'Clear benefits' to water births including less pain and a better experience for mums

A mass study has confirmed the safety and "clear benefits" for women having a water birth, including reduced need for pain relief and a better experience for the mother.

The Royal College of Midwives (RCM), the only trade union and professional association dedicated to serving midwifery and the whole midwifery team, has welcomed the research made up of 36 studies and more than 150,000 participants.

Women having a water birth in a hospital obstetric unit had fewer medical interventions and complications during and after the birth, the analysis from Oxford Brookes University, published in The British Medical Journal (BMJ) found.

“This is really good news for women choosing to have a water birth or thinking of having one," says Clare Livingstone, Professional Policy Advisor at the RCM, commenting on the findings.

"There has been previous research outlining the benefits for women and this significant study adds weight to those. It is also positive because it is more information for women when deciding how they want to give birth."

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It found that water immersion significantly reduced the use of pain relief like epidural and injected opioids, as well as episiotomy (when an incision needs to be made), maternal pain and postpartum haemorrhage.

There was also an increase in maternal satisfaction and odds of an intact perineum (the area between the anus and genitals) with water immersion.

It should be noted that the study did show a small increase in 'umbilical cord snaps', which is when the baby's cord breaks, though the rates remained very low.

The RCM also outlines that even if this does happen, it will not hurt the baby and the midwife will respond quickly and clamp the cord to prevent any bleeding.

There were no differences in any other identified neonatal outcomes.

Livingstone says water births are becoming more widely available for women across the UK, though acknowledges this isn't the case everywhere.

The authors of the study, led by Ethel Burns, echo the increase in demand, writing, "Water immersion during labour using a birth pool to achieve relaxation and pain relief during the first and possibly part of the second stage of labour is an increasingly popular care option in several countries.

"It is used particularly by healthy women who experience a straightforward pregnancy, labour spontaneously at term gestation (developing in the womb) and plan to give birth in a midwifery led care setting. More women are also choosing to give birth in water."

They outline that there is a debate about the safety of intrapartum (childbirth) water immersion, particularly water birth.

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"The challenge now is to ensure this choice is open to all women wherever they live," says Livingstone.

“What is needed now is to see more research into water births in midwife led settings and in women’s homes" she adds. "This will give us a broader picture of the impact of water births across all the places in which women give birth.”

The study authors write, "This review endorses previous reviews showing clear benefits resulting from intrapartum water immersion for healthy women and their newborns.

"While most included studies were conducted in obstetric units, to enable the identification of best practice regarding water immersion, future birthing pool research should integrate factors that are known to influence intrapartum interventions and outcomes. These include maternal parity, the care model, care practices and birth setting."

The 36 studies in the review, with 157 ,546 participants, included 31 in an obstetric unit setting, four in midwife led settings and one in a 'mixed' setting (obstetric and home birth).

Water birth has been listed under a page on pain relief in labour on the NHS website, which says it can help you relax and make the contractions seem less painful.

"Ask if you can have a bath or use a birth pool," the website states. "The water will be kept at a comfortable temperature, but not above 37.5C, and your temperature will be monitored."

The National Childbirth Trust has more helpful information.