Why Water Births are a Safe Choice |

Why Water Births are a Safe Choice

admin May 15, 2015

Recently, I read a post over at The Healthy Home Economist: The Toxic Effects of Water Birth on Mom and Baby.  While I appreciate many of Sarah’s posts, this was not one of them.  The post was unfortunately poorly researched, and looked at one very limited aspect of a very complex issue.  I feel that moms really deserve to read the whole story, so I’m hoping to provide some context and better research today.

Why Water Births are a Safe Choice

The claims in this article are effectively these:

  • Tap water contains chlorine, which is toxic both directly (washing off important gut flora) and indirectly (producing fumes in the air that mom/baby breathe in)
  • Filtered water doesn’t adequately prevent bacterial growth, making infection in baby more likely
  • Water birth has no benefits and should be avoided

Let’s take a look at each of these, one by one.

Is Chlorine in Tap Water Dangerous?

Yes.  Chlorine is a dangerous chemical.  It would be ideal not to ingest it ever, or to breathe it in.  According to a 2012 study, chlorine and chemicals containing it can significantly impact gut flora, which can lead to an increased risk of several illnesses, including auto-immune disorders.  That’s concerning.

In a perfect world, we’d avoid chlorinated water in the birth pool.  Some chlorine will evaporate out of tap water, if exposed to UV light and left for several hours — overnight.  This is unlikely to impact the water in a birth pool, though, which is normally indoors, not left to sit for more than a few hours, and covered.

However, the related claim that filtered water is equally dangerous just doesn’t hold up.

She cites a story out of Texas of a baby dying of legionella.  This was, first of all, the only case of a baby dying from legionella after a water birth in the U.S. — hardly compelling, with thousands of babies water-born each year.  Second, although the birthing tub and water source were tested after the baby’s infection was discovered, they were not found to contain the bacteria.  Which means it was never proven that this baby’s death was due to water birth at all.

Additionally, this water that was suspected to contain legionella (but was not found to) was well water — not filtered tap water.  There is no reason to believe that filtered tap water would harbor bacteria or would allow for easy bacterial growth, especially since water birth tubs are rarely used for more than a few hours.  The most likely bacteria in the water would be the mother’s own bacteria, not something pathogenic.  This concern, being unfounded, seems more like nit-picking than fact.

Does Water Birth Impact a Baby’s Gut Flora?

The next important claim is that water birth, even if not contaminated somehow, will impact baby’s gut flora.  This is supposed to happen through two methods: washing the flora out of the mother’s vagina, and washing the vernix off the baby.

But are these really valid concerns?

One study shows that, in general, water does not enter the vagina.  Thus, as the baby is making its way through the birth canal, it is able to have access to normal flora whether on land or in water — the water does not wash this away.  (It can and does wash away flora in the vulva, or the outside of the mother’s genitals, but most of baby’s access to flora will occur before this point.)

Honestly, a longer pushing phase (in or out of water) is going to lead to a much greater exposure to vaginal flora than a shorter pushing phase.  Some women push for an hour or two; some push for a minute or two!  Yet, we’re not harping on pushing duration as an issue in colonizing gut flora, even though it likely has more impact.

What about the vernix?

Vernix is an oil-based substance.  Therefore, water does not wash it away.  Remember, baby is bathed in amniotic fluid — which is water-based — in the womb and is covered in vernix.  So no, being born in water is not going to wash this important substance off your baby!


Vernix is important and you do want it to stay on your baby.  Rubbing your baby with a towel after birth can remove vernix.  So can a bath with soap.  Both of these should be avoided.  Baby can be patted dry with a receiving blanket or towel very gently, and baths should be delayed for at least a week, preferably longer.  (We wash only the diaper area as needed with soap — like if there’s a massive blow out — but otherwise we stick to water until baby’s mobile.)

Is Birth That Critical to Baby’s Gut Flora?

