Home Waterbirth Tips

published 4 February 2021, updated 4 February 2021

A lot of freebirthers love to have waterbirths!

I was going to call this article "Top 10 tips" but it ended up being a lot more than 10! So here are all the best tips that we've compiled to help you plan your water birth!

Is Water birth right for you?
First tip, and most important in my opinion, is to decide if a water birth is right for you. This could save you a lot of time, energy, and money if you can create the right birth plan. Every woman and every birth is different. Some women are drawn to water, while others hate the thought of getting wet. Some women have precipitous labours too fast to fill a pool.
Remember, home birth is NOT synonymous with water birth. You do not have to birth in water if you don’t want to.
Also remember, water immersion in labour is different to a waterbirth - when the baby is actually born into water.
You can plan for water as a coping technique but still have a land birth. All options and feelings around water are valid, and none is “better” than another.

There are many benefits to water, and very few risks. It provides security and alleviates discomfort.

It is especially beneficial for a VBAC mother, or a woman who has previously had an epidural, as it gives you a solid (liquid haha!) alternative to medical pain relief. It provides a designated safe space, and knowing you won't get out until there is a baby in your arms, helps create the positive headspace of a focused labour.

If you decide you need to transfer to hospital or need to birth in hospital for a non emergent reason OR decide to have an assisted home birth with a midwife, having water immersion for labour or birth will dramatically increase your probability of respectful care, uninterrupted labour, and unmedicated birth. It will provide a degree of modesty, reduce interference, tearing, and c section rate, and ultimately promote a higher chance of a physiological birth.

Supplies

Here are some essentials and suggestions for things you’ll need or want at the birth 

• Standard home birth supply list (linked here)

• "Born in the water" onesie

• Pool (see options below)

• Food grade/drinking safe hose (white RV hose USA)

• Tap adapter (Faucet adapter for Americans)

• Liner

• Tarp or plastic sheet to protect the floor from water damage, or flannel backed tablecloth

• Tape, to secure the plastic/tarp to the floor

• Air pump if you want to save inflation time

• Towels, at least 5. Some for the floor, some for you, especially if you get in and out more than once.
  Tip: Dark coloured towels don’t show stains, and photograph better during the birth (but, all generally will wash out after.)

• Handtowel or towels for your face and the baby

• Floating thermometer 

• Step stool if the pool is large or you are short

• Cheap drain pump  

• Top/bra to wear (if planning to be clothed) that will be cute in photos, won’t hinder you or be see through once wet, and will be easy to take off to nurse baby

• Bucket or large pot, to bail water in and out

• Fairy lights to put between lining and pool for ambience 

• Mini Oasis pool for children to play

• Flashlight, for seeing baby under the water, especially in dim lighting

• Poop Scoop: Get a small fishy net for “floaties”. It happens. Enough said.

Options: Pool, bath, or something else?
Water births can be done extremely cheaply by simply filling up your bathtub.
Or you can spend a lot of money and buy a custom birth pool. You can also hire a pool instead of buying. If you are having a midwife or doula assisted birth, you may be able to rent yours from her.
In a perfect world, everyone would have access to a proper birth pool as these are sturdy, the right depth, and have handles, and a cushioned floor.

But you can easily make do with a few adjustments.

Some popular options are: 

• Built in: spas, (don’t use the spa feature) bath tub

• Portable: animal troughs

• Birth pools: La Bassine, Birth pool in a box

• Alternative: mini swimming pool, kiddie “fishy” pool,  

• Other: inflatable hot tub (It regulates water temp and no need to dump and fill water! You can set it up well ahead of time and even use it to relax in before labor.  You can use 1 cup of regular clorox bleach in the water a day. The bleach evaporates very quickly.  Take off top and let the bubbles run a little when labor begins to clear out any remaining chlorine.)

​

• Whichever you choose, make sure the sides are sturdy enough to hold the water and your weight. That any other comfort and space you require is taken into consideration 

Advance Preparation and Dry run 

It will really save you time and anxiety if you know how to set up your pool quickly and easily. This will be extremely beneficial in labour when you don’t want to be thinking about anything stressful, or having to be fixing something or sending someone to the shops.

Highly recommend reading: https://www.pregnancy.com.au/how-to-set-up-a-birth-pool/ 

• Have your pool in the house by 37 weeks.

• If you have a wooden floor make sure your floor can handle the weight of the water filled pool. Depending which you chose, a pool carries between 300-800 litres of water, which is 300-800 kilo in weight. With a good floor this should not be a problem but in some old or small houses it is worth checking this first.

• Time how long it takes to you fill the pool so you know when your support person should get it ready in labour

• It takes an average 5-15 minutes to inflate, and 20-40 mins to fill.

