Water Birth | Center for Women's Health (2024)

OHSU was the first hospital in Portland to offer water birth, an option that offers many women relief. You’ll find:

  • Certified nurse-midwives with more than 20 years of water birth experience.
  • An excellent safety record and high levels of patient satisfaction.
  • Access to the resources and expert doctors at OHSU, Oregon’s top hospital, if needed.

What is water birth?

Water birth is the process of laboring and/or giving birth in a tub of warm water. Many women find that sitting or floating in water during labor helps them relax and manage pain. Some women choose to give birth in the water. Others only labor in the tub.

At OHSU, water birth is an option only if you choose delivery with our highly skilled nurse-midwives.

Complete care

  • We follow rigorous guidelines to prevent infection.
  • We use monitors that work underwater to track your baby’s heart rate.
  • We are family-friendly and welcome your partner and doula.

What to expect at OHSU

If you have chosen water birth with a nurse-midwife, a freestanding tub will be set up in your private birthing suite.

The tubs have a soft floor, high soft sides and a built-in seat. Water is kept warm. The tubsoffer plenty of space for your partner. Every birthing suite also has a jetted tub and shower to help you manage labor pain.

Water Birth | Center for Women's Health (1)

Water birth videos

These videos are required viewing if you plan to labor or give birth in the tub. Watch to learn about:

  • The benefits of being in water for labor and/or birth
  • The guidelines for use of the tub
  • Safety issues

Water immersion: Watch this video if you plan to labor in the tub, even if you don’t plan to give birth there.

Water birth: Watch this video if you plan to give birth in the tub.

Water birth benefits

Experts agree that laboring in water is safe and offers benefits. They disagree on whether there’s enough evidence that giving birth in water is safe.

  • The American College of Obstetricians and Gynecologists recommends against water birth until there’s more data.
  • Other experts, though, say studies already show that water birth with a trained professional is no riskier than a traditional birth.
  • You can have the benefits of laboring in water even if you decide not to give birth in the water.
  • Many risks of immersion and water birth — such as slips, falls and dehydration — are easy for your nurse-midwife to manage.

At OHSU, we’re committed to helping you understand the research so you can choose the best option for you. We’ve been doing water births with excellent patient outcomes since 1997. Find links to more information in our “Learn more” section below.

Benefits of laboring in water

  • A positive birth experience: Women who have labored or given birth in water say they had less pain and a greater sense of control.
  • Less pain medication: Some studies show that women who labor in water need less pain medication and may have a shorter first stage of labor.
  • Relaxation: Floating in water can be soothing for many women. Your muscles don’t have to work as hard to support you. You can change position more easily. Being relaxed lowers stress hormones. This can give you a sense of reduced pain, and it may help your labor along.
  • Improved blood flow: Soaking in warm water up to your shoulders can reduce your blood pressure. Better blood flow may protect your baby against stress during labor.
  • Comfortable temperature: Being in water heated to your body temperature can help keep you from becoming chilled or overheated.

Possible benefits of giving birth in water

  • Shorter pushing stage: More research is needed, but some women report that being in water shortens the pushing stage of labor.
  • Fewer episiotomies: Giving birth in water may mean you’re less likely to need a surgical cut to enlarge the opening of your vagin*. More research is needed, though.

Water birth safety concerns

Will the baby try to breathe underwater?

Healthy babies begin to breathe only when they feel air on their mouth and nose. They do not try to breathe underwater.

Our nurse-midwives will make sure that you have your bottom and hips completely underwater when your baby is born. This prevents your baby from trying to take a breath. We lift your baby gently to the surface within seconds of being born. Then the baby starts breathing safely.

How will you know if the baby is stressed?

A change in your baby’s heart rate can be a sign of difficulty coping with labor. All babies are monitored during active labor with a waterproof Doppler.

For water births, we use a Doppler (like the fetal heart tones device used in prenatal care to check the baby’s heart rate) or continuous electronic heart rate monitors. If we see signs that your baby is having a problem, we will have you leave the tub.

What if the umbilical cord tears or tangles?

If the cord tears, the baby could lose blood. Your nurse-midwife will be careful not to tug the cord as she lifts your baby out of the water.

If the umbilical cord is wrapped around the baby’s neck during birth, we may have to unwrap it or move the baby through it. We may ask you to change position or stand up.

How do you prevent infection?

Infection can come from two sources:

  • Germs you carry into the pool
  • Germs in the tub or water

Our safety precautions include:

  • Our tubs contain chlorinated city water. During birth, you may lose fluid from your bag of waters, or pass urine, blood or stool into the tub. Research shows that most germs do not live long in chlorinated water.
  • We use a new tub liner and hose for each patient.
  • Tubs are cleaned with special products after each use.
  • Your nurse-midwife will wear gloves to prevent cross-infection.

Water birth FAQ

Does water birth cost extra?

There is no extra cost to use the water birth tub.

How do I arrange a water birth?

You must be a patient of OHSU’s nurse-midwifery practice to have a water birth with us.

To make an appointment with a nurse-midwife, please call the OHSU Center for Women’s Health at 503-418-4500.

Can anyone have a water birth?

To be approved for a water birth, you need to have a normal, low-risk pregnancy.

This means:

  • You have not had a C-section.
  • You are carrying one baby.
  • You are at least 37 weeks pregnant when you go into labor.
  • You have no sign of high blood pressure or gestational diabetes.
  • Your baby is in a head-down position (not breech or transverse).
  • You and your baby have no other health problems.