So here’s an important question.  Sarah says that if you have a water birth, that you’re basically negating all of the work you did to build up your gut flora during pregnancy.  But is that accurate?  Is the moment of birth that critical, that your baby’s flora is messed up forever?  (We already know it’s not highly impacted by the water, but supposing it were.)

It’s an incredible amount of stress for a mother to think that if her baby’s birth isn’t perfect that she’s messed him/her up for life.  But the truth is that many things impact baby’s gut flora, with birth itself being only one part.

Last year, researchers discovered that the baby is actually first colonized in the womb.  The amniotic fluid and the placenta are both rich sources of bacteria, and the baby swallows these and they can be found in the meconium.  Some of the studies showed that most of baby’s gut flora is not similar to the mother’s vaginal flora, meaning that they develop it from many sources.

Vaginal delivery does have an edge over c-section for the development of healthy gut flora, though, for a variety of reasons.  Researchers suspect that some of the biological processes that take place with a natural-onset delivery are absent with c-sections, plus many c-sections lead to delayed breastfeeding.

But, it’s also worth noting that another study found that bacterial colonization in a newborn (as measured in their bowel movements, which were frequent) varied from hour to hour in the first week or so after birth, and that this flora was similar to stool flora from whoever touched the baby most — typically, their mother and their nurse.  This shows that despite the method of birth, early establishment of breastfeeding and limited contact with people outside the family in the first week or two of life is wise.

It’s known that diet is the most critical part of the development of baby’s gut flora.  In the early months, this means that breastfeeding is ideal.  The differences in gut flora between a breastfed and formula-fed baby do disappear between 1 and 2 years of age, but the importance of breastmilk in protecting the immature gut has not been thoroughly studied.  It is assumed to be very important, though, and several studies point to long-term reductions in obesity, diabetes, and more among breastfed infants.

When a mother takes probiotic supplements during pregnancy and breastfeeding, her infant is less likely to suffer from eczema (study).  This implies that yes, it does matter how we take care of our gut flora during pregnancy and beyond!  (And this was true regardless of birth method or location.)

Maternal probiotic supplementation also reduced the risk of colic, or reduced the severity/duration of colic in infants.  If a mother’s gut flora is disturbed, it will affect her infant — a new study shows that a mother’s gut flora ends up in her breast milk, and therefore, in her baby’s gut.

The point?  There are many things we can do to impact a newborn’s gut health.  Birth is not a make-or-break moment.  Taking probiotic supplements during pregnancy and breastfeeding, and otherwise caring for gut health, is important.  Early establishment of breastfeeding (preferably within the first hour after birth) and frequent skin-to-skin time with mom in the early weeks is also important to developing healthy gut flora.  Birth, while important, is not that critical (not so critical that it’s worth freaking out about, or avoiding water birth — which we showed earlier does not have a significant impact on flora transfer).

What’s the Deal on Water Birth?

We don’t have enough evidence, study-wise, to say that water birth is specifically beneficial.  But we also know it isn’t dangerous, as there has not been one proven case of neonatal death in the U.S. from water birth.  And we do know that water provides significant pain relief to many women, and reduces the need for epidurals and other birth interventions.  These interventions potentially have a far greater effect on baby’s health than water ever could.

If you’re interested in water birth, explore the option.  If not, no big deal.  It’s something that women who wish to do, should be encouraged to do.  It certainly is not “toxic” to either mother or baby.

If you do opt for a water birth, attempt to filter the water if possible.  We’ve been looking at a Berkey filter for our shower/tub for a while now (we already have one for drinking water).  If you’re unable, don’t worry too much — remember that there are many other things that more significantly affect your baby’s gut than the tub water!  (Especially if you regularly bathe in the water and will bathe baby in it — those exposures will matter much more, long-term, than a single, brief exposure at birth.)

Also remember not to rub baby roughly with a towel, don’t bathe baby with soap, and establish breastfeeding as soon as possible for optimal gut health.  There’s a lot more to be said on that topic, but we’ll leave it for now since the goal was mostly to explore the effects of water birth on gut flora. 🙂

Do you think water birth is toxic for babies?  Why or why not?

