Giving birth in a tub is becoming a popular alternative to traditional delivery. Many birthing centers and a growing number of hospitals (about 150 at last count) now offer birthing tubs for their clients to use during the first and second stages of labor. This is generally referred to as water immersion or hydrotherapy, not water birth, and new mothers often say that giving birth in a tub eases pain, speeds up delivery time, and creates a more positive overall birthing experience. In fact, in a recent study, researchers found that mothers who labored in water were less anxious, needed fewer pain meds, and were more satisfied.
Most hospitals, however, don’t permit an actual water birth, and their policies dictate that you get out of the tub after labor. After all, giving birth in a tub or pool does have its risks and may not be right for every family.
As with any decision about your pregnancy, it’s important to be informed and empowered. Explore different birthing alternatives with your doctor or midwife, your partner, and your doula. No two birth experiences are exactly alike.
If you’re considering giving birth in a tub, either at home or in a hospital or birthing center, here’s what you need to know.
Benefits of giving birth in a tub
Proponents of water birth say that giving birth in a tub offers many benefits over a traditional birthing experience. Because your baby spends nine months suspended in amniotic fluid, some believe that entering the world in water makes the postpartum transition easier for them.
Fans also claim that giving birth in a tub dramatically reduces the need for pain relief medication. This may be because immersion in water helps women feel more comfortable and relaxed. According to tests by Evidence Based Birth, women who gave birth in water had higher rates of spontaneous vaginal birth (no vacuum or forceps) than women who gave birth in other ways.
Giving birth in a tub is also said to reduce vaginal and perineal tearing during delivery because the warm water softens tissue. Some women also find that they’re able to assume an easier birthing position thanks to flotation.
So what actually happens in a tub birth?
Typically, a woman giving birth in a tub is in about 18 inches of water. It’s not a pool or a full tub; it’s just enough water to cover her belly. Once the baby is born, the baby is slowly guided to the surface, face first. Most babies don’t take a breath until they are pulled out of the water because the umbilical cord is still attached, a phenomenon called the “diving reflex.”
Potential risks of giving birth in a tub
While there are many potential benefits to spending time in water during birth, birthing pools also carry risks. Complications of giving birth in a tub are rare; however, they can be serious—and that’s why hospitals aren’t approving the practice. Giving birth in a tub can expose you and your baby to infection. It’s possible for the umbilical cord to snap before the baby emerges from the water—the snapping occurs in 1 in 288 water births, compared to 1 in 1,361 land births. The water can be too hot or too cold, which can negatively impact your baby’s body temperature. Your baby may also breathe in water and experience asphyxiation or seizures.
Additionally, there is much debate about the actual medical benefits of giving birth in a tub. WebMD states that studies on water birth during the first phase of labor show no improvement or added benefit to you or your baby’s overall health. Other studies about the benefits of water birth offer unclear conclusions.
Although several serious neonatal complications have been reported during water births, the actual incidence has not been determined in population-based analysis. Until further data is available, the American College of Obstetricians and Gynecologists recommends giving birth on land, not in water—which is a big part of why hospitals have pulled back from offering the options.
Is a water birth right for you?
After considering the benefits and risks of giving birth in a tub, it’s time to decide if water birth is right for you.
Water births are considered unsafe if:
- You’re carrying multiples.
- You have a breech baby.
- The baby is premature or needs special care, such as neonatal surgery.
- You have certain underlying medical conditions or pregnancy-related complications such as preeclampsia or gestational diabetes.
- You are younger than 17 or older than 35.
If the above conditions don’t apply to you or your pregnancy, you may be a great candidate for giving birth in a tub. Discuss water birth with your doctor or midwife and your doula. Your pregnancy support team will help you decide if a water birth is right for you.
How to choose and prep a birthing tub
If you decide to use a birthing center, or your hospital offers water birth, the facility will already have birthing tubs for you to use. However, if you’re giving birth in a tub at home, you can rent or buy your own tub. Plan to have your birthing tub at least two to three weeks before your due date so you can familiarize yourself with it.
Birthing tubs can be inflatable or made from a hard material, such as plastic. Make sure your tub fits in the space where you intend to give birth. You’ll want a tub that’s big enough for you, and make sure there’s enough room around the tub so your partner, midwife, and doula can move freely around you as they provide support. You can purchase birthing tubs online or at a specialty store. Some birthing centers and doulas may even have tubs you can borrow, so speak to your birthing team about your options.
Once you’ve selected your birthing tub, make sure it’s clean and filled with warm water by the time labor begins. Experts advise heating the water to 98°F maximum. The water can be cooler than 98° but may cause complications if it’s too hot. Make sure there’s a visible thermometer so your midwife can monitor the water temperature.
Have a backup plan
Finally, as with any alternative birth, make sure you have a backup plan. If there’s a problem with the birthing tub or complications arise during labor, be prepared to deliver in a nearby hospital. Ultimately, the health of you and your baby are the most important part of any birthing plan, whether you plan on giving birth in a tub or not.