WATERBIRTH SAFETY SERIES PART 3: What Are the Risks of Water Birth?
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If we’re going to talk seriously about the benefits of water birth, we also need to talk about the risks.
Because “I love water birth” and “water birth has no risks” are two entirely different statements.
Umbilical cord avulsion
One of the clearest differences identified in current research is an increased risk of umbilical cord avulsion — when the umbilical cord snaps before it has been clamped.
It remains uncommon, but NICE specifically includes this increased risk in the information women should receive when considering water birth.
This is one reason that the way a baby is brought to the surface after a water birth matters.
What about infection?
This is another obvious concern.
Birth pool hygiene matters. Clean equipment, appropriate water, infection-control procedures and correct pool management aren’t optional extras.
However, large research reviews have not found an overall increase in maternal infection associated with water birth.
So yes, hygiene matters enormously.
No, that does not mean birth pools are inherently unhygienic.
And no, your child’s paddling pool that’s been sitting behind the shed since last August is not the same thing.
What about the baby?
Most neonatal outcomes in recent large studies and systematic reviews have been reassuring.
However, evidence about some extremely rare outcomes remains limited. NICE specifically says that evidence about babies dying during or after birth is inconclusive, so we cannot currently say whether there is a difference between water birth and birth out of water.
Risk doesn’t mean danger
This is perhaps the most important point.
Every birth option has benefits, disadvantages, risks and uncertainties.
Good informed choice isn’t about being told:
“Water birth is completely safe.”
Nor is it about being told:
“Water birth is dangerous.”
It’s about being given the actual information and being trusted to make an informed decision about your own birth.
Sources
NICE – Current Water Birth Recommendations
NICE – Water Birth Rationale and Evidence
2024 Systematic Review and Meta-analysis
Waterbirth International – Research Resources
This article provides general information and does not replace individual medical or midwifery advice.