Mothers have many choices when it comes to creating a birth plan, and some of them are quite controversial among the medical community. Water births — also called immersion births — have long been viewed as problematic for a variety of reasons, but now doctors and public health officials have identified even more reason for concern.

Last year, two infants born in birthing pools in Arizona contracted Legionella, a potentially deadly bacteria that thrives in damp environments. Both infants who contracted Legionella from birthing pools during water births were thought to have inhaled contaminated water into their lungs during the birth. Fortunately, with antibiotic treatment, both infants survived.

Legionella is a bacteria that lives in warm, damp environments, so it can easily multiply in water tanks or pipes. People can then become infected by breathing in the contaminated water droplets, or if the water accidentally goes into their lungs. Legionella can cause pneumonia and other respiratory problems. Left unrecognized and untreated for too long, this can prove to be deadly, especially among immunocompromised individuals, such as infants and the elderly.

Legionella can cause outbreaks of illness, often in areas with large heating and cooling systems. This bacteria has been linked to outbreaks in hotels, nursing homes, hospitals, and cruise ships.

Public health officials do state that such infections are rare, but infants born in water are at risk due to the fact that there are no standardized infection prevention measures for water births. Even if the birthing tub is thoroughly cleaned and disinfected prior to use, the plumbing system itself could be contaminated.

The American College of Obstetrics and Gynecology (ACOG) does not recommend water births, as they have shown no proven benefit to the mother or the newborn. They also state that the safety and efficacy of submersion in water during delivery has not been established, so both the mother and the baby could be at risk.

If you do decide to give birth in a birthing pool or tub despite the risks, there are precautions you should discuss with your physician or midwife before you go into labor. Make sure the facility you are using has strict protocols to maintain and clean the tubs as well as criteria for monitoring both the mother and the baby during active labor while submerged. Also make sure the facility has a plan in place to move you quickly and safely out of the water if an unexpected complication arises.


  • Immersion births are when a baby is delivered in a pool of water.
  • The bacteria that causes Legionnaire’s disease thrives in warm, wet environments.
  • Two cases of Legionnaire’s in newborns have been linked to immersion births.
  • ACOG advises against immersion births.

Last reviewed by Diana Huang, MD, FACOG. Review Date: May 2020


  1. American College of Obstetricians and Gynecologists. Immersion in Water During Labor and Delivery.
  2. Centers for Disease Control and Prevention. Legionnaire’s Disease.
  3. Red Book Online. Legionella pneumophila Infections.
  4. Washington Post. Infants born in water births at risk of Legionnaires’ disease, CDC says.


  1. The link to legionnaires disease from immersion birth is mere conjecture. Both mothers and babies are more likely to get an infection in the hospital environment because hospitals are petri dishes for all kinds of microbes. Hospital areas can be sanitized by various standard means until h-ll freezes over, however, dangerous microbes still persist. Perhaps the most dramatic case is MRSA. I would never birth my children in the hospital because in the hospital birth is treated like a medical procedure with IVs, monitors, restraint, denial of food and liquid, needless intervention and impatience by the attending medical professionals. I am 29 years old and I’ve had all three of my children at home. My last birth experience was 2 1/2 of years ago in which I had twin boys with the assistance of two traditional midwives and it was an immersion birth. One thing you seldom get in a hospital or even freestanding birth centers is one of the most important things of all: continuity of care. The morbidity/mortality rate of homebirths attended by traditional midwives is slightly less than that of birthing in hospitals. This is partly because traditional midwives become friends from the very first prenatal visit of a pregnant mother and stay with that mother all through pre- natal exams, labor and birth and breast-feeding and early childhood assistance. When a mother gives birth with the help of traditional midwives who have thousands of successful births with less than five to no mortalities. Mothers sho give birth at home using traditional midwives are in a safe and familiarplace with people they trust instead of in a unfamiliar place in which they have little or no control. Treating labor and birth as if it is a medical procedure – with the use of concommitment hospital paradigms like anesthesia or epidurals or various kinds of pain blockers and over-intervention – serves to create stress and anxiety, hence, hospital-induced complications which makes for unnecessary long and painful labor. This is the main reason why there are so many c-sections in hospital births. For so many mothers having their babies in hospitals is very traumatic. It ends up this way because hospital births tend to have iatrogenic effects on both the mother and the baby. I totally agree with the commentor who stated that the established, hospital-based, medical profession does not want to have people having their babies at home because that means a loss of revenue. That is the only reasonable explanation as to why an article like this would be published implying by conjecture that A whopping total of two cases of babies having legionnaires disease who were born through the water immersion method are somehow linked. Slowly but consistently women are coming to realize that they can and should take control of their own reproductive and birthing responsibilities – that they have the power within themselves to make the right decisions without being brainwashed by entities who really have their motivations based on how much money they can make. Surgery, like a C-section, is a lot faster and cost a lot more than allowing the mother to follow her instincts and the guidance of Highly experienced traditional midwives who know what they’re doing.

    1. Hi Julianna, Thanks for your comment! I feel we present a pretty balanced article about home birth here, acknowleding current data, recommendations, and the importance that a woman should be free to make her own choice about where she delivers:

      1. Hi, Dr. Lincoln

        As a PA who had four home births (three of them water births), I would just like to add that this article does not come across as balanced. It is negative about water births from the first paragraph to the last. It would seem more balanced if the article included any information about why mothers choose to birth in the water, or if the article included ACOG’s admittance that, “Immersion in water during the first stage of labor may be associated with shorter labor and decreased use of spinal and epidural analgesia…”

        It is worth noting that according to the CDC, one of the two infections occurred in an infant who was birthed into a tub where the tap water had been kept at 98 deg F for a full week before the delivery. The other infant had an underlying congenital heart defect deemed to be primarily responsible for the nearly 2-month hospital stay.

        It is also worth mentioning that exactly a year ago CDC reported on the occurrence of Legionnaire’s Disease in hospitals (and nursing homes), with the conclusion that, “high case fatality rate of health care–associated Legionnaires’ disease highlights the importance of case prevention and response activities…” meaning Legionnaire’s Disease is not a danger specific to home water births but is a threat in the hospital, as well.


  2. After almost loosing 2 babies to a Hospital Birth we choose to deliver at home as far away from Doctors as possible. We also choose to deliver in warm water but we do not use a birthing tub or a regular bath tub we purchase a brand new inflatable pool and deliver in there that way it is clean and can be thrown out when done… ACOG is just upset that Homebirth’s are becoming n\more and more popular and that is eating into their profits..


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