Water immersion for labor and delivery refers to giving birth in pool of warm water. The goals are to improve comfort of the mother and to give the neonate a transition from in utero to the outside world. However, its use may be associated with complications.

Recommendations: There are some limited benefits in stage 1 of labor. It is not recommended for the second stage of labor.


Infectious complications may include several water-associated pathogens such as:

(1) Pseudomonas species

(2) Legionella species


Features of these pathogens:

(1) Onset of infection may be delayed.

(2) The organisms may be poorly responsive to empiric therapy.

(3) The neonate may present with respiratory distress, pneumonia and/or sepsis. Less often other infections may occur such as otitis media.


In addition, water with fecal contamination may contain enteric bacteria which can cause a range of infections.


These can be prevented by rigorous cleaning and disinfection. Special care is necessary if the water has been in the delivery tub for several days or if there is temperature dysregulation.


Non-infectious complications:

(1) hypothermia (if water is not warm)

(2) drowning or near-drowning

(3) respiratory distress

To read more or access our algorithms and calculators, please log in or register.