When can women opt for water births

Many pregnant women across the globe are turning towards water births as an option for delivery due to its promise of a painless and comfortable experience, in contrast to the excruciating pain faced during traditional deliveries. “As the name denotes, water birth refers to the process of labour and delivery that occurs in a tub of warm water, usually in a hospital or birthing center,” says Dr Neelam Suri, a senior consultant, obstetrician, and gynecologist at the Department of Obstetrics and Gynaecology, Indraprastha Apollo Hospital, New Delhi, in interaction with indianexpress.com.

Dr Suri adds that water acts as a cushion to provide comfort, buoyancy, and hydrostatic pressure during contractions. “It is good for the first stage of labour,” however, she explains that the actual delivery requires more precautions, making safety a potential challenge.

So, who should opt for water births?

Dr Anjana Singh, director and HOD of Obstetrics and Gynaecology at Fortis Hospital, Noida, explains that only low-risk pregnancies are suitable for water births. “The foetus should be between 37 to 41 weeks, with the baby’s head positioned downward and adequate amniotic fluid.”

Water births are only recommended for healthy-term pregnancies, starting from 37 weeks onwards. “Preterm deliveries can face difficulties in thermoregulation, respiration, and neonatal complications. Women with complex medical histories involving risks like infection, bleeding disorders, or placental issues are better served by conventional delivery protocols,” says Dr Suri. Additionally, preterm pregnancies or women with previous caesarean sections should not opt for water births.

Listed below are benefits of water births as shared by Dr Singh:

• A more satisfying experience of labour
• Less requirement for epidural
• Shortens labour duration
• Lesser required episiotomy (a surgical procedure)

However, such benefits warrant careful evaluation of individual risks.

“Lower genital tract infections can be exacerbated due to prolonged water exposure. Maintaining optimal water temperature outside the normal core body range also brings challenges. Dehydration and overheating from immersion pose concerns. Furthermore, babies risk aspirating water if incorrectly handled during delivery or resuscitation. Pelvic floor functioning may also be weakened due to the extra buoyancy,” says Dr Suri.

Meanwhile, water births necessitate skilled personnel and additional infrastructure for infection control, emergency interventions, and neonatal management linked with water births, thereby restricting its availability across regions. Intermittent foetal heart rate monitoring is also recommended given the possibility of decompensation (organ failure).

Ultimately, an informed decision must balance the promised comforts of a water birth against one’s personal medical needs and risks. “Open discussions with providers are key to determining suitability. While not universally recommended, it can offer a satisfactory birthing experience for many low-risk pregnancies when undertaken cautiously,” Dr Suri concludes.

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