• Check all hose connections, length of hose, movement around the pool space etc

• PLEASE empty the pool after your trial run. It will grow bacteria after 24hrs and remain a drowning hazard for other children or pets if you leave it up until labour.

Heating methods

Keeping the water at a constant and warm temperature is a big component of a home water birth. Make sure you have a plan to keep it perfect for you.

• Turning the water heater up before filling the pool can help make sure you have enough hot water.

• If in the bath, it is simple to turn the tap on when you need more hot water.

• If using a traditional birth pool or fishy pool you need to be prepared to have someone willing and ready to take buckets of water out of the pool and add boiling water back in to keep water to temp.

• You can connect a hose directly to your hot tap or mixer tap.

• You can boil water on the stove or with instant kettles.

• Some people use a heating element or heater in the pool but you cannot do this with plastic inflatable pools (unless you find a safe way to suspend it). The element or boiling water will melt and damage the pool.

• You can fill the pool and put a cover on to retain heat if you need/want to fill it early in labour.

Lining
You can buy plastic or eco friendly single use pool liners. These allow the pool to be reused easily if buying for multiple use or if you’re renting.

• You can use a large clean, strong plastic sheet as an alternative. )example: 12ft square 2mil (thick and sturdy) painting drop cloth)

• Pool liners also work well to keep things dry if you are putting blankets or padding in a kiddie pool, or to keep the water clean if you are using a pool that isn’t very clean.

• They block the holes if using a spa so that you don’t need to clean the jets before or after.

• Put the liner in the pool, fill the pool 1/4 of the way up, then tape the liner all the way around the outside with duct tape to help hold it in place.

• After use, simply throw away!

When to get in
Knowing when to get in will help you get the most benefit out of the pool.

• Make sure you read up on the normal stages of labour and talk to other mums about what worked for them.

• Don't get in the tub as soon as labor starts. The warm water can actually stall early labor. Spend some time on your feet helping the babe into optimal birth position. 

• Some women get in when feeling "pushy" but for other women that may be too late if you are a multi parip or precipitous birther 

• In a long labour, you may find it beneficial to get in so you can rest then get out again to help baby move down, and then return to the water to birth

• Do what works for you!

Positioning and comfort

Water is soothing and relaxing. It takes the weight of your body while allowing you to move around easily. And the warmth dramatically reduces pain.

This is the main reason women choose waterbirth: pain relief.

To get the full benefit from utilising the water;

• The water needs to be at least 65cm deep. It needs to be able to adequately cover your belly. The water should ideally come up to under your breasts if you are sitting.

• It is wise to not stay longer than 2 hours in the bath without a break of 30 minutes or so. This gives optimal pain relief and the movement of getting out of the pool can help the baby move through the pelvis.

• If the pool will be set up in the living area or on a different floor than the bedroom, make a comfortable place in the same room as the pool for mother and baby to lie on. A good sofa or guest bed/mattress work fine. This way you can lie there and enjoy the baby after the birth instead of moving upstairs or to the bedroom. This can also be used if you need to birth the baby or the placenta outside of the water. Make sure it is protected well from bloodstains and covered well with an old sheet and plastic if needed. 

• Keep the water at a continuous 37c. Don’t overheat the water as it can put baby in distress or contribute to postpartum hemorrhage

• You can put pillows, blankets, foam pads, or other soft items at the bottom of the pool or over one side for padding, before the liner and water go in. This is especially beneficial in hard tubs like the horse troughs that have deeper water and are more uncomfortable than inflatable pools.

• If you would like someone to get in the water with you to catch the baby or support you in some way, make sure to choose a bigger pool option.

Assessing Bleeding

After the baby is born, it is common for the placenta to detach soon after birth.
This will cause your after birth postpartum bleeding to start. It is important to know what is normal.

•  Read about birthing the placenta, here

• When bleeding after birth, or passing the placenta in the pool (it happens, by choice or accident) the blood can be diluted and make it hard to accurately assess blood loss. 

• The water turning a light wine “blush” colour can be fine, but if it turns to merlot, that’s sign for concern. A hemorrhage should be treated quickly.

• When setting up the birth pool for your practice run, you could measure out cups of coloured water or animal blood to add to the pool or pour on puppy pads to get an idea. (these midwives used animal blood in a bath)

• Keep in mind when exiting the pool: leaving the warm water, and standing suddenly, especially after the exertion of labour, can contribute to symptoms of shock such as shivering and lightheadedness, so take your time, and lay down immediately after exiting, and keep warm to minimise these feelings. Consume warm, sweet fluids.

