Using a Bathtub for a Water Birth
During a water birth, a woman delivers her baby while submerged in warm water, since the buoyancy reduces labor pain. This natural method typically happens in a stand-alone birthing center or at home, says Marra Francis, M.D., a gynecologist practicing in San Antonio, and the former chair of the OB-GYN department at Memorial Hermann Hospital. At-home births tend to be more comfortable, but they require you to have a safe and acceptable birthing tub.
Sure, you can shell out $250 for an inflatable birthing tub online. You can also ask your midwife about a birthing tub rental. But did you know that home bathtubs are often an acceptable alternative? These tubs do, however, need to fulfill basic requirements for overall safety, such as size, accessibility, cleanliness, and water temperature. Here's what you need to know.
5 Guidelines for a Home Birth Tub
We spoke with experts to break down the guidelines for using your bathtub during a water birth. Read what they had to say.
Bigger Isn’t Necessarily Better
Most birthing tub rentals are about two feet deep, inflatable like a kiddie pool, and made with soft sides. Although your bathtub doesn’t have pliable siding, it’s about the same depth, which works well for a water birth. (Even better if your home has a bigger Jacuzzi-sized tub!)
Give your tub a test run to ensure you and your partner (if you choose to have one accompany you in the tub) fit comfortably. The most important thing is that your belly can be fully submerged; this increases buoyancy, which can alleviate some of the pain and pressure of labor.
Make Sure the Birthing Tub is Accessible
While your bathtub doesn't need to be a certain shape, you do need to think about accessibility. "Most home bathrooms are not made to accommodate the number of people that might be needed to get the mother out of the tub quickly if she needs assistance, nor are most bathtubs positioned in such a way that someone could get on either side to help her out of the tub," says Sharon Mikol, M.D., an OB-GYN practicing in Cleveland.
If you're using a home tub in a confined space and with limited access, speak with your midwife about your options in case of an emergency, and plan what you'll do if something goes awry. "Asking a full-term pregnant woman in the throes of labor to get up and out of the bathtub all by herself without slipping and falling is not reasonable or safe," Dr. Mikol warns.
Cleaning for a Tub Birth
Take a cue from birthing tubs in hospitals, which are clean, sterile, and sanitized. Before the water birth, clean the tub with a nonabrasive cleaner, such as Comet or Lysol. Then use a 10 percent bleach and water mixture (one part bleach for every nine parts water). A good amount to start with is 1/4 cup of bleach and 2 1/4 cup of water. Rinse thoroughly. You'll want to bleach the tub again after you deliver.
Proper Temperature for a Water Birth Tub
Warm water is necessary for a birthing tub, since cold temperatures can be detrimental to a newborn. "Newborns lack the ability to regulate their body temperature in the first moments of life. If the baby is born and placed in water that is not warm enough, his body temperature will lower, which can be dangerous and life-threatening," Dr. Mikol says. "Babies with low body temperature cannot shiver to get warm, like adults do, and it can predispose them to breathing problems, increase their risk of infection, and decrease their oxygenation."
On the other hand, water that’s too warm "can burn the mom's or the baby's skin. It also can cause the mom's blood vessels to dilate, which can lead to a lack of blood flow to her head, and she'll get dizzy or feel sick," Dr. Mikol says.
For these reasons, it’s vital to keep the tub water at the correct temperature: between 95 and 101°F. Maintain the temperature by using floating thermometers available for baby bathtubs; if it starts to cool, add warm water to keep the temperature stable.
Know the Risks
In 2010, the American Journal of Obstetrics & Gynecology published a study of neonatal mortality rates. It found that "less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate." In other words, home water births may be more dangerous than hospital births, since Mother and Baby have less support in case of emergency. Possible complications include infection (if the infant swallows feces in the tub), pneumonia, drowning, a torn umbilical cord, and meconium aspiration (the infant inhales poop in the amniotic fluid, which needs immediate medical attention after birth).
Mothers with certain high-risk conditions, including gestational diabetes and preeclampsia, are also advised against an at-home birth or a water birth. Always speak with your healthcare provider before making the decision.
What You Need for a Home Water Birth
It's important not to get into the tub too soon—Mikol recommends waiting until active labor or even pushing. "Getting in the tub in early labor can feel comfy, but it can also slow the process down and stall things," she states.
You don't need much more than a birthing tub and water, but there are a few things that will make the process easier, and perhaps more comfortable.
- Towels (preferably old) to soak up water spills and to keep the mom and baby warm
- Tank top/bra to wear in the tub
- Mat to catch water outside the tub and prevent slipping
- Bucket to hold towels or additional warm water
- Labor or delivery gown to change into after birth
- A debris net or colander to scoop out any matter from the pool
- Gloves to clean the tub
- Plastic drop sheets to protect the floor
- Baby hat to keep the baby warm after birth
- Adhesive maternity pads to use for the first few days postpartum
- Perineal rinse bottle to help sooth your tender bottom
- Floating thermometer to regulate temperature
Alternative Birthing Tub Options
If you decide not to use your bathtub, your midwife can help you find a company that offers birthing tubs. You can buy an inflatable birth pool that can be used for multiple births; these usually cost around $250 with liners and filters. Using an inflatable pool can also be cozier than a home tub because the sides are softer, making it easier to for you to change positions during labor. If you don't want to keep the tub, your midwife might have a birthing tub rental option.