If you qualify for a water birth, you will need to:

  • Watch our water immersion and water birth videos. (See above.)
  • Have a hepatitis C test.
  • Sign a consent form. This includes agreeing to get out of the tub if your nurse-midwife asks.

How long are babies in the water after birth?

The nurse-midwife will lift the baby out of the water 5 or 10 seconds after birth. She will make sure not to tug on the cord, and she will untangle it if necessary. She may ask you to change position or stand up.

When do babies start to breathe?

As soon as the baby is out of the water, you will hold your baby skin-to-skin to keep the baby warm and to promote breathing.

What happens if there’s a problem?

You will come out of the tub. Any problem for you or the baby will be handled the same way as with a traditional labor. When needed, all labor and delivery patients at OHSU have fast access to:

  • Monitors
  • Medications
  • Anesthesiologists
  • Childbirth specialists
  • Newborn specialists
  • A state-of-the-art NICU (neonatal intensive care unit)

What is the water temperature?

We keep the water temperature close to your body temperature, about 98 degrees. This makes sure that your baby doesn’t get overheated. We encourage you to drink plenty of clear fluids to stay hydrated and comfortable.

When do I get in the tub?

Experts recommend that you get in the tub when your cervix is at least 4 centimeters dilated. Some research suggests that getting in earlier may slow labor.

If your labor slows while you’re in the tub, it’s a good idea to get out and walk around for 30 minutes or so.

Can my partner be in the tub?

Yes. Your partner should bring a swimsuit.

Learn more

Water Birth | Center for Women's Health (2024)


Why don't hospitals allow water births? ›

The American College of Obstetricians and Gynecologists (ACOG) says that while water may provide some benefits in the first stage of labor, there isn't evidence yet to support benefits for the baby. So, while ACOG says it's okay to labor in water, they recommend “delivering on land.”

Is it better to have a water birth yes or no? ›

Waterbirth is extremely safe and evidence from numerous studies have confirmed the many advantages of giving birth in water, for both mothers and babies.

Why are water births less painful? ›

The advantages of immersion in water during labour and/or birth include reduced pain, increased functional diameter of the true pelvis, increased quality of contractions, increased release of endorphins, decreased need for opiates, increased movement for the mother as well as improved positioning in different stages of ...

Does waterbirth prevent tearing? ›

Concluding message Overall water births were associated with less perineal tears. The reduced incidence of pelvic trauma in the hands-off group is encouraging and might be the way forward in all water births; however this needs to be employed with caution in spontaneous vagin*l deliveries.

How come babies don't drown in a water birth? ›

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.

What are the risks of a water birth? ›

Water Birth Risks

You or your baby could get an infection. The umbilical cord could snap before your baby comes out of the water. Your baby's body temperature could be too high or too low. Your baby could breathe in bath water.

Why can't you have an epidural with a water birth? ›

It's not possible to have an epidural in water. TENS is electrical stimulation so it's also incompatible with water births. As for what you can use in water, you can breathe a bit sigh of relief that entonox (gas and air) is fine for water births.

Are water births sanitary? ›

Experts agree that laboring in water is safe and offers benefits. They disagree on whether there's enough evidence that giving birth in water is safe. The American College of Obstetricians and Gynecologists recommends against water birth until there's more data.

Does insurance cover a water birth? ›

Is water birth covered by medical insurance? “Water birth, which is covered by insurance the same way traditional birthing options* are,” says Shatken-Stern, “are a great way to bring a bit more of control and natural relief to the birthing process.

What is the truth about water birth? ›

Laboring in a tub of warm water can help lower the mother's blood pressure, making for a calmer experience overall. It's important to note: labor pains are still present during the water birth process, but the environment is likely more relaxing and pleasurable.

Do water births increase risk of infection? ›

Overall rates of newborn infection do not differ between waterbirth and land birth (Bovbjerg et al. 2021). However, there have been reports of rare cases of newborn infection after waterbirth (Vanderlaan & Hall 2020).

Do you feel the ring of fire with a water birth? ›

As a repeat client of mine described her waterbirth experience: “My water birth was by far my favorite and easiest. There is just something about warm water and the relief it brings. Crowning had less of the “ring of fire” feeling than it usually does, but I feel that I was more aware of everything I was feeling…

Who would be a good candidate for a water birth? ›

If you are healthy, between 37 and 41 weeks in your pregnancy, your baby doesn't have any known fetal abnormalities that could put you or your child at risk (like placenta previa, for example), and you want to labor and/or give birth in water, you could be a good candidate for a midwife-attended water-birth.

Are water births expensive? ›

A water birth in a hospital setting may cost the same as a vagin*l birth. In many cases, most or part of a hospital birth is covered by your health insurance. Without insurance, a vagin*l birth at a hospital in the United States may cost anywhere between $5,000 and $10,000, though costs vary by location and facility.

Can you have a water birth in the hospital? ›

Some maternity units have birthing pools so you can go through labour in water. You may find this helps you to relax. If labour progresses normally, it may be possible to deliver the baby in the pool. Speak to your midwife about the advantages and disadvantages of a water birth.

Why water is not given during labor? ›

Strict rules on eating and drinking during labor began in 1946 with Dr. Curtis Mendelson. He wanted to avoid aspiration in pregnant people under general anesthesia by keeping them from eating or drinking during labor. This was a helpful discovery that prevented many deaths, so the rule became a medical precedent.

What are the problems with water birth? ›

Water Birth Risks

The umbilical cord could snap before your baby comes out of the water. Your baby's body temperature could be too high or too low. Your baby could breathe in bath water. Your baby could have seizures or not be able to breathe.

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