thumb|A mother participating in a water birth.
thumb|Water birth
Water birth is childbirth that occurs in water, usually a birthing pool. It may include the use of water for relaxation and pain relief during the first stage of labour, birth into water in the second stage of labour, and the delivery of the placenta in the third stage of labour.
Benefits
Water birth was associated with more positive childbirth and with more relaxed, less painful experience. A 2018 Cochrane Review of water immersion in the first stages of labour found evidence of fewer epidurals and few adverse effects but insufficient information regarding giving birth in water. A moderate to weak level of evidence indicates that water immersion during the first stage of childbirth reduces the pain of labour. Water birth was also associated with higher rates of breastfeeding initiation in the delivery room.
Criticisms
Waterbirth may lead to a higher rate of cord avulsion, or the snapping of the umbilical cord. Statements on water birth by peak gynaecological and midwifery bodies in the UK, Australia and New Zealand all stipulate that exclusion criteria apply for high risk births.
There is limited evidence for some of the purported benefits of waterbirth.
Birth pool
thumb|A birth pool at the [[Royal Women's Hospital, Australia]]
A birth pool is a specially designed vessel for waterbirth. They are generally larger than bathtubs to enable buoyancy and freedom of movement during labour. A birth pool can either be permanently installed or portable.
Characteristics
Before birth pools became readily available there were many stories of women labouring and birthing in re-purposed tub-like products including animal watering troughs.
The original circular birth pool used by Michel Odent, the originator of the concept of birthing pools, at Pithiviers hospital in France in the early 1980s was in diameter and deep, large enough to comfortably accommodate two people. Modern birth pools are somewhat smaller, with a diameter between and at least , preferably , of water.
Around the world
United Kingdom
The first official water birth in the UK was recorded on the 12th October 1984 in Hendon, London.
Approximately 10% of births in the UK take place in water, and approximately 20% of births include the use of water for pain relief. A cohort study carried out in the UK of 73,229 women concluded that there was no association with adverse fetal or maternal outcomes.
Health policy in England stipulates women should be given the opportunity to labour in water through the publication of Intrapartum care guidelines issued in 2007 by the National Institute for Health and Care Excellence (NICE). The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have jointly supported labour and birthing in water, and encourage hospitals to ensure birth pools are available to all women.
Birthing pools are available in many public hospitals in the UK.
Australia and New Zealand
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists supports the use of water immersion during labour within safety and clinical guidelines, noting that there is evidence of benefits to the mother and no evidence of adverse effects to the mother or baby. and New Zealand.
United States
Water birth is not commonly available in hospitals in the United States, and American clinical opinion is generally skeptical of the practice. The American College of Obstetricians and Gynecologists does not recommend birthing in water, although its 2016 Committee Opinion on the matter states that immersion in water during the first stage of labour may be offered to women with uncomplicated pregnancies.
In a 2005 commentary, the Committee on Fetus and Newborn of the American Academy of Pediatrics (AAP) released an analysis of the scientific literature regarding underwater births. The Committee noted several positive studies for underwater birth but went on to criticize them for lacking proper scientific controls, a significant number of infant deaths and diseases, and the general lack of information to support the use of water births.