WATER BIRTH SAFETY SERIES PART 1: Is Water Birth Safe? What the Evidence Actually Says

If you’re considering a water birth, there’s one fairly obvious question to get out of the way first:

Is water birth safe?

For healthy women with low-risk, term pregnancies, the current evidence is broadly reassuring.

In 2025, NICE updated its UK guidance after reviewing newer large studies of water birth. It now recommends that women should be offered the option to consider giving birth in water.

The evidence suggests that water birth is not associated with an increased risk of serious complications for mothers or babies in the low-risk pregnancies studied.

There may even be some benefits. NICE found associations with:

• lower rates of postpartum haemorrhage
• fewer severe tears among women who have given birth before
• fewer admissions of babies to neonatal units

A large 2024 systematic review and meta-analysis looking at 52 studies also found broadly reassuring outcomes for mothers and babies.

So is water birth completely risk-free?

No.

But then neither is giving birth on land. Birth has never been particularly interested in offering us a zero-risk option.

One specific risk that occurs more frequently during water birth is umbilical cord avulsion, where the cord snaps before it is clamped. It remains uncommon, but it’s something parents considering water birth should know about.

There are also some extremely rare outcomes where researchers simply don’t yet have enough evidence to know whether water birth makes any difference.

And that distinction matters:

“We don’t know yet” is not the same thing as “we know this is dangerous.”

The bottom line

For appropriately selected, low-risk pregnancies, water birth is a legitimate, evidence-supported birth option.

Whether it’s the right option for you is something to discuss with your midwife or maternity care provider.

And remember: preparing for a water birth doesn’t mean signing a contract with the pool.

You can get in. Get out. Get back in.

Birth plans are allowed to be plans, not promises.

Sources

NICE – Intrapartum Care: Water Birth Recommendations⁠

NICE – Rationale and Impact: Water Birth⁠

2024 Systematic Review and Meta-analysis – PubMed⁠

Waterbirth International – Water Birth Research Library⁠

This article provides general information and does not replace individual medical or midwifery advice.