Water Birth Malpractice: What to Know

Giving birth is one of the most meaningful and intensely personal experiences a woman can have, culminating in the great joy of holding her newborn child and taking the baby home. Because this is such an important moment, and because most women only experience it a few times in their life, it is common to put a lot of thought into planning the birth experience.

Increasingly, those plans include what is commonly called a “water birth.” The American College of Obstetricians and Gynecologists (ACOG) acknowledges that a woman whose body is immersed in water during the first stage of labor may experience a shorter labor. Importantly, there may also be less need for spinal and epidural analgesia, allowing healthy women with uncomplicated, full-term pregnancies a greater chance for a “drug-free” labor. Many women report increased warmth, relaxation, and a feeling of being in control while laboring in water.

Most of the time, water births go well, and the experience is everything the new parents hoped for. But when water births go wrong, they often go terribly, devastatingly wrong—and the pain is frequently compounded by the fact that the problem was avoidable, caused by medical malpractice. Let’s talk about how to make sure a water birth goes right, and what to do if yours didn’t.

Potential Risks to Mother and Baby in a Water Birth

Studies reviewed by ACOG do not show worse outcomes for mothers who labor in water. For instance, there was no greater prevalence of infection for women who spent the first stage of labor immersed in water, and no statistically significant increase in postpartum hemorrhage for those who labored in water during the second stage of labor.

That said, ACOG noted that there simply was not enough data on rare, serious outcomes (including death) to conclude with absolute certainty that water births pose no danger to mothers. The risks of water births to babies are a bit clearer.

The good news is that babies of women who were immersed in water during the first stage of labor showed no greater risk of adverse outcomes than those who were not. Issues watched for included meconium-stained amniotic fluid, infection, abnormal fetal heart rate patterns, need for NICU admission, or five-minute APGAR scores below 7.

The less encouraging news comes from studies of babies whose mothers were immersed in water during the second stage of labor, including delivery. These babies were at greater risk of infection such as Pseudomonas aeruginosa and Legionella pneumophila; in some cases, those infections led to the baby’s death.

Other noted complications included aspiration of water (also called fresh-water drowning), and avulsion (rupture or “snapping'') of the umbilical cord, which frequently leads to the need for a NICU admission. The risk of water aspiration is likely greater for fetuses who are already compromised, but the risk is not zero even for otherwise healthy fetuses. In addition to the risk of aspiration that exists under perfect circumstances, other factors often present in a water birth can heighten this risk, including inadequate disinfection of the birthing pool and water from a contaminated source.

Medical Recommendations Regarding Water Birth

The research reviewed by ACOG identified some benefits for mothers who are immersed in water during early labor, but no particular benefits for babies (though the organization did not rule out the possibility of benefit). There is also the potential, though rare, for serious birth injury or death to a baby in a water birth.

If a water birth is important to you, the medical community has some recommendations. Immersion in a birthing pool should take place only in the first stage of labor. The second stage of labor and delivery should take place on land. At this time, there is not enough data to decisively conclude that later-stage labor and delivery in water is safe.

Mothers who want to give birth in water in spite of the lack of data confirming it is safe to do so should give informed consent. Providers must inform mothers that there are rare, but very serious, complications from giving birth in water, including the potential death of the baby. Medical staff should also warn mothers that there have not been extensive studies regarding the safety of giving birth in water. Any doctor who has reason to believe that a water birth would be dangerous to a patient or her child should discourage the patient from pursuing one.

Those facilities that offer women the opportunity to labor or give birth in water must do everything possible to ensure the safety of mothers and babies. Standard measures should include carefully screening candidates for water birth; rigorous infection control procedures; proper maintenance of pools and tubs, including cleaning procedures; and regular monitoring of laboring mothers and their fetuses. If complications arise, the birthing center should be willing to transport the mother and baby to a hospital better equipped to handle their needs.

If you or your baby suffered injury that might be due to negligence on the part of your OB/GYN, midwife, or birthing facility, you may have a valid claim for medical malpractice, especially if your baby died or will need lifelong care due to a birth injury. You have only a limited amount of time in which to make your claim, so we encourage you to contact The Fraser Law Firm P.C. to discuss your options.