published 1 August 2021

What? A home birther, freebirther, natural birther doesn’t believe in waterbirth?

Yup. 

I don’t.

I don’t believe in waterbirth.

I don’t think babies should be born into water.

BUT before you come for me, let me clarify! 

I do believe in water immersion in LABOUR.

Water for labour, good.

Waterbirth, bad.

Now that we’ve made that distinction, you might be thinking you’re following me a bit more.

Or you might still be completely confused.

Let me explain a little more.

Everything we do in birth is an intervention. Some are good, some are bad, some can be neutral, and some really depend on when and how they are used as to whether they are good for mother and baby or not.

Some interventions like episiotomies and synthetic oxytocin (Pitocin/Syntocinon) will always be bad in my opinion.

Some, like cesarean sections, or neonatal resuscitation can be crucially life saving when done at the right time.

Some, like Spinning Babies or having a doula/partner/wise woman/support person, are going to be neutral all the way to absolutely AWESOME when the woman wants them.

Where do I believe water immersion in labour fits? I consider it a neutral to awesome choice ( in fact I wrote a whole article about tips for waterbirth)

But I cannot get behind mothers being in the water while the baby is being born. The baby being born into water. I think the act of emergence should be done as a land birth.

Now, please remember, this is just my opinion. If you chose a waterbirth and loved it, that’s great. Or you even wanted to get out to push, but were physically unable, no biggie.

Everyone promotes the benefits of waterbirth/water immersion:

• Lowered pain while pushing

• Calm entrance for baby

• Warmth for mother and baby

• Less tearing and trauma to the vulva and perineum 

• Less chance of cesearean and episiotomies 

(however most of these studies were done in a hospital so birthing at home already lowers your risk for interventions a ton, regardless of water or land - if birthing in a hospital, definitely get in water for most, if not all of your labour, it has many, many benefits in an assisted and medicalised setting)

The reasons I don’t believe in waterbirth!

Now, the flip side, that most people don’t consider or promote. ( and some of these might not seem important enough to get out of the tub for but I present them anyway.)

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I don’t believe there are any benefits to the newborn for waterbirth, except those that occur indirectly from the mother if she has a calmer labour.

Newborn 

• The baby loses the benefits of the microbiome of the mother’s vaginal canal, washed off by the water

• Very rare chance that baby will start to breathe underwater and inhale water

• Moment of birth is hurried if baby needs to be passed straight to mother

• Bonding interrupted if the mother needs to be moved out of the pool

• Smell interrupted by the water, makes it harder for baby and mother to sniff each other, baby to snuffle for breast

• Baby can be cold and wet if the water temp wasn’t maintained well

• More likely to have shoulder dystocia because of position and lack of gravity

• In the case of shoulder dystocia, valuable time and positions are lost

• Water isn’t great for breech either since gravity is crucial. 
  (If you do breech water, Gail Tully recommends the best position for breech land birth is hands and knees or kneeling, but breech water birth requires semi sitting because if the mother is on hands and knees, the baby can get caught on the pelvis as the body floats out. In this case, it’s best to work with gravity and buoyancy. It is normal for a breech baby to pass meconium as he is birthed.)

• Born into mother's poop. A common piece of equipment in home water births is the “fishy net” for scooping out “floaties”. But even if you get all the lumps, there’s still lots of tiny particles in the water. And pushing is prime time for women to poop as baby’s head moves down.

• Chance for infection if birthing in a less than clean environment

• Chance of the cord snapping (this was fairly often, up to 3.1:1000 in the waterbirth studies but of course they didn’t have any comparison to land labour so I have no evidence based stats on that for you, the closest I could find quickly was 1:6000 births )

Mother

• Not biologically normal to water birth (where would you get heated water except for modern conveniences?)

• Birthing in your own poop. See note above under baby.  Poop.

• Moment of birth is hurried, the mother cannot have her important pause

• (Less likely to have severe tear) but more likely to have minor tearing, especially to the labia, in part I believe because the water washes away the natural lubrication right at the outside of the birth canal, vulva, and labia

• More likely to hemorrhage due to heat and relaxed uterus

• Hard to track postpartum bleeding in water

• Chance of infection, especially if the membranes have been ruptured for a while in labour

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Lots of this is just small things that add up, in my opinion, to a bunch of reasons why I don’t believe in waterbirth.

Personally, after baby is born, I would like to be warm, dry, and sniffing my micro-colonized baby, not dealing with wet towels and bleeding and stuff.

Ultimately I believe water is an intervention, and all interventions, even positive ones, should still be weighed and assessed for individual application.

I believe water births are *more* beneficial in the hospital because they reduce other interventions such as epidural, cervical checks, and for VBAC mamas, can be a physical way to help them keep a determined mindset.

At home in an already unhindered birth, the benefits may be much less.

So weigh up what works for you! Every mother should do what she feels is best for her at the time of birth.

Thanks for sticking with me on this opinionated jaunt! I know it’s a bit different from the usual tone I take in the how-to-freebirth posts I mainly write.

And I hope to see you around on Instagram or Facebook, where you can let me know what you think!

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