This is the writings of:



  1. Thank you for such a well laid-out response to the other post. The way she “informs” people can be so off-putting at times without being a well-rounded, researched piece.

    I appreciate how quickly you responded because even though I’ve had two water births, that post still planted a seed of doubt in me. Definitely more harm than good came from it for women looking into water birth..


  2. Thank you for this! I have liked some of the things published by The Healthy Home Economist in the past, although I stopped following her page/blog a few years ago (when she tried to push the idea that a vegan mother should use homemade formula for her baby rather than breastfeed). I didn’t read her water birth article, but it sounds like it wasn’t particularly well-researched, which is disappointing. Thanks for getting the real facts out.

    Also, Evidence Based Birth did a lengthy article about water birth not too long ago, which cited any and all relevant research related to the safety of water birth. Like you pointed out, while there may be no specific benefits to baby, the benefits to the mother are tremendous, and there is no real evidence of harm. Women with low-risk pregnancies who desire a water birth should have that option available to them!


  3. Thank you Katie! By the way, it looks like your comment did not actually include the link to this post (over on Sarah’s page).


  4. Yes! Thank you. That is all.


  5. Almost all of Sarah Pope, The “Healthy Home Economist” ‘s posts are poorly thought out, self serving, drama driven tripe.

    Why the Weston A. Price Foundation has aligned with such a woman, who has a master’s in government administration, is a mystery and a disgrace.

    Wouldn’t she view that degree in anyone else as alignment with “the man” she is always railing against?


  6. Don’t forget about flouride in city water, it is very toxic and you definitely dont want it in the birth pool. Many city water supplies also have excessive amounts of drug residues, heavy metals, agri chemicals, etc. Just be careful and filter it!


  7. Vaginal birth most definitely has more than just an edge over c-section. Watch the documentry called Microbirth. One thing that further proves though, that water does not enter the vagina, is that a mother CAN still be in the water after her water has broken, it has not been shown to have any affect on increased rate of infection.


    • I was thinking of that documentary too while reading this. It definitively shows how the transfer of flora at birth is quite significant. I don’t recall if they mentioned water births one way or another. In any event, these decisions are portent and very personal. I appreciate all the time and research being put into this subject; even contrasting views. Collectively it helps parents make a well-informed choice.


  8. Thank you so much for posting this! I found the HHE article so full of fear mongering and such a self-righteous tone. I read many of the comments on her FB page also because I expected a push back and she attacked everyone who didn’t agree with her. I still follow her site because I find some of her stuff interesting, but this was just one of many articles that I found over the top and aggressive. I’m very close to unfollowing her because I can find similar information elsewhere without the horrid attitude. Thank you also for addressing the issue in a respectful manner and not stooping to personal attacks and rude responses.


  9. I do appreciate your response but I think you come across as being a bit defensive. The main concern about colonisation by vaginal flora was not the “washing it off” but the weakening or killing of it by chorine. You didn’t seem to understand her concerns about water that hadn’t been disinfected, and she didn’t say that water birth had no benefits whatsoever.

    You may be underestimating the importance of colonisation by vaginal flora during birth, but as with the duration of pushing, I don’t believe that being born into normal water is going to have much of an impact. If all bacteria was washed off easily we’d essentially destroy our microbiome each time we had a shower. Chlorine in the water is different matter entirely , and it is nonsensical to think that exposure to it at one of the earliest stages of colonisation is nothing to worry about. It’s like saying that a newborn can handle whatever an adult can. So chlorine is really the issue here, and fortunately it can be filtered out.

    Another point that she made regarding water that doesn’t have disinfectant in it seems to have been missed. Yes, the only microbes in the tub are likely to be from the mother, but just because they aren’t causing disease in her doesn’t mean they are not pathogenic. We all have beneficial and pathogenic microbes colonising our bodies. Most of the time the pathogenic bacteria are kept in check by the beneficial bacteria and other environmental factors. As soon as the bacteria are washed into the water they enter an entirely different environment. The conditions in warm, still water allow pathogenic bacteria to thrive, whereas on the mother’s body they wouldn’t. You would have to be very careful about how long the water was used for during and after birth. Ideally you would use running water.

