Water Birth Hurts Less: Fact or Fiction

True or false: Giving birth in water hurts less than giving birth on land. Answer: neither! There is no definitive answer because each labor is unique and every woman tolerates pain differently. Compared to a land birth, water birth seems to be more relaxing for the mother and baby but not necessarily less painful. If you're looking for a pain-free delivery, water birth can't promise that, but if you're looking for a way to manage a natural childbirth (sans medication, epidural, and C-section), water birth might be for you. We consulted experts (all women) who answered our questions about the truth behind water birth pain.

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What Is It Like to Labor in Water?

"The first word that comes to mind when describing a water birth is gentle. Having been present for many births on water and on land, I am always struck by the calmness [with] which a mother brings her baby into the world as well as the ease of transition for the newborn," says Laura Kattan, a certified nurse-midwife and women's health nurse-practitioner in Arlington, Massachusetts. Water often acts as a relaxer and can have the same effect during labor as taking a soothing bath after a stressful day. By increasing relaxation, the water also helps lessen the chances of tense breathing, because taking short, shallow breaths can intensify contractions, increasing the pain. The less stress placed on the body during labor the better -- as you relax, the body releases the hormone oxytocin, which stimulates labor contractions to make them strong and regular, and releases more endorphins to help you cope with contractions. Water makes the body buoyant and feel lighter so it's also easier for you to move about and find a comfortable position in the water; this makes labor easier. "When the baby is born, it is brought to the surface. Usually, this is a quiet transition from labor to birth. I have seen many babies with a calm serene look after arriving in the water," Kattan says.

Is Water Birth Painful or Painless?

Although some women refer to laboring in water as a "liquid epidural" and describe the water birth experience as calm and serene, it is not always pain-free. Being in the water does not take pain entirely out of the equation, but it can be more managed or subdued. Depending on the woman, the water may alleviate a majority of the pain or it may not. Marra Francis, M.D., a gynecologist practicing in San Antonio, recalls water births where "women could not tolerate the pain of contractions and had to get out to receive epidurals." We talked to moms who shared their personal water birth pain experiences.

Painful

"Personally, for me, I had a very fast, intense painful labor. It still hurt in the water, but much less than when I wasn't in the tub. I had an 11-lb. 4 oz., 231/2-inch baby, so it probably was going to hurt either way!" --Ami Burns, Chicago

"I had heard water was a great way to manage labor pains. I tried it but I didn't feel any less pain than being out of the water." --Carlie Rapier, Riverside, California

Painless

"The contractions outside the tub were definitely manageable, but I knew that the water would bring extra relief. Laboring in the water just made things feel lighter and helped to relax my body in ways that couldn't happen outside of the water. In the water I could just float in between contractions." --Kassie Anderson, New York City

"The feeling of floating and being suspended in water seems to help my body to relax and allow the contractions to more fully and easily do their work of bringing the baby down." --Bonnie Wiscombe, a mom of six in Mesa, Arizona.

• When a Water Birth Is Not Right for You

Is It Possible to Have an Epidural During a Water Birth?

It is important to know that epidurals are not used during water births. "A water birth means that the use of epidural anesthesia is not possible, or extremely difficult," says Richard Pollard, M.D., an anesthesiologist in Charlotte, North Carolina, and contributor to the medical website healthtap.com. This is because water births usually take place at home, not in a hospital, where an anesthesiologist is on hand to administer an epidural. The water also presents problems when taping in the epidural catheter, and it can compromise a woman's ability to get in and out of the tub, increasing the risk of falling. All these factors "would delay an emergency situation because you would literally have to be lifted and carried out of the tub to a birthing bed or gurney," Dr. Francis says. It is a personal choice to forgo other interventions and rely on a water birth to manage pain. It's always important to consult your doctor and to know your options for meeting your pain-reducing labor expectations.

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