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It’s OK for a woman in labor to take some of the pressure off in a tub, but there’s no advantage to actually giving birth in water and it could be dangerous for the baby, two big doctor groups advised Thursday.
The new joint guidelines from the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) are the first to offer any real professional guidance on a practice that’s had on and off popularity for decades.
“Before this report, there wasn’t any standard advice,” says Dr. Tonse Raju, chief of the pregnancy and perinatology branch the National Institute of Child Health and Human Development, who helped write the guidelines.
“The practice has been going on without a whole lot of endorsement from any major group.”
Water births, where moms labor and sometimes deliver in water, are currently becoming more popular again. Supermodel Gisele Bundchen became a super-advocate when she delivered her son, Benjamin, in 2010 in the bathtub in the home she shares with husband, celebrity NFL quarterback Tom Brady.
However, doctors have shied away from recommending water births.
The report finds that it is safe for mothers with uncomplicated pregnancies to spend the first stage of birth, when they are laboring, in a tub. Laboring in water often reduces a mother’s pains and can relax her.
Moms certainly agree. When Cassandra Sirl of West Cleveland went into labor eight months ago with her son, Zen Cameron, she labored in a tub at home.
“My muscles relaxed,” Sirl says. “[Baths are] a space where we’ve always been able to relax in.”
When it came time to deliver, she had her son on the couch because it felt better for her.
Shadman Habibi, a certified nurse midwife at the Ronald Reagan UCLA Medical Center, says the hospital is adding tubs to help mothers during the first stage of labor, but there are no plans for water deliveries.
“Our clients are asking for it and we are midwives and we are trying to provide alternative ways to labor,” she says.
When Habibi trained as a midwife she worked in a center with a large Jacuzzi and noticed the water relieved the mothers’ aches.
“It’s pain management,” she says, adding that many moms said the water improved the overall birth experience.
ACOG and AAP say that delivering in water provides no health benefits for the baby or mom, can be dangerous, and even fatal.
Raju says that while the risks are infrequent, they can be severe. Contaminated bath water poses a danger—some babies get infections if they swallow water containing fecal matter or amniotic fluid. And, there have been a few reported cases of babies drowning after aspirating.
But mostly, doctors just don’t know if there’s any benefit.
“It is difficult to quantify those risks. The information that is out there [is incomplete and inconclusive],” says Dr. Jeff Ecker, an obstetrician at Massachusetts General Hospital and chair of the ACOG’s Committee on Obstetric Practice, which wrote an opinion for the report.
“There is a potential for more risk with an underwater birth.”
Katie Brinton, a transplant nurse at Temple University Hospital in Philadelphia, knew there was a slight risk of infection if she delivered in water, but still felt that it would provide the relaxed environment she wanted. In August of 2013, she delivered her first baby, Marin Palazzolo, in water at Wilmington Birth Center in Delaware.
“Water’s buoyancy allowed me to change positions easily, it soothed my muscles,” Brinton said via emails. “Overall it just allowed me to be more independent during labor.”
And, if she had to choose again, she’d pick a water birth.