Approximately 10% of women in the UK give birth in pools, and around 20% use water for pain relief (National Childbirth Trust, 2024). The National Institute for Health and Care Excellence (2023) guidelines state that all women should be offered the opportunity to labour in water for pain relief.
Water births gained popularity in the 1990s; in fact, I was born in a birthing pool myself. The National Childbirth Trust (2024) highlights that the benefits of water births include that women report feeling more relaxed, involved in decision making and in control. Women who are immersed in water also use less epidural or spinal pain relief (National Childbirth Trust, 2024).
However, although water immersion in labour is generally considered safe, there have been concerns around remaining in water for second-stage labour and birth, with some case studies reporting adverse neonatal outcomes, such as water inhalation and sepsis (Vanderlaan and Hall, 2020). There is mixed evidence concerning the effect of a water birth on tearing or episiotomy and isolated cases of newborn infections have been reported, although this risk is mitigated by effective cleaning and pool management protocols (National Childbirth Trust, 2024). Generally, there is a lack of high-quality research on water birth (Vidiri et al, 2022).
Sanders et al (2024) conducted a cohort study in the UK to explore whether water birth was as safe for women and their babies as being immersed during labour and then leaving the water before birth. The study was carried out by a team of researchers from Cardiff University, and published in the British Journal of Gynaecology and Obstetrics. It focused on the water births of women without antenatal/intrapartum risk factors or birth complications. Having examined the records from 73 229 women across 26 NHS maternity services, the study concluded that having a water birth was not associated with increased risk of adverse primary maternal or neonatal outcomes (Sanders et al, 2024).
As Professor Peter Brocklehurst, who was part of the study team, commented, the study's findings ‘will have implications for thousands of women a year in the UK and many more around the world’ (Cardiff University, 2024). Hopefully, this study is an important step towards providing women with the evidence to support their choice for a water birth.