• Watch this video on estimating blood https://www.pregnancy.com.au/estimating-blood-loss-in-an-inflatable-birth-pool/ 

• Visual Images at bottom of page 
  
  

Considerations for baby

“People are giving birth underwater now. They say it’s less traumatic for the baby because it’s underwater. But it’s certainly more traumatic for the other people in the pool.” -  Elayne Boosler

Jokes aside, there are definitely some considerations you should take to keep the birth as calm and trauma free for your baby. 

• Babies usually come out head first. Don't freak out if the baby's head is out while under water. They haven't started using their lungs yet. The cord blood is still their source of oxygen. It can takes few minutes at times for the baby to come fully out.

• Swipe around the neck to check for a possible cord wrapped. If you find one you can usually gently unwrap it by hand. 

•  Baby cannot breathe while underwater. And thankfully, they are unlikely to try to breathe while still under. This is due to a reflex called the “dive reflex”. They should be brought to the surface reasonably quickly though, and especially if you see signs of them attempting to breathe. Once they are out of the water, do not resubmerge their face at all.

• The water should have a minimum depth of 18in/45cm so that as baby is being born, they remain completely submerged the whole time and don’t go in and out of the water, triggering the breathing reflex 

• Babies born in warm water can be very calm and sleepy at birth. Their transition into the world was a smooth one from warm body temp water to warm body temp water! They may take some rousing and rubbing on the back to get their first cry and breath going. When in doubt suck nose and mouth out and perform some ventilation breaths.

• It can be dangerous to have the water colder than 98° or hotter than 100°. (37.5c)
  Too hot can put baby in distress and too cold can prematurely trigger lung reflex to kick in. (Remember to get a water thermometer to keep track of water temp)

• Babies are SLIPPERY when first born! Especially in the water so hold on! 

• Keep the baby dry out of the water and make sure their blanket or towel stays dry, so baby stays warm. 

• Or, keep baby mostly submerged in the warm water (head out) and held on the mother’s warm body. The important thing either way is that baby stays warm!

 "It sounds like a good idea to wrap baby in a towel while still in the pool but it actually just makes them colder. I keep them dipped in the warm water with me until I birth the placenta. Also rub that vernix in!" - Deb, Freebirther

“What initiates the breath in the newborn? As soon as the newborn senses a change in the environment from the water into the air, a complex chain of chemical, hormonal and physical responses initiate the baby’s first breath. Water born babies are slower to initiate this response because their whole body is exposed to the air at the same time, not just the caput or head as in a dry birth. Many midwives report that water babies stay a little bit bluer longer, but their tone and alertness are just fine. It has even been suggested that water born babies be given the first APGAR scoring at one minute thirty seconds, not at one minute, because of this adjustment.” (SOURCE: Barbara Harper, water birth guru) 

Emptying and cleanup 

After the birth, once you are done with the pool, it’s time to empty it! This nay seem an underrated and thankless job once the excitement of the birth is over, but it’s an important and appreciated one. Remember to thank your birth support thoroughly!

• Take any photos immediately after birth if you can while the water is warm and clean, so you don’t have to come back and get in. 

• Designate someone to empty it while you rest and have your golden hour. Mother should never have to empty the pool

• You can use buckets, siphon, hose, or pump, depending on where your pool is located, and what works for you.

• The easiest way I've found to drain the pool is to put the submersible sump pump in the pool, and the other end of the hose waaaaay down the toilet. Wrap the hose around the rim of the toilet, and then shut the seat and lid, so the chances of it flying out are low. If there's another person there, they can hold it in place. Start the pump and pump the dirty water straight down the toilet. It will not overflow. Be sure to strain out any solids, including blood clots that are big enough to clog the pump or hose. Stop the pump when the water is low (the motor will burn out if the pump is out of water and running). Put the pump in the bucket for cleaning. Gather up the liner with the remaining water, and carry it to the toilet. Cut a small hole in the watery part of the liner to drain the remaining water into the toilet, and then throw the empty liner away. -freebirthing midwife

• If you plan to ever use the hose or sump pump again, they'll need to disinfect it. You can do this by putting the pump in a bucket of water and bleach or a other disinfectant (eg. chlorhexidine)and running several buckets full of the solution through the pump and hose into the toilet, before running clear water through.

• Try to get it emptied and deflated quickly so children won’t get in and it doesn’t remain a drowning hazard.

​

Waterbirth!

Congratulations on choosing a home waterbirth as the way you bring your baby into the world! It is my hope for you that when it comes time, your birth will unfold however it needs to for you to have a safe, perfect and empowering birth, and a happy and contented baby.
May the water relax and soothe you, and carry you warmly through from maidenhood to motherhood.

​

​

(Click on images below to view full images)