I get a lot of questions about waterbirth. “Do you do them?” “Is it beneficial?” “Are there risks?” “Can I have one?” Some of these questions arise from hospital policies and even ACOG’s position statement that waterbirth is too risky to accommodate, despite the balance of evidence saying otherwise. (PS: A Cochrane Review is far superior to an ACOG Opinion in every way. You can read more about the Hierarchy of Evidence here.)
For a long time, my general spiel about waterbirth has been that it’s a personal preference, as are many of the choices that women have when they birth at home. Some women love birthing in the water, and will even hold out until that tub is filled up. Some like to labor in the water, but prefer to be elsewhere for delivery. Others say terra firma all the way. There are some logistical considerations for water birth, but if you want one, go for it! As well, I have always said, if you don’t set up a tub, you won’t have the choice (ergo, if you want the choice, set up a tub).
But this January the team at Midwives Alliance of North America‘s Division of Research published an excellent study using data from the MANA Statistics project. This study looked at over 18,000 women who birthed out-of-hospital, over a third of whom had waterbirths. As well, these births were attended by providers who routinely offer waterbirth as a choice–midwives. No increased risks to babies or serious adverse impacts on the mothers were found. Though there was an increased incidence of minor perineal lacerations, many women find the many benefits in terms of comfort outweigh that singular risk.
I continue to have a separate list for waterbirth supplies, as not everyone who is planning a home birth wants to have a waterbirth. And that is perfectly okay. But at the end of the day it is a choice–and now we have more evidence of its safety and benefits thanks to MANA Stats. And to midwives and clients everywhere who participate in the MANA Stats project–thank you!