

What happens if my baby is born in water?

Don’t worry, your baby won’t drown. If your baby is born in the water, they are brought gently to the surface by the mother or midwife.  The baby will not breathe until they meet the air, and they continue to get oxygen through the umbilical cord.

Initially, the baby’s body is kept in the water, and against the mother’s body, to stay warm. The baby might be very calm, and not cry loudly. You can offer your breast at this point if you like.

Do I need to get out of the pool to birth my placenta?

You don’t have to get out of the pool to birth the placenta (RCM, 2018).  Sometimes women decide to get out, and sometimes they stay in. You can tell your midwife what you’d prefer in advance, and you can always change your mind.

Try to remember, this is a common way to birth (CQC, 2018). Midwives are well trained to help you give birth in water. So you’re in good hands, and you can relax and let the water help you along.

This page was last reviewed in March 2019.

Further information

Our helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.

For further support and information, see the AIMs, MVP and Which? Birth-choice websites.

Make friends with other parents-to-be and new parents in your local area and see what NCT activities are happening nearby.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Brocklehurst P, Hardy P, Hollowell J, Linsell L, Macfarlane A, McCourt C, Marlow N, Miller A, Newburn M, Petrou S, Puddicombe D, Redshaw M, Rowe R, Sandall J, Silverton L, Stewart M. (2011) ‘Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study’. BMJ.343:d7400. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22117057 [Accessed: 13th November 2018]

Cluett ER, Burns E, Cuthbert A. (2018) Immersion in water in labour and birth. (5):CD000111. Available from: https://www.cochrane.org/CD000111/PREG_immersion-water-labour-and-birth [Accessed: 13th November 2018]

CQC. (2018) 2017 Maternity survey: national tables for England. Available from:  https://www.cqc.org.uk/publications/surveys/maternity-services-survey-2017 [Accessed: 13th November 2018]

Cumberledge J, Expert Maternity Group; Department of Health. (1993) Changing childbirth. Part 1, report of the expert maternity group, London, HMSO. [Accessed: 13th November 2018]

Dekker R. (2018) The evidence on: waterbirth. Available from: http://evidencebasedbirth.com/waterbirth/ [Accessed: 4th March 2019]

Garland D. (2000) Waterbirth: an Attitude to Care. 2nd edition. Oxford: Books for Midwives Press

Lewis L, Hauck YL, Crichton C, Barnes C, Poletti C, Overing H, Keyes L, Thomson B. (2018) ‘The perceptions and experiences of women who achieved and did not achieve a waterbirth’, BMC Pregnancy and Childbirth. 18(1):23. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763519/  [Accessed: 13th November 2018]

NICE. (2014) CG190 Intrapartum care. Available from: https://www.nice.org.uk/guidance/cg190/chapter/recommendations#timing-of-regional-analgesia [Accessed: 13th November 2018]

Public Health England. (2014) Patient Safety Alert: Legionella and heated birthing pools filled in advance of labour in home settings. Available from:  https://www.england.nhs.uk/wp-content/uploads/2014/06/psa-legionella-birth-pool.pdf [Accessed: 4th March 2019]

Redshaw M, Henderson J. (2015) Safely delivered: a national survey of women’s experience of maternity care 2014, Oxford, NPEU. Available from: https://www.npeu.ox.ac.uk/downloads/files/reports/Safely%20delivered%20NMS%202014.pdf [Accessed: 13th November 2018]

RCM. (2012) Evidence based guidelines : Immersion in water for labour and birth. Available from: https://www.rcm.org.uk/sites/default/files/Immersion%20in%20Water%20%20for%20Labour%20and%20Birth_0.pdf [Accessed: 13th November 2018]

RCM. (2018) RCM Midwifery Blue top guidance No. 1, London, Royal College of Midwives.

Ulfsdottir H, Saltvedt S, Georgsson S (2018) ‘Waterbirth in Sweden – a comparative study’, Acta Obstet Gynecol Scand. 97(3):341-348. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29288489 [Accessed: 13th November 2018]

Winterton N. (1992) Maternity Services: Second report of the House of Commons Health Committee (The Winterton Report), London, HMSO.

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