Midwife shares benefits, risks of water birth

As a midwife at The Ohio State University Wexner Medical Center, I receive a lot of questions about water births, including “What are they?” and “Are they safe?”
First, water birth is childbirth that occurs in a tub of warm water. It’s a gentle birth for baby and provides excellent pain relief for mom.
It’s not a fad. In fact, women have been giving birth in water for centuries, most notably in the United Kingdom, where, based on the Royal College of OB/GYN guidelines, all women should have access to hydrotherapy during labor.
Water births also are an option in the United States, but they’re relatively new to appear in the hospital setting. Ohio State is the only hospital in Franklin County that offers them. They’re performed in regular delivery rooms, where there are currently three, soft-sided tubs available. The tubs are about three times as large as a normal bathtub.
The benefits of water birth are mainly for mom’s experience and include:
  • Reduced desire for anesthesia
  • Less risk of vaginal tearing
  • Shortened labor duration because of relaxation
  • Higher reported patient satisfaction
The relaxing effects of water birth are important. Women can get into different, relaxing positions that would be more difficult to hold outside of water. We use intermittent monitoring for water birth, so women are free from cords and monitors. There are strict criteria that women must meet in order to have access to water birth. They must have a normal pregnancy without complications such as diabetes or high blood pressure.
Here’s how it works: The tubs are partially filled with water kept at human body temperature – 98.6 degrees. These tubs have disposable liners that decrease the risk of infection and eliminate cross contamination. Water-proof monitoring also can be used during a water birth. Unlike a normal bath, you can’t add essential oils or bubbles.
A woman enters the tub during active labor, when she’s roughly about six centimeters dilated. Some women choose to get in and out of the water during labor. They may even choose not to deliver in the tub at all, and that’s OK.
Only midwives offer water births at Ohio State, and our midwifery team delivers babies only at the Ohio State Maternity Center. This ensures the mother and baby have quick access to care in the event a complication arises during delivery. All of Ohio State’s midwives are nurses with advanced training and master’s degrees.
Midwives take a more holistic approach to pregnancy and delivery. Studies show that women who choose a midwife for care may experience fewer interventions, including cesarean sections and episiotomies; fewer hospitalizations during pregnancy; and feel more empowered during childbirth. Water birth can add to positive birth experiences. 

How does it work for babies? It’s difficult to know the true benefits for newborns. Anecdotally, babies come out more calm than babies born the traditional way. They do tend to be bluer initially. The baby is still receiving oxygen through the umbilical cord and they’re stimulated to breathe by the dive reflex, which occurs when they reach air.
What are the potential risks? Although rare, risks include:
  • Mother or baby could get an infection from bacteria in the tub.
  • The umbilical cord could detach.
  • Baby’s body temperature could be too high or too low.
  • Mother and baby could breathe in bath water.
A woman can consider having a water birth at any time during her pregnancy, but it’s usually decided during the third trimester. Women shouldn’t consider water births if the baby is premature or in the breech position, or if mother has preeclampsia, diabetes or an infection such as herpes, which can spread in water.
In addition to supporting you throughout pregnancy and delivery, midwives care for women during other phases of life, providing well woman exams, pap smears, contraception and preventative care.
Laurie MacLeod is a certified nurse midwife at The Ohio State University Wexner Medical Center.