Water birth: what are the benefits? what are the risks?

During a water birth, the mother remains in the water not only during the pushing stage but also at the moment of the baby's birth[2]. The baby is then brought to the surface after birth. The placenta is subsequently delivered in or out of the water. It is a method ofnatural birth. 

Based on the available research, several benefits are associated with giving birth in water.

A better birth experience

On average, women who give birth in water report a better experience than those who give birth on land: 72% say they would choose this method again, compared to 8% in the second group [3]. Another study found that the majority of women described their waterbirth experience as positive and very enjoyable [4], in contrast to their previous births if it was not their first child.

Less pain experienced

Studies suggest that women who give birth in water experience less pain [5][6]. As a result, there is less need for analgesic medication [7], and almost no use of epidurals (0% in some studies) [8].

Less pain medication needed

An American study found that women who use a birthing pool rate water as effective for pain relief in 84% of cases (compared to 24% effectiveness for medication among those who received analgesics) [9].
Another benefit of labouring in water: it may help avoid the potential side effects of morphine-based medications (reduced maternal awareness, slowed breathing in the baby) [10].
Another interesting finding: women who give birth out of water report feeling less pain during pushing. However, those who give birth in water do not recall the pain afterwards, contributing to a very positive memory of the experience [11].

Possibly a shorter labour

A 2005 randomised study of 160 mothers found a reduction in total labour duration (50 minutes less!) for those who gave birth in water [12].

It is also possible to take a pregnancy supplement or a raspberry leaf infusion to support the body in the lead-up. 

Greater likelihood of a vaginal birth

In studies where women were randomly assigned to a waterbirth or a land birth, those in the water group had a higher likelihood of a vaginal delivery. In one study, for example, the vaginal birth rate was 94% in the waterbirth group versus 84% in the landbirth group [13].

Lower risk of episiotomy

Episiotomies cause more damage to mothers than a spontaneous tear, increasing the risk of long-term perineal injury [14]. In studies on the impact of episiotomies, researchers observed a significant reduction in episiotomy rates among women who had waterbirths (2 to 33 times lower risk!). Of course, it is more difficult for a healthcare professional to perform an episiotomy in water, which partly explains these figures.

Potentially lower risk of third- or fourth-degree perineal tearing

These tears are associated with issues such as faecal incontinence, long-term perineal pain, and pain during intercourse. Six observational studies found that these severe tears occur less frequently in waterbirths [15], while 3 found no significant difference. This reduction in risk is likely due to the fact that giving birth in water lowers episiotomy rates, and episiotomies can increase the risk of third- and fourth-degree tears [16].

Less blood loss

One review concluded that women who give birth in water lose less blood, or a similar amount, compared to those who give birth on land [17]. Another study found that women who gave birth on a birthing stool had twice the risk of postpartum haemorrhage than women who gave birth in water [18].

In some studies, researchers were able to show that babies born in water were less likely to be transferred for hospital care after birth, or in the first 6 weeks of life (3.4% versus 4.5%) [19]. But of course, water birth is only offered to mothers with low-risk pregnancies, and when the birth proceeds without complications…

It is difficult to observe benefits, but we can note an absence of risks. Studies have not been able to show an increased risk for babies during a water birth, even though there are only 4 studies on the subject [20]. Studies have not demonstrated a difference in the APGAR score (an assessment of a newborn's vitality based on empirical observation at the moment of birth) of newborns at birth after 5 minutes [21].

Studies do not allow us to say whether water birth brings benefits for babies. It is difficult to draw conclusions on this point, as midwives or doctors remove mothers from the water when the birth becomes complicated, thus leaving most "uncomplicated" births to take place there.

It can be difficult to observe or state with certainty that there are risks associated with water birth, as it is stopped as soon as any risks are suspected. 

Carrying out part or all of labour in water has had recognised benefits for some years now — both for pain relief and for shortening the first stage of labour. While giving birth in water was long considered controversial, studies have not found any increased risks for the baby.

Of course, studies are still limited, but it would appear that for low-risk births, the benefits of a water birth are noteworthy for mothers: fewer medications, giving birth without an epidural, fewer episiotomies, fewer severe tears, less blood loss, and a more positive and empowering experience for the mother.

And after giving birth, to support your recovery, you can turn to the best post-partum food supplement: collagen! It supports muscle recovery, helps maintain tissues and the body.