For doctors

A submersion birth is exactly what it sounds like: giving birth while partially submerged, usually in a bathtub or a special submersion birth tub found in some hospitals and birthing centers. Already popular overseas, submersion births have been gaining a following in the United States. According to proponents of submersion births, they reduce the stress on the baby as well as make birth less painful and traumatic for the mother.

There is, however, much controversy surrounding submersion births. In fact, the American Academy of Pediatrics strongly opposes them for safety reasons. According to the AAP’s Committee on Fetus and Newborns Commentary on Underwater Births:

“A review of the available literature indicates that the risks of underwater birth to the newborn seem to outweigh the benefits, and caution is urged before widespread implementation. Although there is no suggested benefit of underwater birth to the newborn, morbidities identified in clinical reports have raised concerns that this mode of delivery may not be safe.”

Submersion birth pros (although these have not been supported by research):

  • Mom’s pain and anxiety can decline.
  • Mom may have a shorter initial labor.
  • Mom may have less vaginal tearing.
  • Baby can cry less and appear more comfortable.
  • Baby can achieve higher Apgar (reflex) scores.

Submersion birth cons:

  • Baby can inhale bath water and drown.
  • Baby can suffer brain injury from lack of oxygen under water.
  • Baby can suffer low blood sodium from swallowing water, leading to seizures.
  • Baby’s umbilical cord can rupture and cause uncontrolled bleeding.
  • Baby can get an infection from unclean bath water.
  • Mom with herpes can transmit infection to baby, causing a life-threatening infection.

Who’s a candidate for submersion births?

  • Mom who’s free of pregnancy complications, like blood infection or high-blood pressure.
  • Mom who’s free of transmittable STDs.
  • Mom who’s giving birth to one baby.

Who’s not a candidate for submersion birth?

  • Mom who’s in premature labor.
  • Mom who’s giving birth to twins or more multiples.
  • Mom who’s suffering from excessive bleeding.

Before deciding on submersion birth, make sure to talk it over with your obstetrician and carefully consider whether the well-documented risks to your baby’s health are worth the experience.


  • If your baby is in a breach position (feet or bottom first), check with a medical professional before you try submersion birth.
  • If you plan to deliver at a medical site, make sure it offers submersion birth—most U.S. hospitals do not.
  • Talk with your obstetrician about the benefits and risks of submersion births for you and your baby.
  • If you try submersion birth, make sure that both your pool and water are clean.


  1. American Academy of Pediatrics Journal. Underwater Births.
  2. Mayo Clinic. Water birth: Safe for mom and baby?
  3. Fox News. Growing number of women choosing water births.

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  1. Great questions! It is well documented that many babies have become sick or even died from inhaling water into the lungs during a submersion birth, which supports the fact that sometimes newborns do in fact take that first breath while still under the water. Some infants have also been found to have low sodium levels (which can lead to seizures), also supporting the fact that they have inhaled the water, causing their sodium levels to become diluted in a sense. As for herpes, a baby born to any woman who has active herpes lesions at the time of birth is at significant risk of developing a potentially fatal infection. If this is the case, it is recommended that the woman have a c-section to prevent the baby from coming into contact with the vaginal secretions (reducing the risk to the baby by as much as 80% in some studies). In a water birth, the baby comes through the vaginal canal, so the baby comes into direct contact with the herpes lesions. So while a water birth is no more dangerous than an out-of-water vaginal birth in regards to herpes, the recommended method of delivery of a mom with active herpes is via c-section, not thru the birth canal regardless of whether it is in or out of water.

  2. I’m not trying to sound stupid but I really don’t understand…how can a baby drown if it breathes in the water when the baby has been in a sac of fluid for 40 weeks? I thought the baby didn’t take it’s first breath until it hits the air (which it wouldn’t if underwater). Also, how is birthing in water risky for herpes transmission? I mean, unless born via c-section, how does water make it riskier than a “dry” vaginal birth?