Think about how great it feels to be surrounded by warm water, whether in a hot tub, a bath, or natural hot springs. The caress of the water on the skin creates a release of endorphins, or nature’s anesthesia, which leaves one in a blissful, pain-free state of both mind and body. Water immersion during labor and water birth have the same effect and are excellent non-pharmacological option for pain-relief.

Having labored in water myself and attended many water births as a certified nurse-midwife, I can confidently state that all women I’ve known who have chosen water immersion were extremely satisfied with the results. As the current birthing culture is working towards reducing Cesarean and induction rates for low-risk women, water birth is a perfect tool to help achieve a low-intervention labor and birth. Additionally, women are empowered when offered a variety of choices for pain relief, both natural and medical, and water labor, at the very least, should be part of that menu.

Nitrous Oxide for Labor and Birth

Access to water immersion and water birth

Despite its positive effects, access to water birth in the United States is minimal. Many birth centers offer the option of water birth; yet, proportionally, few hospitals have tubs, and those that do often allow water immersion during labor only, not birth. A 2014 position statement by the American College of Obstetricians-Gynecologists and the American Academy of Pediatrics states that “the practice of immersion in the second stage of labor (underwater delivery) should be considered an experimental procedure that only should be performed within the context of an appropriately designed clinical trial with informed consent.”  According to the American Association of Birth Centers (AABC), the ACOG/AAP position may create unjustified fear with regard to the option of water birth. In their counter-position, the AABC reports that the “data demonstrate that water birth, with careful selection criteria and experienced providers, does not negatively affect mothers or newborns.” Barbara Harper, owner of Waterbirth International, refuted the ACOG/AAP position in a Science & Sensibility interview and on npr, stating that, “carefully managed, water birth is both an attractive and low-risk birth option that can provide healthy patients with non-pharmacological options in hospital facilities while not compromising their safety.”

My daughter, my firstborn, is thirteen now and I still remember her birth as if it were yesterday. I arrived at the birth center at 8 centimeters dilated, jumped in the tub to labor through transition, and in less than an hour, I was ready to push her out. The water had a dramatic and positive effect for me and immediately numbed the pain of the contractions. As a midwife, I had witnessed women experience this transformation while immersed in water, but did not fully believe the extent of the effect until my own first-hand confrontation with labor. How wonderful would it be for more women to have the option to experience the gentle, nurturing, protective, and pain-relieving effects of water during their labor and birth.