I think it's safe to say that most moms-to-be spend time thinking about and planning their baby's birth, or at least their version of the "ideal birth." While every person's vision of the perfect labor and delivery experience is unique, more and more women are now adding water birth — or giving birth while submerged in a tub or pool of water — to their birth wish lists. If you're one of them, you probably have questions about its safety, including, "Can a baby drown during a water birth?" Unfortunately, experts disagree on the potential risks associated with a water birth, which can make it difficult for a soon-to-be mom to make an informed decision.
According to a 2016 Committee Opinion of the American Congress of Obstetricians and Gynecologists (ACOG), a water birth does pose a few potential risks to both the laboring woman and the baby, including babies aspirating water and drowning at birth. The ACOG'S official opinion explains that while some water birth proponents suggest that babies will naturally and intrinsically keep themselves from breathing under water at birth, research suggests that it is totally possible, which puts them at risk for drowning. So, you know, yikes.
A study published in the journal Pediatrics found that four newborns had been admitted to hospital NICUs after their water births with health conditions possibly caused by inhaling or swallowing water. Pediatrics did note, however, that correlation doesn't necessarily equal causation, and explained that studies involving water births don't always include details related to cause of death, which makes it hard to accurately asses safety. However, they report that one large study of water birth in the U.K. had a larger than expected number of deaths among babies born in the water. In contrast, a large review of studies by the Cocraine Review showed no evidence of risk to newborns during water birth, but recommended that more research still needs to be done.
The American College of Nurse Midwives has taken a different stance on water birth than their OB-GYN counterparts — that healthy moms-to-be be offered the choice to labor and birth in water — as it has been associated with numerous positive benefits, including reduced need for pain medication during labor and increased patient satisfaction. Their practice model states that water birth is not associated with a higher risk of newborn death during low-risk births. They do recommend that people who request it need to be informed of the potential benefits and risks of water birth, so they can make an informed decision about where and how to birth. They also add that water birth is not right for all patients, and that people who labor or deliver in water should be monitored closely to reduce the risk of harm.
So, how do you know if water birth is a safe choice for you and your baby? The answer is unfortunately that there's no way to know. Ultimately, if you are concerned about your baby drowning during water birth, you should talk with your obstetrics provider about risks, get out of the tub before delivery, or choose to remove the risk entirely by avoiding water birth altogether.