The Benefits of Water During Labour and Birth

As doulas, we know that feeling safe, supported, and in control can profoundly shape a birthing person’s experience. One option that consistently supports physiological birth, emotional wellbeing, and comfort is using water during labour and birth.

Water immersion is widely available across the UK in NHS birth centres, alongside midwifery-led units, and some obstetric settings. It is supported by national guidance and a growing body of high-quality research.

Below, we explore the evidence-based benefits of water and why it can be such a powerful tool when combined with continuous doula support.

Gentle, Effective Pain Relief

Warm water immersion is one of the most effective non-pharmacological pain relief options available during labour.

Evidence shows that water:

• Reduces the perception of pain

• Encourages muscle relaxation

• Supports endorphin release

• Reduces tension and fear responses

The National Institute for Health and Care Excellence (NICE) recommends that women in established labour should be offered the option of water immersion for pain relief.

A major Cochrane Review found that women who laboured in water were less likely to use epidural or spinal analgesia, which can support more active, mobile births and fewer interventions.

For many clients, water provides a sense of relief and coping rather than simply “pain removal” - something doulas frequently witness firsthand.

Supporting Physiological Labour

From a physiological perspective, water can help labour unfold more efficiently.

Warm water immersion:

• Reduces adrenaline and stress hormones

• Supports oxytocin release

• Encourages rhythmic, effective contractions

  
  

UK research suggests that immersion during first stage labour is associated with shorter labours and reduced need for labour augmentation, such as synthetic oxytocin.

As doulas, supporting environments that promote calm and reduce fear can make a meaningful difference, water often becomes a key part of that environment.

Freedom of Movement and Instinctive Birthing

Water supports the body’s weight, allowing birthing people to move freely and respond instinctively to contractions.

In a birth pool, clients often:

• Change position easily

• Adopt upright or forward-leaning positions

• Follow their body’s cues

  
  

This aligns with NICE guidance encouraging mobility and upright positions to support labour progress and optimal fetal positioning.

For doulas, water can enhance our ability to offer hands-on comfort, reassurance, and presence without directing or interrupting the labouring person’s instincts.

Reduced Perineal Trauma and Intervention

Evidence from UK and international studies indicates that water birth is associated with:

• Lower episiotomy rates

• Comparable or reduced rates of severe perineal tears

  
  

Warm water increases blood flow and elasticity to the perineal tissues. The gentle resistance of the water may also slow the birth of the baby’s head, allowing tissues to stretch gradually and naturally.

Emotional Wellbeing and Birth Satisfaction

The emotional benefits of water immersion are significant and should not be underestimated.

Women who use water during labour often describe:

• Feeling calmer and safer

• A greater sense of control and privacy

• Increased confidence in their body

  
  

The Royal College of Midwives (RCM) highlights water immersion as a practice that supports dignity, autonomy, and personalised care - values central to both midwifery and doula support.

Positive birth experiences are closely linked to improved postnatal wellbeing, bonding, and mental health.

Safety for Babies

For healthy, uncomplicated pregnancies, water birth is considered safe for babies when evidence-based guidelines are followed.

Large studies show no increased risk of:

• Neonatal infection

• Breathing difficulties

• Admission to neonatal units

  
  

Babies do not inhale water at birth due to protective reflexes and the fact that breathing begins only once exposed to air.

Many NHS trusts actively support water labour and birth, in line with National Health Service guidance.

When Water May Not Be Recommended

Water immersion may not be suitable in all circumstances, including:

• Heavy bleeding

• Certain medical or obstetric complications

• Situations requiring continuous electronic fetal monitoring

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As doulas, our role is to support informed decision-making, ensuring clients understand both benefits and limitations, and feel empowered to discuss options with their midwifery or obstetric team.

Conclusion

The UK evidence is clear: water during labour and birth offers meaningful physical and emotional benefits, without compromising safety when used appropriately.

For many birthing people, water provides a calm, supportive space where labour can unfold instinctively and where doula support can be deeply effective.

References

• National Institute for Health and Care Excellence (2014, updated 2023). Intrapartum care for healthy women and babies (CG190).

  
  

• Royal College of Midwives (2018). Evidence Based Guidelines for Midwifery-Led Care in Labour: Immersion in Water for Labour and Birth.

  
  

• Cluett, E. R., & Burns, E. (2009). Immersion in water in labour and birth. Cochrane Database of Systematic Reviews.

  
  

• Nutter, E., Meyer, S., Shaw-Battista, J., & Marowitz, A. (2014). Waterbirth: An integrative analysis of peer-reviewed literature. Journal of Midwifery & Women’s Health.

  
  

• NHS England (2019). Better Births: Improving outcomes of maternity services in England.