Even if you know someone who has had a waterbirth, or have done some research on your own, the very idea of birthing underwater may seem strange or even dangerous. However, in reality, waterbirth provides great benefits to both mother and child and is a safe option for women to explore and experience. When you’re physically or mentally stressed, do you like to visit the spa, or soak in a warm bath? Laboring in water offers many of the same relaxation benefits that these simple pleasures afford, during an event that is often considered the most physically taxing a woman may ever experience. However, being immersed in warm water offers benefits far beyond relaxation during labor. Water’s release of gravity allows a laboring woman the ability to move into positions that would not be possible on land. The sense of weightlessness itself can be a huge relief, which may feel especially liberating following the later months of pregnancy. Physiologically, immersion in water can also help tissues soften, promote dilation and facilitate progression of later stages of labor. Often, waterbirth promotes an overall peaceful state in which a woman is less likely to be stressed, allowing for natural pain-relieving hormones, called endorphins, to be released, assisting in the progression of labor.


Many have called waterbirth the “aqua dural,” comparing the pain relief of immersion in warm water to having a shot of Demerol. The Gate Theory of Pain proposes that the stimulation of surface nerves, such as touch and temperature, can block impulses that simultaneously come from deeper pain nerves. Based on the experience of women during waterbirth, the sensation of warmth and buoyancy offered by being in the tub appears to lessen the intensity of deeper pain that occurs during labor. While relaxing, feeling weightless, releasing natural endorphins and having less pain sounds wonderful, what about the safety and experience of the baby who is being born? Care providers are trained in reading these signals and remain constantly aware of any stressors that may occur. 


Below are the answers to the most frequently asked questions: 


Isn’t it dangerous for the baby to be underwater? No. Babies have been growing in a watery environment all along. For a baby, being underwater is a normal condition, and there are several physiological factors that prevent babies from swallowing water at the time of birth. Babies naturally have a “Dive Reflex” that stays intact until their face has contact with air. When a newborn baby is fully submerged in water, the larynx instinctively closes when water passes by, and the liquid is swallowed rather than inhaled.


Do you hold the baby underwater? No. There’s no reason to keep the baby underwater, even though the placenta continues providing oxygen. Immediately following birth, baby is lifted to the surface and into mom’s waiting arms, almost always within the first 10 seconds following birth. How do you moniter the baby’s well being during waterbirth? Waterproof fetal dopplers are used throughout labor to monitor baby’s heart tones at regular intervals while mom remains in the tub.


How do you monitor baby’s well being during waterbirth? Waterproof fetal dopplers are used throughout labor to monitor the baby’s heart tones at regular intervals while mom remains in the tub


Is waterbirth sanitary? Birth itself is not a sterile procedure. Of course tubs have sterile liners and built-in tubs are disinfected between births, but there is no problem with mom’s or dad’s bacteria being introduced into the water. Baby’s exposure to household bacteria is actually important for proper colonization of the gut and respiratory tract during the birthing process. Bodily fluids and substances, diluted to such a degree in a tub, is not at all worrisome. 


Can you plan a waterbirth? You can certainly prepare yourself to have a waterbirth. Get in touch with a local midwifery practice or birth center, and check with local hospitals regarding their policies. Once you have found a trained care provider, secured a birthing tub or reserved a local birth center, and have taken an appropriate childbirth education class, you are as prepared as you can be to have a waterbirth. However, every woman should be aware that no birth plan comes with a guarantee. While in most cases a woman is able to labor and remain in the tub to birth her baby, under some circumstances a care provider may ask her to come out of the tub to give birth. 


Whether or not waterbirth calls to you, we encourage you to be open to the journey that birthing your child will offer. Find care providers and doulas who will empower you to move safely  and confidently through the territory of your labor and birth experience. Take the time to meet new people who are also expecting – finding a community to support you as you become a parent is vital! Most of all, give yourself space and time to be present to the wonder of growing a new life in your body, and be prepared to be transformed by the victory of giving birth to your child.

Demystifying Waterbirth

By Aleksandra Evanguelidi I LM, CPM;

Molly Jarchow I ND, LM; Stuart Fischbein I MD, OB/GYN


Aleksandra Evanguelidi LM, CPM, Clinical Director, Molly Jarchow, ND, LM, and Stuart Fischbein, MD, Ob/Gyn provide prenatal and birth care at The Sanctuary Birth & Family Wellness Center in Mar Vista, CA. Together with the Sanctuary Team they have attended thousands of births, many of them in water.