What's New in Waterbirth

With more mothers-to-be discovering its soothing approach and many benefits, Waterbirthing is one of today’s most fashionable birthing methods.

Imagine coming home after a trying day, climbing into a tub and letting the hot water melt away your stress and pain. Apply this idea to labor and delivery and you have waterbirth.

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"The more relaxed one can be in labor, the less pain there is going to be,” says Susanna Napierala, a licensed midwife and author of Waterbirth: A Midwife’s Perspective.

Women from native cultures knew this. They labored and delivered in warm tidal pools, hot springs and other water sources centuries before “civilized” societies discovered waterbirth. Waterbirths came to the United States 22 years ago, but took place mostly in home births and birthing centers.

"It’s becoming more and more popular," Napierala says. "Women are realizing it is an alternative to drugs during labor."

Waterbirth's Growing Popularity

Barbara Harper, RN, founder and director of Waterbirth International Resource and Referral Service, a project of the nonprofit Global Maternal/Child Health Association, says her organization fields 50,000 e-mail inquiries and 700 phone calls a month. "Our prime directive is to make waterbirth available as an option for all women in all birth settings by 2015."

The organization is well on its way to that goal: Nearly 250 American hospitals and 70 percent of all birth centers now support waterbirth, compared to two hospitals and a few birth centers in 1991.

The Women’s Health and Birth Center in Santa Rosa, Calif., has seen its business grow by 20 percent in 2002, in large part to parents interested in waterbirth. This year, 60 percent of the center’s patients gave birth in the water, up from 20 percent a decade ago.

How Waterbirth Works

During waterbirth, a tub is filled with water between 95 and 100 degrees that’s clean enough to drink. Birthing tubs, now available for rent or sale online, should be deep enough for the birthing mother, the midwife or doula, and a spouse to sit in comfortably. Napierala says she tracks the unborn baby with waterproof monitoring equipment, and will bring the woman out of the water at the first sign of trouble.


Advocates say waterbirth babies benefit by transitioning from amniotic fluid to warm water, instead of exiting the womb into cold air.

“The baby’s face is brought up immediately and the rest of the baby can just relax in the water if all is going well,” Napierala says.

Fears of newborns drowning in birthing tubs are unfounded, Harper says. During birth, the baby receives oxygen through the umbilical cord as it has for the previous nine months. The newborn will only start breathing air when exposed to temperature and air pressure changes.


“It is physiologically impossible for a newborn to breathe until up in the air,” she says.

What Mainstream Medicine Says

The American Academy of Obstetricians and Gynecologists’ (ACOG) Committee on Obstetric Practice indicates that there is insufficient data, especially concerning rates of infection, to render an opinion on whether warm-water immersion is a safe birthing alternative. The committee asserts that this procedure should be performed only if the facility can be compliant with Occupational Safety and Health Administration (OSHA) standards regarding infection.

For Amy Welp, learning about waterbirth’s pain reduction and relaxation benefits clinched her decision to have a second child. She and her husband rented a birthing tub that was 3 feet high and 4 feet in diameter.

"It relaxed me enough that I wasn’t fighting against the labor," Welp says. "The warmth of the tub, the even pressure of the water and the weightlessness, the freedom of being able to move any way I wanted, that was a big help. Every part of my body was supported."

Two hours after getting into the tub, and with her midwife by her side, daughter Lily was born. "Two pushes and she was out," Welp says. "It's an amazing difference."