Water birth and home birth

Water birth is the process of giving birth in water using a birthing pool.

You can labour in water and leave to give birth if you wish. Being in water during labour is shown to help with pain as well as being more relaxing and soothing than being out of water. The water can help to support your weight, making it easier to move around and feel more in control during labour.

What are the advantages of water birth?

• The warm water can help to relax, soothe and comfort you.
• The support of the water means you can try different positions and move more freely.
• When upright in the water, gravity will help move the baby down towards the birth canal.
• Being in water can lower your blood pressure and reduce feelings of anxiety, making your body more able to release endorphins, which can help ease pain.
• The water can help to improve back pain and the feeling of pressure, especially when you are fully dilated.
• Being in the pool during labour and birth can be a “cosy” experience, making you feel safe.

If you have a straightforward pregnancy, and both you and the baby are well, you might choose to give birth at home.

Giving birth is generally safe wherever you choose to have your baby.

If you give birth at home, you’ll be supported by a midwife who will be with you while you’re in labour. If you need any help or your labour is not progressing as well as it should, your midwife will make arrangements for you to go to hospital.

You have lots of decisions to make during pregnancy, in labour and when you have had your baby. In order to make informed decisions about your care you can use a decision making tool like the BRAIN tool.

B Benefits. What are the benefits?

R Risks. What are the risks and considerations?

A Alternatives. What are the alternatives, and what are the risks and benefits of those?

I Intuition / information. How do you feel? Do you need more information?

N Nothing / not now. Do I need to decide now? What if I do nothing?

Sometimes a doctor or midwife may need to make a cut in the area between the vagina and anus (perineum) during childbirth. This is called an episiotomy.

An episiotomy makes the opening of the vagina a bit wider, allowing the baby to come through it more easily.

Sometimes a woman’s perineum may tear as their baby comes out. In some births, an episiotomy can help to prevent a severe tear or speed up delivery if the baby needs to be born quickly.

If your doctor or midwife feels you need an episiotomy when you’re in labour, they will discuss this with you. In England, episiotomies are not done routinely.

Up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze or episiotomy.

The National Institute for Health and Care Excellence recommends that an episiotomy might be done if:

• the baby is in distress and needs to be born quickly, or
• there is a need for forceps or vacuum (ventouse), or
• there is a risk of a tear to the anus

Around 1 in 7 deliveries in England involves an episiotomy.

If you have a tear or an episiotomy, you’ll probably need stitches to repair it. Dissolvable stitches are used, so you will not need to return to hospital to have them removed.

Massaging the perineum in the last few weeks of pregnancy can reduce the chances of having an episiotomy and perineal trauma during birth.

The type and frequency of massage varies across research studies. Most involve inserting 1 or 2 fingers into the vagina and applying downward or sweeping pressure towards the perineum.

The most benefit was in women who repeated this every day.