Water Birth: What You Need To Know
Exploring a gentle, empowering way to welcome your baby into the world
Preparing for your birth experience is an exciting yet daunting task, accompanied by many questions about what the right choice is for you. It is one of the most personal and meaningful experiences for families, and exploring the variety of options available is a benefit for all those planning their journey.
Water birth has become a popular choice over the past few decades and continues to gain popularity. In states like North Carolina, changes in midwifery-led care legislation and an increase in out-of-hospital birthing options have allowed more access to water birth options.
But what exactly is it?
Is it safe?
What are the benefits?
And how do you know if it's the right choice for your journey?
Whether you're hoping for a calm, unmedicated birth or simply exploring all your options, learning about water birth can be an excellent place to start.
Let's explore these questions and help you make an informed decision.
What is a Water Birth?
Water birth involves laboring and birthing your baby in a warm tub or pool of water. This setting creates a cozy, womb-like environment that babies are used to, offering comfort and calm to both the birthing parent and baby.
Typically recommended for those with low-risk pregnancies, water birth can help reduce stress, ease discomfort, and support a smoother birthing journey. Many parents have described it as a peaceful, grounding, and empowering experience.
The Benefits of Water Birth
Over the years, research and personal stories have highlighted the numerous advantages of water birth, particularly for individuals seeking to avoid or minimize medical interventions.
Here are some well-researched benefits:
Reduced pain and discomfort: The warm water and sensation of weightlessness can significantly alleviate the discomfort associated with labor. Having the body submerged in water can facilitate easier movements and position changes, while also providing a sense of security and comfort.
A greater sense of control and calm: The private, soothing environment of the water can help reduce anxiety and keep you centered.
Fewer interventions: The reduction in discomfort, paired with the ability to move more freely, has been shown to significantly minimize the need for medical interventions such as epidurals, narcotics, and the use of pitocin (a medication commonly used to progress labor by increasing the power and frequency of contractions)
Lower risk of tearing: The water can help soften tissues, potentially reducing perineal trauma.
Gentle transition for baby: Water birth benefits not only the parent but also the child. As the baby is born into the water, it creates a smoother and gentler transition into the world outside the womb by providing an environment similar to the womb. After the baby is born, the parent or provider can slowly bring the infant to the surface to the comforting arms of the parent.
In their well-documented and thorough article about water birth, Evidence Based Birth (EBB)® compiled these benefits from a group of multiple studies:
Reduced pain levels
Greater birth satisfaction
Reduced request for pain medication (Opioids/Epidural)
Reduced need for interventions
Reduced perineal trauma
Reduced risk of postpartum hemorrhage
Reduced rates of meconium in amniotic fluid
In addition to these benefits, the EBB® article also states that parents who have experienced water birth have reported feeling a greater sense of autonomy, control, privacy, and bonding.
“Evidence shows that water birth is a safe option that decreases pain, lowers interventions, and protects the perineum.”
- Evidence Based Birth®
Fun fact: Some parents affectionately call water birth the "Aqua-dural", a natural alternative to an Epidural for pain relief!
What Are the Risks?
As with any birth option, water birth comes with its own set of considerations. However, with proper protocols water birth has been shown to be very safe for low-risk clients.
Potential risks include:
Infection: This is extremely rare when proper hygiene and water standards are maintained. Studies have compared the infection risk of water birth to land birth, resulting in similar risk levels.
Cord avulsion (When the umbilical cord disconnects from the placenta shortly after birth): This occurs when the umbilical cord is pulled too quickly as the baby is brought to the surface. Slow, gentle movements and provider training can prevent it.
Limited to low-risk pregnancies: If you're considered high-risk (e.g., due to preexisting conditions or complications), your provider may recommend an alternative plan.
Because birth centers such as North Carolina Birth Center, located in Chapel Hill, North Carolina, are only able to provide care to low-risk clients, water birth is deemed safe and greatly beneficial for the majority of birthing clients.
Research has concluded that the benefits of birthing in water outweigh the risks, especially for those classified as low-risk during their pregnancy.
The key is working with a care team experienced in water birth and having open conversations about what is best for you and your baby.
Who Is a Good Candidate for Water Birth?
Water birth is generally recommended for those with low-risk pregnancies, meaning there are no significant complications for the parent or the baby. Water birth may not be advised if you have:
A fever over 100.4°F (38.0°C)
Less than 37 weeks of gestation
Abnormal vaginal bleeding
Abnormal or fetal heart tones
Active Herpes lesion, Hepatitis B/C, or HIV+
Certain medications or medical conditions (e.g., hypertension)
Limited mobility or need for continuous monitoring
Receiving sedative medication an hour or less before entering the water
This is not a complete list of contraindications. It’s important to review your full medical history and birthing preferences with your provider to make the best and safest informed decision.
Questions to Ask Birthing Facilities
If water birth sounds like the right path for you, the next step is to find a supportive birthing location.
Not all hospitals or birth facilities offer water birth as a standard option, especially if you're planning to birth in a traditional hospital setting.
Here are some helpful questions to ask when touring facilities or meeting with care providers:
Do you support water birth in your facility?
Are tubs available in all labor rooms?
If not, can I request a tub room upon admission?
Am I allowed to labor in water if my water has already broken?
Do you use wireless fetal monitors?
Are they waterproof?
What criteria might make me ineligible for water birth?
Is your clinical staff trained in supporting water births?
Do all providers in your practice allow water births?
For those in the Triangle Area of North Carolina, it’s worth noting that no hospitals allow full water births, even if tubs are present. However, Birth Centers, such as the North Carolina Birth Center in Chapel Hill, are an example of facilities that routinely offer water birth as a standard of care. North Carolina has hospitals outside the Triangle Area that may offer water birth options.
Common Myths - Debunked
Let’s clear up some common misconceptions you might hear about water birth:
“The baby could drown.”
Babies don’t take their first breath until after being exposed to air. They continue to receive oxygen from the umbilical cord which is still connected to the placenta. Once a baby is removed from the water, they should never be resubmerged.
“There’s a higher risk of infection.”
Research shows no increase in infection rates compared to land birth for either parent or baby when standard hygiene practices are followed.
“The water could be too hot or cold for the baby.”
Water temperature is closely monitored hourly throughout labor, typically kept between 97–100°F to ensure comfort and safety. The temperature is monitored by clinic staff using a thermometer.
“It’s unsafe for me and the baby.”
In fact, water birth has been linked to lower rates of complications, including postpartum hemorrhage and respiratory issues for babies.
Final Thoughts
Water birth is an option available at the North Carolina Birth Center for those clients interested in exploring its benefits. The most important thing when laboring is that you feel safe, informed, and supported in your birth experience, and opting to use hydrotherapy for some part of your labor is a way to reach those goals.
For many families, water birth offers a calm, empowering, and deeply connected way to bring their baby into the world. With thoughtful planning and the right team by your side, it can be a beautiful option worth considering.
Knowledge and information are the keys to finding the right choice for your body, your baby, and your journey. Trust your wisdom, strength, and intuition during this profound time of preparation.