    “Some of the studies showed that most of baby’s gut flora is not similar to the mother’s vaginal flora, meaning that they develop it from many sources.” While it is true that babies are colonised by many sources, the fact that “most baby’s gut flora is not similar to the mother’s vaginal flora” is not a valid argument due to the fact that most babies do not satisfy the ideal circumstances likely to produce gut flora most like the mother’s vaginal flora, i.e born vaginally, born at home, and breastfed.

    I think it was a bit dishonest to claim that she said there were no benefits to water birth. She acknowledged the analgesic benefits and simply stated they weren’t enough for her to take the risk.

    Yes, she is quite vehement in her article, but pretty much all of her writings are like that. While you may not agree with her assessment of the situation this time, she has raised some very important points that should be considered if anyone is planning a water birth; points that not everybody will think of and that midwives aren’t necessarily addressing. I appreciate knowing how and why you would proceed in this area, just as I appreciate how and why she would proceed. It’s now up to us to decide what we do based on this knowledge.


    • Not defensive. I believe women deserve information from all angles, that is well-researched, in order to make an informed decision. It’s my goal to provide that. Nothing more or less. If you were reading defensiveness, that’s just you.


  10. Thanks for the article… I am doing my third water birth this winter, and this caught my eye. I have my own well, so I will be doing some research about chlorine levels but I was wondering why Sarah doesn’t just say, “don’t expose your kid to chlorine” and leave it at that… http://www.wikihow.com/Dechlorinate-Water you can just de-chlorinate the water, right? then its a win win… no need to demonize such a wonderful birth option.


  11. I had a water birth with my first child and had a wonderful experience. Having my husband in there with me was really comforting and I found the birthing process much more peaceful that I’d imagined. Now, my son was born with eczema, which progressed to a pretty serious case, and he’s now developed severe food allergies and asthma. So, is it possible the birth contributed to this? Possibly, but that would be hard to prove. And in the end, the experience was really calm and loving and I wouldn’t trade it for the world.


  12. Thank you for this common sense!


  13. Thanks for this great post. I appreciate seeing both sides of the picture. I look forward to checking out more of your articles.


  14. Thank you for this response. I read Sarah’s article the other day and felt so deflated as I laboured/birthed all 3 of my babies in a birthing pool (at home). I was so blessed to have peaceful and successful births with all of them and stepping into the water was just heavenly for me. I am pregnant with my 4th and was planning the same home water birth situation for this one, but it felt slightly threatened by Sarah’s article. I now feel relieved! As for the vernix; my second was born covered in thick white vernix in the water, when he came out we gently patted him dry and it took about 10 days for it to naturally disappear (we didn’t bath him in the first couple of weeks), the water didn’t seem to affect it at all. So thank you! ☺️


  15. Thank you for this article! Sarah’s article was done very poorly and had more fear mongering than helpful facts. I very much appreciate your information and common sense. I had a water homebirth with my first, it was so peaceful and wonderful. I am planning a water birth again for my next (in 8 weeks or less) and her article very much bothered me. We moved and will be filtering the water since we’re on city water but we’ve planned for this already to remove the chlorine. We don’t shower without a filter so this decision was no different. Water birth has amazing benefits and as someone who researches birth a lot, I am adamant that women should have this option if possible.


  16. Thank you for this article!!!


Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Hi, I’m Kate.  I love medical freedom, sharing natural remedies, developing real food recipes, and gentle parenting. My goal is to teach you how to live your life free from Big Pharma, Big Food, and Big Government by learning about herbs, cooking, and sustainable practices.

I’m the author of Natural Remedies for Kids and the owner and lead herbalist at EarthleyI hope you’ll join me on the journey to a free and healthy life!

Meet My Family
Love our content? Sign up for our weekly newsletter and get our FREE Nourished Living Cookbook!