When you imagine your ideal birth, what does it look like? Maybe you see yourself in a hospital delivery room, planning a home birth, or even considering a water birth—at a hospital, a birth center, or at home. Many women are drawn to water birth because it allows immediate closeness with their baby after birth and, according to many experiences, may make labor feel less painful. In this guide, you’ll learn how water birth works, how to prepare, and the possible advantages and disadvantages.

How to Prepare for a Water Birth

Like any birth, a water birth requires preparation. It’s best to talk to your midwife early about your wish to give birth in water. If you plan to deliver at a birth center or hospital, make sure to register in advance and let them know about your preference. Many maternity wards also offer information evenings where you can learn more about the facilities and options available. If you’re planning a home birth, you’ll usually need to rent a birthing pool. It should be large enough, easy to enter, and meet proper hygiene standards. It’s also important to plan ahead for filling and draining the water. Don’t forget to consider the floor’s structural capacity, as a filled birthing pool can be very heavy—especially if you live in a rented apartment. You may also want to think about what you’d like to wear during the birth. Some women feel comfortable being naked, while others prefer a bikini top or a loose T-shirt to cover their upper body. As with many other birth methods, your partner can also be part of the experience. They can prepare as well and bring suitable clothing if they plan to enter the water.

Water Birth: What Happens During Labor

The big moment has arrived—your little explorer is ready, and you’re preparing for a unique experience. Birth is something special, and it’s important that both you and your baby feel safe and supported. You may already have thought about your wishes for labor and perhaps even written them down in a birth plan. Because warm water is often described as relaxing and pain-relieving, many parents choose water birth for this reason. Water births are possible in many hospitals, birth centers, and at home. It’s best to ask your chosen facility whether they offer water birth and whether your request can be accommodated. During labor, your midwife will primarily look after you and your baby, often together with doctors on site. They monitor your baby’s heartbeat and keep an eye on your contractions. Whenever you feel ready, you can step into the birthing tub. The water is typically kept between 32 and 37°C, which most women find comfortable during labor. Only a small number of women spend the entire birth in the water. If you enter the tub once the cervix is already about 3 to 5 centimeters dilated, the likelihood of your baby actually being born in the water is higher. Warm water acts like a natural relaxant and can ease labor pain. Many women experience this as very pleasant during birth. Some women choose to have an enema before labor begins to prevent stool from entering the water during birth. This is not required, but it can make some mothers feel more comfortable. Birthing tubs usually include supports and handles that allow you to move freely throughout the stages of labor. You can try different birth positions—semi-sitting, squatting, lying down, or on all fours—to find what feels best for you.

When Is a Water Birth an Option?

If you’re considering a water birth, it’s important to discuss it with your gynecologist and especially your midwife. If you have no serious pre-existing medical conditions, your pregnancy has been uncomplicated, and your baby is in a head-down position, a water birth may be a suitable option.

When a Water Birth May Not Be Recommended

In some situations, a water birth may not be advisable. These include complications during pregnancy such as gestosis, preeclampsia, or beta-hemolytic streptococci, certain pre-existing conditions such as HIV, hepatitis, or diabetes, labor before the 38th week of pregnancy, multiple births, breech position, weak fetal heart tones, the use of an epidural, or if your waters broke more than 12 to 18 hours ago. 

Advantages and Disadvantages of a Water Birth

Water birth is often described as a particularly gentle way to give birth. Warm water can help the mother relax, and many babies seem comfortable in the warm environment because it resembles the womb. However, before deciding, it’s important to weigh the pros and cons and discuss them with your midwife so you can make the choice that feels right for you.

Benefits of Water Birth

• Warm water can feel relaxing and help relieve pain during contractions.
• Some women need less pain medication.
• Buoyancy in the water can ease pressure on the back.
• The water may intensify contractions and potentially shorten labor.
• Tears and episiotomies may occur less often because the perineal tissue becomes more elastic in warm water.
• Skin-to-skin contact and the first breastfeeding attempt can often happen while still in the water.

Possible Disadvantages

• It can be more difficult for medical staff to intervene quickly in unexpected complications.
• Pain relief via epidural is not possible in the tub.
• Warm water can sometimes cause circulation problems.
  

Does a Water Birth Pose Risks for Your Baby?

Many expectant parents are interested in water birth but still worry about their baby’s safety. A common question is how long the baby is underwater and whether there are risks involved. The reassuring news is that the risk of infection during a water birth is not higher than during a birth outside the water. Parents also often worry that their baby could inhale water. However, babies are protected by the so-called diving reflex, also known as the breathing protection reflex. This reflex closes the airway while the baby is still underwater. In the meantime, your baby continues to receive oxygen through the umbilical cord. As soon as your baby reaches the air, they begin breathing normally. Birth is a natural process and can’t be planned exactly. It may unfold differently from what you imagined. Still, it is a unique and powerful experience. Whether your baby is born in water or on land, the most important thing is that both you and your little one are healthy and safe.