The history of water birth (2024)

How long has water birth been around?

We tend to think of labouring in water as relatively new. However, a writer on water births, Janet Balaskas (2004), says that's not so. She describes legends of South Pacific islanders giving birth in shallow sea water and of Egyptian pharaohs born in water. In some parts of the world today, such as Guyana in South America, women still go to a special place at the local river to give birth.

Giving birth in water (rather than labouring in it) is a relatively recent development in the western world (Houston 2010). The first water birth that we know about in Europe was in 1805 in France. A mother whose labour had been extremely long and difficult was helped into a warm bath. Soon after immersing herself in the tub, her labour progressed, she started to push, and gave birth to her baby in the water (Avery 2013).

In the 1960s, the Russian water birth pioneer Igor Tjarkovsky experimented with babies being born into cold rather than warm water. His thinking was that this would help protect the baby's brain and enhance the baby's cognitive abilities (Avery 2013, Phillips 2014). Understandably, this approach to water birth didn’t last long!

Next, in the 1970s, some midwives and doctors in France became interested in ways of helping babies make the transition from life in the womb (uterus) to life outside as smoothly as possible, by using warm water.

Their concern was that modern maternity care, with all of its interventions, was making birth traumatic for babies. Some doctors, including French obstetrician Frederick Leboyer (1975), thought babies could be affected for life by the way they came into the world.

Leboyer's approach was to use a warm bath for the newborn baby a short time after the birth, after a period of skin-to-skin with the mother and a natural third stage (Leboyer 1975). Leboyer's work influenced our next water-birth champion, the French obstetrician Michel Odent, who installed birth pools in each room at the birth unit where he worked in France.

Odent noticed that as well as helping women cope with the pain of childbirth, being immersed in water seemed to help labour progress (Phillips 2014). He found that water births also seemed to offer babies a more peaceful journey from the womb into their mums' arms (Odent 1994). Babies are bathed in warm water as they emerge from the birth canal, and the pool environment feels similar to the enveloping warmth of the womb.

Doctors and midwives noted how calm babies were after they had been born in water. They cried less than babies born in air. They appeared more relaxed and were eager to have eye contact with their mums and to breastfeed.

Pioneers, such as Odent, thought that babies may feel more comfortable being born into water because of our aquatic past (Phillips 2014). Many evolutionists now support what's called the "aquatic ape theory ", based on the idea that we had a long period in our evolution when we lived by the waterside. This explains why our babies are born with a subcutaneous layer of fat, the ability to swim at birth, and the reflex that prevents babies from breathing when they are born into water (Phillips 2014).

During the 1980s and 1990s, interest in water birth grew in the UK, Europe and Canada. More water birth-champions emerged in the form of the obstetrician Michael Rosenthal, registered nurse and childbirth educator Barbara Harper in the US, plus midwife and educator Dianne Garland in the UK (2000). These pioneers helped increase confidence in birth pool practice by sharing their experiences of and promoting the use of water, and making sure guidelines for labour and birth in water were safe.

How has access to water birth changed in the UK?

Two influential reports in the UK, the 'Winterton Report' in 1992 and the Department of Health's Changing Childbirth (DH) report in 1993, recommended that women should be given choice in the position they birth in, with the option of using a birth pool where practicable.

As a result, many hospitals installed birth pools. Some became experts in helping women give birth in water.

The DH, as well as professional bodies such as the Royal College of Midwives (RCM 2008, RCOG/RCM 2006), continue to support the use of birth pools, along with staff skilled in assisting water births, (DH 2004, 2007), whether at a hospital, a birth centre or in the home.

The current national guideline for labour and birth recommends the use of birthing pools for pain relief. (NCCWCH 2014). In Scotland, knowledge of the use of water to relieve pain has been highlighted as important for units where epidurals are not available (Scottish Executive 2005, Scottish Government 2011) and midwife-led units in Northern Ireland also tend to offer birth pools. (DHSSPS 2012).

Birthing pools were once used by a minority, but more women are choosing to use them to labour in. In 2007, just three per cent of women who didn't have caesareans gave birth in water. In 2015 this had risen to nine per cent(CQC 2015). A 2014 survey of births in England reported that about 30 per cent of women used water or a birth pool for pain relief (NPEU 2014).

Scotland and Northern Ireland have reported slightly lower water birth rates than in England at around six per cent to seven per cent of women who did not give birth by caesarean (Alderdice et al 2016, Scottish Government 2015).

Thinking of having a water birth? See what other mums have to say about giving birth in water.