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Water birth is childbirth that occurs in water, usually a birthing pool. It may include the use of water for relaxation and pain relief during the first stage of labour, birth into water in the second stage of labour, and the delivery of the placenta in the third stage of labour.
Water birth may offer perineal support for the mother, and some theorize that this may decrease the risk of tearing and reduce the use of episiotomy. Evidence for this is not strong.
A 2014 review reported that water immersion during the first stage of labour can reduce the length of that stage, labour pain, and the use of epidural or spinal anaesthesia. It is also associated with a lower rate of cesarean delivery and stress urinary incontinence symptoms 42 days after delivery. The review reported that immersion during labour did not appear to increase the rate of infections for the mother or the baby, and Apgar score scores for the newborn infant were similar to those of conventional births.
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There is limited evidence for some of the purported benefits of waterbirth.
The original circular birth pool used by Michel Odent, the originator of the concept of birthing pools, at Pithiviers hospital in France in the early 1980s was in diameter and deep, large enough to comfortably accommodate two people. Modern birth pools are somewhat smaller, with a diameter between and at least , preferably , of water. (1993). 9780946551705, Gateway Books. ISBN 9780946551705
Approximately 10% of births in the UK take place in water, and approximately 20% of births include the use of water for pain relief. A cohort study carried out in the UK of 73,229 women concluded that there was no association with adverse fetal or maternal outcomes.
Health policy in England stipulates women should be given the opportunity to labour in water through the publication of Intrapartum care guidelines issued in 2007 by the National Institute for Health and Care Excellence (NICE). The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have jointly supported labour and birthing in water, and encourage hospitals to ensure birth pools are available to all women.
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In a 2005 commentary, the Committee on Fetus and Newborn of the American Academy of Pediatrics (AAP) released an analysis of the scientific literature regarding underwater births. The Committee noted several positive studies for underwater birth but went on to criticize them for lacking proper scientific controls, a significant number of infant deaths and diseases, and the general lack of information to support the use of water births.
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