Giving Birth
Labouring in Water
A guide to labouring in water for comfort and pain relief, how it differs from water birth, individual suitability, maternal and fetal monitoring, water temperature, infection control and reasons to leave the pool.
Important medical note
Labouring in water is a provider-dependent option that requires individual clinical assessment and appropriate maternity-facility protocols. Entering a birth pool does not mean that the baby will be born in water. Leaving the pool may be necessary if maternal or fetal concerns develop or monitoring or treatment cannot be provided appropriately while immersed.
What does labouring in water mean?
Labouring in water means spending part of labour in a purpose-designed pool of warm water for comfort and pain relief.
A woman may enter the pool and later leave it, with the baby ultimately born out of water.
Labouring in water is therefore different from water birth.
Main purpose
Comfort and pain relief
NICE recommends offering the opportunity to labour in water as a pain-relief option.
Water temperature
No higher than 37.5°C
NICE recommends checking maternal and water temperature hourly and keeping the water at no more than 37.5 degrees Celsius.
Availability
Provider dependent
A suitable pool, candidate-selection process, monitoring, infection control and trained maternity staff are operational requirements that vary by facility.
Labouring in water versus giving birth in water
These terms describe different parts of the birth pathway.
Labouring in water means using the pool during part of labour and does not require the baby to be born while the mother is immersed.
Water birth means the baby itself is born while the mother remains in the water.
A maternity facility may support labour in water without supporting underwater birth, so the two capabilities should be checked separately.
Who can discuss water immersion during labour?
Suitability should not be determined by an online page or automatic checklist.
Assessment considers maternal health, gestational age, fetal wellbeing, the course of pregnancy, findings when labour begins and local facility protocol.
International guidance can use specific candidate-selection criteria, while local policies may differ in detail.
A hospital having a birth pool therefore does not mean every woman is automatically suitable to use it.
How water can support comfort during labour
Warm-water immersion is a non-pharmacological option for comfort and labour pain management.
Buoyancy can make movement and position changes easier for some women and may support relaxation and privacy.
Individual experience varies, and water does not guarantee complete pain relief.
It also does not guarantee vaginal birth or prevent intervention if circumstances change.
Entering the pool and timing its use
The maternity team can advise when pool use is appropriate according to labour progress, maternal and fetal condition and local policy.
Maternal observations, fetal heart assessment and labour progress may be reviewed before entry.
The woman may leave the pool whenever she wishes, and the team may also recommend leaving if the clinical situation changes.
Water temperature, cleaning and infection control
Water temperature
NICE recommends checking the temperature of both the woman and the water hourly while labouring in water.
Water temperature should not be above 37.5°C.
This helps maintain comfort and reduces concern about maternal overheating.
Pool cleaning
Birth pools require an agreed cleaning and infection-control protocol.
NICE recommends cleaning in accordance with infection-control guidance and manufacturer instructions where applicable.
A pool should therefore be part of an organised clinical system, not simply a piece of equipment placed in a birth room.
Monitoring mother and baby while immersed
Entering the pool does not stop normal clinical assessment.
The team continues to assess maternal wellbeing, labour progress and fetal wellbeing using methods appropriate to the pregnancy and available equipment.
Fetal monitoring may be intermittent or continuous depending on clinical risk.
If the required monitoring cannot be provided appropriately while immersed, leaving the pool may be necessary.
When leaving the pool may become necessary
Pool use should be understood as a flexible option, not a commitment to remain in water throughout labour.
The maternity team may recommend leaving if maternal or fetal concerns develop, or if assessment, monitoring or treatment cannot be delivered appropriately in the pool.
A woman may also choose to leave because of discomfort, dizziness, feeling too warm or simply wanting a different way to manage labour.
Leaving the pool does not mean the birth plan has failed.
Pain-relief options alongside water immersion
Water use does not prevent discussion of other labour pain-relief options.
If immersion no longer provides sufficient comfort, other options available at the facility can be discussed.
Some forms of analgesia or monitoring require leaving the pool, so understanding the local options in advance can be useful.
If the woman wants the baby to be born in water
Remaining immersed for the birth itself changes the discussion from labouring in water to water birth.
These are separate options because the evidence, facility protocols and clinical requirements are not identical.
International professional guidance does not take an identical position on underwater birth, so informed discussion of the local policy and available evidence is important.
A facility appearing as supporting labour in water on LahaLak should not automatically be interpreted as supporting water birth.
Planning to labour in water in Saudi Arabia
The Saudi Ministry of Health lists water birth among the birth details women can choose from available options.
Availability remains important because maternity facilities differ in equipment, staffing and clinical protocols.
Questions to ask a maternity facility
- Is a dedicated birth pool available?
- Does the facility support labour in water only, or water birth as well?
- What are the eligibility criteria for pool use?
- How are maternal and fetal wellbeing monitored in the pool?
- How are water temperature and pool cleaning managed?
- What circumstances require leaving the pool?
- What alternative pain-relief options are available?
A provider-dependent option
LahaLak represents labouring in water as a provider-supported option requiring clinical assessment.
A listed capability describes what a maternity facility can potentially support; it does not guarantee individual eligibility.
Frequently asked questions about labouring in water
Answers about water immersion for labour pain, water temperature, monitoring, leaving the pool, water birth differences and maternity-facility availability.
Is labouring in water the same as water birth?
No. A woman can use a birth pool during labour and leave before the baby is born.Water birth means that the baby itself is born while the mother remains immersed, and it requires a separate clinical and facility discussion.
Can water help with labour pain?
Warm-water immersion can provide comfort and help some women manage labour pain.NICE recommends offering the opportunity to labour in water as a pain-relief option, but individual experience varies.
What temperature should the pool water be?
NICE recommends that the water temperature should not be above 37.5°C.Maternal and water temperature should also be monitored hourly while labouring in water.
Can I stay in the pool regardless of what happens during labour?
No. Pool use remains flexible and depends on maternal and fetal wellbeing.Leaving may be recommended if concerns develop or if monitoring, assessment or treatment cannot be provided appropriately while immersed.
Does using a birth pool prevent epidural pain relief?
Water immersion does not remove the option of discussing other methods of pain relief.Some options, including epidural analgesia, require leaving the pool and preparing for the treatment outside the water.
Is labouring in water suitable for every pregnancy?
No online page can determine individual suitability.Suitability depends on the pregnancy, maternal and fetal condition when labour begins, monitoring needs and the maternity facility protocol.
Does every Saudi maternity hospital offer labour in water?
Availability should not be assumed at every facility.A service needs appropriate pool equipment, candidate-selection protocols, monitoring, infection control and trained staff.
Does entering the pool mean my baby will be born in water?
No. Pool use during labour does not guarantee or require underwater birth.A woman can leave and give birth outside the pool, and water-birth availability should be checked separately.
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