Giving birth in the bath

17 February 2023

A bath birth

A bath birth (giving birth in the bath) is a popular way to give birth for many pregnant women. It offers a pleasant and relaxed environment in which you can feel at ease during childbirth. The warm water in the bath can help relieve pain and tension, and gravity often makes giving birth easier in the bath. Also, for a baby, a water birth is a gentle, natural experience. Birth in water forms a smoother transition from the warm enclosed womb to the outside world. This all sounds ideal, but how does it work and are there any disadvantages?

How does giving birth in the bath work?

Most women step into the delivery bath during the active phase of labour. The contractions then become more and more powerful and the warm water makes the pain more bearable. After about two hours in the bath, the power of the water decreases and you have to get out for a while. When you step into the bath again after half an hour, you will again experience the relaxing effect of the warm water.

Advantages bath birth

  • #1: water has a relaxing effect. Water has a physical and mental relaxing effect during childbirth. When you step into the warm water of the bath, you relax and your body is stimulated to produce more endorphins. Endorphins are our own body’s calming and pain-relieving hormone. In addition, endorphins make it easier for you to shut out the outside world and to turn inwards more easily, making it easier to relax again.

  • #2: Water is an analgesic. The discomfort of the contractions that you still experience is more distributed over your body in water, making it more manageable. It is not the case that the contractions will hardly or no longer hurt (unfortunately). But the pain in the bath becomes better to ‘handle’.
  • #3: Birth often goes more smoothly. You make oxytocin more easily in the warm water. Oxytocin provides effective, powerful contractions. This speeds up the dilation phase.

  • #4: Move more easily. You notice less of gravity in water, making it easier to move and change posture. This creates more space in the pelvis, which makes it easier to descend. For women with pelvic pain, giving birth in the bath can be a godsend.

  • #5: Less chance of tearing or cutting. Although the digestion phase is faster in the water, the expulsion phase is often more gradual and controlled. You often have more control over your contractions and they follow each other less quickly, so that your perineum gradually stretches. In addition, the warm water makes the perineum supple. As a result, the chance of tearing or cutting in during a water delivery decreases.

  • #6: You give your baby a gentle start. A bath birth is a wonderful, peaceful start for your baby. Because you produce less stress hormones, the baby also experiences less stress during birth. The chance of defecating (meconium) in amniotic fluid with additional risks and interventions is therefore also lower. The baby is carried by the water making it easier for him/her to make the pivotal turn in the birth canal. The baby also experiences less stress immediately after birth. The water dissolves mucus in the baby’s nose and throat, making it easier to get breathing going. And the baby is generally less likely to be umbilical, so that he / she receives extra oxygen and blood through the umbilical cord. That in turn helps to unfold the lungs and gain strength. Newborn babies also have a diving reflex: the trachea closes automatically under water. Only when he gets cold air on his skin does the breath reflex get going. So you don’t have to worry about your baby getting water. So you can gently lift your baby out of the water and place it against you.

giving birth in bath
Black and white image of a young mother holding her newborn son after giving birth at home.

Disadvantages of bath delivery

  • #1: It costs money. Renting a delivery bath costs between 170 and 250 euros. Reserve your bath in time, so that you have it at home at 37 weeks of pregnancy. Birth baths are popular, if you want to reserve a bath last minute, there is a chance that no bath is available anymore. The rental rate depends on the model you choose, the size (1 or 2 persons) and whether it has a heating element. You pay the costs for renting a delivery bath yourself as a pregnant woman. In the Netherlands it is not (yet) possible to declare these costs with most health insurers.

  • #2: It’s a bit more of a hassle. It is good to realize that setting up and filling the bath takes a good hour, just like emptying and cleaning up the bath. Not everyone is looking forward to that at the moment 😊

  • #3: Pay attention to the water temperature. The ideal water temperature is 37 degrees Celsius, just like your body. The bath water should not be warmer than 37.7 degrees. Because if your body temperature rises too much, your baby’s heart rate can become too high. Incidentally, you often notice automatically when you are too hot, and you would prefer to get out of the bath.

  • #4: You need space. You must have or make room for it at home, because the midwife must be able to walk around the bath properly. A delivery bath is approximately 1.90 x 1.60 m in size. Your floor must also be strong enough to bear the weight of 650 liters of water.

  • #5: out of the bath after 2 hours. After about two hours in the bath, the power of the water decreases and you have to get out for a while. If you step into the bath half an hour later, you will again experience the relaxing effect of the warm water. It is therefore possible that you have to deal with the most intense contractions on dry land, or that you give birth on dry land.

  • #6: abort bath birth. If you have to give birth in the hospital for medical reasons, it is unfortunately not always possible to give birth in a bath. More and more hospitals have a delivery bath. If they don’t have this, you can discuss whether you can bring your own birthing bath.

There may also be certain care protocols that need to be followed; For example, in case of rupture of the water, the protocol at some midwifery practices and/or hospitals is that you are not allowed to take a bath until the delivery is more advanced. Some healthcare providers also find it difficult to determine how much dilation there is under water and they ask you to get out of the bath to do so. In addition, not all healthcare providers like it if the placenta is born in a bath because of the measurement of blood loss after birth.

Also note that some hospitals or midwifery practices do not offer bath deliveries. It is therefore important to consult your midwife or doctor beforehand. Be sure to consult if you have a medical indication, or whether you can use a bath birth before you arrange a bath.

Because giving birth in your own bath is often not possible, because baths are usually too small for this. A delivery bath is deeper, so that your entire belly is supported by the water. There are different types of birthing baths, so think carefully in advance which type of birthing bath would suit you:

  • Do you want a one or two-person birth bath? The advantage of the two-person bath is that you can stretch out in it during the birth or together. Now you may still think that your partner does not want to take a bath, but he may change his mind during the birth, because he wants to support you better, for example, and then it is nice to know that this is not a problem with this bath. He can just fit in. The two-person bath is obviously also larger, so consider whether it fits in your home in terms of size and whether your floor can support the weight.

  • Do you want a bath that is inflated with air or do you want a sturdy plastic bath? Do you think it is important that the bath has a seat? Do you like it if there are handles on the side so that you can hang over the edge of the bath and the bath can be moved slightly? Only the Birthpool in a Box has a built-in seat and handles on the outside of the bath. There is also an oval white plastic bath with a solid edge on the market. This bath has the most interior space. It does not inflate and has a heating element. The inflatable pools La Bassine and Birthpool in a Box do not work with heating elements. They are designed in such a way that they only lose 0.5 – 1 degree of temperature per hour when you use the heat cover (depending on the room temperature, humidity and air circulation at the location of the bath). You use this cover when you’re not in the bath.

But the most important thing is that you listen to your body at all times and act accordingly. If giving birth in the bath doesn’t feel right at the moment, don’t do it!

Trust your body!

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