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Water birth—where a person gives birth in a tub or pool of warm water—has long been promoted for its calming, low-intervention approach to labor. But how safe is it really, for both the birthing parent and the baby? A new systematic review and meta-analysis1 brings much-needed clarity to this topic by compiling data from dozens of studies worldwide.
The Study at a Glance
This meta-analysis covered 52 articles that were included in the meta-analyses, comparing outcomes between:
- Water births (where the baby is delivered in water)
- Land births (where labor may begin in water but birth occurs out of the water)
The goal? To evaluate maternal and neonatal safety, and determine if water birth offers meaningful benefits—or risks. The aim of this review was to analyze deliveries that occurred while the patient was submerged in water during the second stage of labor. Therefore, studies that only focused on water immersion during the first stage of labor or the second stage without water birth were not included.
Key Findings: Maternal Outcomes
✅ Water birth was not associated with increased probability of maternal infection compared with land birth
✅ Patients undergoing water birth had decreased odds of postpartum hemorrhage
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Key Findings: Neonatal Outcomes
✅ Neonates delivered while submerged in water had decreased odds of ,
- Low Apgar scores
- Neonatal aspiration requiring resuscitation
- Neonatal infection
- NICU admissions
❗ Neonates delivered while submerged in water had increased odds of cord avulsion
Understanding the Reduced Risk of Neonatal Infection in Water Births
The lower incidence of neonatal infection following water birth may be attributed to a combination of environmental, clinical, and procedural factors:
- Cleaner Birth Environment: Water births involve rigorous sanitation protocols for tubs and pools, often resulting in a birthing environment with no higher bacterial presence than land births.
- Improved Maternal Hygiene: Immersion in warm water may enhance maternal hygiene during labor, reducing the risk of bacterial transmission to the newborn.
- Shorter Labor Duration: Water birth is associated with shorter labor and reduced time in the birth canal, limiting the newborn’s exposure to potential pathogens.
- Midwifery-Led Care: Water births often occur at home or in birthing centers where continuous one-on-one midwifery support allows for early detection and management of complications, contributing to better outcomes.
- Fewer Interventions: The non-invasive nature of water birth—typically with lower rates of episiotomies, forceps, or vacuum use—further minimizes opportunities for infection.
What This Means for Families and Providers
This comprehensive study supports the idea that water birth is a safe option for healthy, low-risk pregnancies when managed by trained professionals and conducted in appropriate settings.
It shows that water birth can offer:
- Greater comfort
- Reduced medical interventions
- Comparable safety for babies
Cautions and Considerations
Water birth may not be recommended in all situations. It’s not suitable for high-risk pregnancies or when complications arise. Medical oversight and adherence to evidence-based protocols are essential.
Healthcare providers should ensure:
- Water temperature is monitored
- Infection control procedures are followed
- Emergency protocols are in place
Read the full article here.
Content
- Water birth: a systematic review and meta-analysis of maternal and neonatal outcomes
McKinney, Jordan A. et al.
American Journal of Obstetrics & Gynecology, Volume 230, Issue 3, S961 - S979.e33
Disclaimer: This blog's content is provided for informational purposes only, and does not intend to substitute professional medical advice, diagnosis, or treatment and you should not rely solely on this information. Always consult a professional in the area for your particular needs and circumstances prior to making any professional, legal, medical and financial or tax-related decisions.
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