Should You Make Water Labor Part of Your Birth Plan?

Do you long to have your baby without medicatio­n and an array of beeping medical equipment in the room? If so, water labor may seem like an appealing option.

Some women find it to be more comfortable, while helping labor progress naturally — especially if they’re planning for a drug-free birth.

How does water labor work?

Water labor is exactly what it sounds like: You’ll go through some or all of your active labor in a clean, warm tub.

This option is typically best for healthy women with uncomplicated pregnancies who don’t want medication during labor. Some hospitals have rooms designed for this.

One of Cleveland Clinic’s birthing sites offers rooms with large tubs that are drained and refilled to maintain a constant, comfortable water temperature. A handheld shower head can help ease sore stomach and back muscles and promote relaxation.

Potential upsides of a water labor

1. Helps manage anxiety and fear. Feeling more comfortable and confident is an important benefit for many women. “That’s good, because 99 percent of labor happens between a woman’s ears,” says certified nurse midwife Sue Hudson, CNM.
2. Reduces the need for medication. Labor tends to progress more smoothly, so you’re less likely to need medications to move it along. “For a woman who is really attempting natural childbirth, they find that it ameliorates pain significantly and is helpful for avoiding an epidural,” Hudson says.
3. Reduces costs. Much of the cost of a birth comes from medication (such as epidurals that block pain) and the care associated with it, Hudson says. Using a room with a tub can reduce the cost of labor by one-third compared with traditional rooms, she says.
4. Shortens hospital stay. “With water labor there are lower C-section rates, the cost of care is less and length of stay is lower,” Hudson says. “Lots of moms who choose unmedicated labor are ready to go home within 24 hours.”

Are you a good candidate?

If you want to deliver your baby without medication and you’re expecting a traditional (low-intervention) birth, you could consider water labor. Hudson says it’s typically an option for women who:

• Are only having one baby.
• Had good prenatal care.
• Have a baby facing head down.
• Go into labor between 37 and 42 weeks.

It’s even an option for women who have had a C-section, have (well-controlled) diabetes or may need regular monitoring during labor, Hudson says. Newer technology such as wireless monitoring systems or telemetry is available in some locations, she notes.

Who is not a good candidate?

Water labor is likely not a good option for those who have:

• An eating disorder.
• Uncontrolled hypertension.
• Uncontrolled diabetes.
• An active drug problem.
• Little or no prenatal care.
• Hepatitis.
• A high-risk pregnancy.

What about water delivery?

While many hospitals around the country offer women the opportunity to labor in water, actually delivering in water is a slightly more controversial topic.

Many hospitals no longer offer water delivery. In 2016, the American Academy of Pediatrics and American College of Obstetrics and Gynecology issued a joint statement saying that water birth is an experimental procedure and that they felt there was little evidence that it improves delivery. In fact, they stated, it may increase the risk of infection.

The organizations say water delivery can increase the risk of umbilical cord damage and make it difficult to regulate a newborn’s temperature. They also suggest that there is a risk of respiratory distress or asphyxia if a baby inhales tub water during delivery.

Hudson says water delivery can be safe and effective for many mothers. Cleveland Clinic, she says, is working on protocols to re-initiate the practice in its birthing center. If you are considering a water labor or delivery, consult with your midwife or physician about your options, she advises.