What are some advantages of a water birth?

Patients of the Nurse-Midwifery practice at Ohio State have the unique option of using hydrotherapy for labor and birth.

Hydrotherapy is the use of water during labor, and water birth refers to delivering in a pool of warm water. It's believed to be a gentle birth experience for the baby, and it can provide excellent pain relief for the patient.

People have been laboring and giving birth in water for centuries. Today in the United States, water births occur at home, in birthing centers and, less frequently, in hospitals. In Ohio, several hospital systems offer hydrotherapy for labor and water birth, but in Franklin County, Ohio State is the only hospital where water births are performed.

These deliveries occur in regular labor rooms. Portable, soft-sided birthing pools (about three times as large as a standard bathtub) are set up for patients in labor. There are strict criteria that patients must meet in order to have access to use of the pools. For example, they must have a normal pregnancy without complications such as diabetes or high blood pressure.

The benefits of water birth are mainly for the birth parent’s experience and include:

• Reduced desire for anesthesia
• Less risk of vaginal tearing
• Shortened labor duration because of relaxation
• Higher reported patient satisfaction

Here’s how it works: The pools are partially filled with water kept at human body temperature — 98.6-100 degrees. It is not a “hot tub.” These pools have disposable liners that decrease the risk of infection and eliminate cross-contamination. Water-proof monitoring also can be used during hydrotherapy. Unlike a normal bath, you can’t add essential oils or bubbles.

Before entering the pool, the patient must be in active labor, or roughly six centimeters dilated, and the baby must have a healthy heart rate. Some laboring patients choose to get in and out of the pool during labor.

Some choose not to stay in the pool for birth or may opt for other pain relief options, like an epidural.

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What are the potential risks? Although rare, risks include:

• Birthing parent or baby could get an infection from bacteria in the tub
• The umbilical cord could detach
• Baby’s body temperature could be too high or too low
• Baby could swallow bath water
• The birthing parent could have increased bleeding after delivery

A patient can consider using hydrotherapy for labor or a water birth at any time during their pregnancy, but it’s usually discussed during the third trimester. Water births shouldn't be considered if the baby is premature or in the breech position, or if the birthing parent has preeclampsia, diabetes or an infection such as herpes, which can spread in water.

At Ohio State, only midwives offer water labor and birth, and our midwifery team delivers babies only at the Ohio State Maternity Center. This ensures that patients have quick access to care in the event a complication arises during delivery. All of Ohio State’s midwives are nurses with advanced training and master’s degrees.

Midwives take a more holistic approach to pregnancy and delivery. Studies show that patients who choose a midwife for care might experience fewer interventions, including cesarean sections and episiotomies; fewer hospitalizations during pregnancy; and feel more empowered during childbirth. Water birth can add to positive birth experiences.

In addition to supporting pregnant patients throughout pregnancy and delivery, midwives provide care during other phases of life, providing regular gynecological exams, pap smears, contraception and preventive care.