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Water Birthing

Three Ways of Using Aquatherapy in Labor

Water birthing is growing in popularity. Discover 3 methods of using aquatherapy for your labor. Evaluate research on women's response to laboring and birthing in water.

99% of women who used water birth rated it as effective. Aquatherapy was the second most popular comfort technique rated by pregnant women in childbirth class for what they wanted in their labor.

Although it is rated as a highly effective method by women, one study indicated only 8% of women used it. Once they get to the hospital, hospital routines often take over the management of labor, and they don't get to take full advantage of aquatherapy.

Aquatherapy is simply the use of water. We are all familiar with the pleasure of a relaxing bath. Others may prefer the sound and steady rhythm of a shower.

So what is best during labor? Each mother should listen to the signals of her own body to determine when she might prefer to let the water fall over her, or submerge herself in it. Here are some general guidelines.


The shower enhances the birth process by having an open pelvic outlet, allowing gravity to assist the anterior direction if the woman leans forward, and allowing for movement in labor. Running water over the nipples can cause release of natural oxytocin, also having a labor-promoting effect. The sound of the water is also relaxing to many women. The shower is often recommended for early labor as the relaxing effect aids the establishment of an active labor pattern.


Immersion in water enhances relaxation like nothing else. It produces what some have termed, “the ahhh effect.” Many mothers who seem skeptical about getting out of bed visibly relax once submerged.

Some recommend that a mother not stay in the water for extended periods of time until at least six centimeters dilated. Simpson's 2004 study indicated that if a mother stays submerged for longer than 2 hours in the early phase, labor may slow down. If someone desires to get into a tub before the active labor pattern has been established, there is no problem of intermittently going in and out of the tub.

Cluett and Pickering's study of women with labor dystocia showed that those who used water immersion had a lower rate of augmentation than those who did not use water. Thoni's 2004 study indicated there were no cases of pitocin augmentation with waterbirth.

Burke and Kilfoyle's 1995 study reported that 100% of women who labored underwater stated the water made the contractions easier to deal with. Birth pools are much better than tubs for labor. To have maximum effect, the pool should be large enough to cover the mother’s abdomen with the water level going up to her arm pits. Some birth places have installed Jacuzzis and tubs, which do not allow for complete immersion unless the woman lies down on her back in the tub--a rather uncomfortable position in labor.

In fact, if it is just a bath tub, most women do not stay in it for much time because it has a confining effect. A birth tub should not only cover the abdomen, but also allow for change of positions like kneeling, squatting, and all fours.

Water birth

Over the last decade, the interest in water birthing has grown. Research with thousands of water births has shown no difference in the rate of infections or hypoxia with water birth. While some studies have shown the same Apgar for both waterbirths and landbirths, others have shown higher Apgar scores for water births. In addition to the reduction in pitocin augmentation already mentioned, there is also a significant reduction in episiotomies, lacerations, maternal blood loss, and the use of pain medications for women laboring underwater.

Some have wondered if the baby might drown when he takes his first breath. This will not happen because the infant will not take the first breath until air touches his or her face.

Advocates for water birthing do caution that labor best unfolds without a woman deciding in advance she WILL give birth underwater, and the most satisfying underwater deliveries occur when a laboring woman in water decides she is so comfortable in that position she doesn’t want to change.

Preparing for Your Birth

Ask what facilities are available for aquatherapy in labor. Most birth environments have tubs, showers, or both.

If you are interested in water birthing, ask what their policy is regarding birth in water. Many hospitals that advertize birth tubs and jacuzzis may not allow women to stay in them past a particular point in labor.

You may purchase or rent birth pools which can be set up in homes, hospitals, or birth centers. It is generally cheaper to rent than buy. Many communities have local birth organizations that may rent them for a reasonable fee.

More Information On Water Birthing

Barbara Harper has been a national leader in promoting aquatherapy and waterbirth. You can read more about water birth in her book "Gentle Birth Choices."

Barbara's website at Waterbirth International has a list of resources for those interested in water birthing.

Return from Water Birthing to the Better Childbirth Outcomes HOME PAGE.




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By Karen Newell Copyright 2011 - 2012 Better Childbirth Outcomes - All Rights Reserved
Camp Hill, Pennsylvania, USA