Childbirth with hydrotherapy during labor contractions at the Genesis Dnipro maternity ward, Dnipro.

What are water births during contractions:

a way of managing labor in which part of the active phase takes place in water (in a birth tub or pool) to ease discomfort and promote relaxation.

Who these births are suitable for:

most often women with an uncomplicated (physiological) pregnancy and no medical contraindications, after an initial assessment of their condition.

It is important to discuss in advance with the doctor and midwife the indications and contraindications, methods for monitoring mother and fetus, pain-relief options, and organizational details.

The decision to labor in water is made individually based on the clinical picture and can be changed if new indications appear.

The priority is the safety of the mother and baby, so the birth plan remains flexible.

What does water-assisted labor during contractions mean

This is a format in which part of the active phase of labor takes place in water — in a birthing tub or small pool — to promote relaxation and reduce discomfort. It offers a different environment and organization of care than standard bed-based labor and requires a particular approach to monitoring. Before planning it is important to discuss indications, contraindications, and practical details with your doctor and midwife.

Practical meaning: some contractions are experienced in warm water to relax muscles and reduce tension.
Difference from other scenarios: there is greater freedom of positions and movement in the water than on land.
Monitoring methods: maternal and fetal monitoring are adapted for the aquatic environment.
Questions to discuss: water temperature, duration of time in the water, and pain-relief options.
Limitations: not suitable when there are medical indications for operative delivery or in the presence of complications.
Organization: preparing the tub, monitoring by a doctor and a midwife, and rules for partner presence.

The choice to use water during labor is made individually and may be changed during labor if indications arise. The main priority is the safety of the mother and baby.

Who might be suitable candidates for labor with hydrotherapy

Labor with hydrotherapy during contractions can be considered an option under certain clinical conditions and depending on the patient's preferences. It may be appropriate for those who want to try part of labor in water while under medical supervision. It is important to discuss indications, contraindications, and organizational details in advance with a physician and a midwife.

A desire to discuss the birth scenario and organizational details in advance.
A need for the partner or a support person to be present for organizational or medical reasons.
Interest in discussing pain-relief options and maternal and fetal monitoring.
A wish to understand who will attend the birth and how it will proceed.
A pregnancy without serious complications — a possible but not guaranteed factor.
An intention to remain active and free to change positions during contractions.
Consideration of previous birth experience when forming an individual plan.
A need for a calm, clear, and flexible birth plan.

The final decision is made based on clinical assessment; the plan may change if indications arise.

When water birth may not be suitable or may require restrictions

Water birth is not a one-size-fits-all option, and in some situations it is limited or modified. Restrictions are usually related to clinical necessity or organizational circumstances. Decisions are made with the safety of the mother and baby in mind.

Obstetric complications that require operative intervention or increased maternal monitoring.
Signs of fetal distress on monitoring that require urgent assessment and possible intervention.
The need for an urgent cesarean section or other operative delivery.
Contraindications to certain analgesia/anesthesia methods when their use is critical for safety.
Infectious or organizational reasons that prevent a partner/support person from being present.
Rapidly progressing labor when preparing a birthing pool and arranging a water birth is not possible.
Maternal conditions requiring continuous on-land monitoring or emergency treatment.

Such restrictions are a normal part of clinical decision-making; the plan is changed when necessary for the safety of the mother and baby.

Who is involved in deciding the mode of delivery

The choice of delivery mode is a shared clinical decision based on the pregnant woman’s preferences and medical indications. The woman may state her preferences in advance, for example for a water birth (hydrotherapy), but the final decision depends on the current situation. The obstetrician and midwife assess lab results, ultrasound, fetal condition, and the progress of labor. Other specialists are involved in the discussion as necessary.

- The woman’s preferences are taken into account when forming a preliminary plan.
- The obstetrician and midwife evaluate the current status of the pregnancy and the results of examinations.
- Assessment of the fetal condition and the pattern of the fetal heart rate influence the choice of delivery mode.
- An anesthesiologist is consulted when discussing pain relief and its limitations.
- A neonatologist will be involved if there are risks to the baby or in cases of preterm birth.
- Organizational and infection-control factors are also considered when deciding on water birth.
- The decision is made jointly and recorded in the birth plan.

A birth plan is not set in stone: it may change during labor for medical reasons.

The main principle is shared decision-making aimed at the safety of the mother and baby.

What to discuss with your doctor before labor

Before the appointment, it's helpful to make a list of questions and go over the key points of your birth plan. These questions will help you prepare to talk about having a water birth and understand which decisions can be made in advance. Bring your notes to the visit and clarify which items are relevant to your particular situation.

What birth format do I prefer, and are there any medical restrictions?
Is my partner allowed to be present, and what are the requirements for their participation?
What pain-relief options are available, and do I need an anesthesiologist consultation beforehand?
Are my previous births, a cesarean, or past complications taken into account when choosing the birth format?
Which chronic conditions affect the birth plan and monitoring?
Which ultrasound results and tests are important for deciding the birth format?
What is the plan of action if the mother's or baby's condition changes?
What should I pack for the maternity hospital and which documents should I prepare in advance?
When is it best to go to the clinic after labor starts or if my waters start leaking?
What accommodation and immediate postpartum arrangements are provided by the maternity hospital?

Write down the answers and save contact details for your doctor and midwife for quick access.

Remember that the plan may change for clinical reasons in order to ensure safety.

How to prepare for labor with hydrotherapy

Preparing for labor with hydrotherapy is a coordinated effort by the medical team and the expectant mother to assess safety and organizational details. It usually includes a clinical assessment, discussing the plan, and preparing the space for water labor. It is important to understand that preparation facilitates the process but does not guarantee that the water format will remain possible until the very end.

Consultation with a doctor and an obstetrician to assess condition and indications.
Review of the maternity record and verification of up-to-date ultrasounds and lab tests.
Discussion of the birth plan: when and how time in the water will take place.
Consultation with an anesthesiologist if pain-relief options are to be discussed.
Organizational preparation of staff and preparation of the birthing tub.
Briefing the partner on presence requirements and safety rules.
Discussion of criteria for transfer to land-based management or operative intervention.
Clarifying belongings, documents, arrival time, and route to the clinic.

Good preparation helps you feel more confident, but the final decision is made during labor based on medical indications.

How labor with hydrotherapy typically proceeds

Labor with hydrotherapy proceeds in stages and resembles a conventional birth, but part of the active phase takes place in warm water. The decision to move into the tub and how long to stay is made based on examination and monitoring. The entire process is attended by an obstetrician and a midwife; an anesthesiologist or neonatologist is called in if needed. The plan remains flexible and may change for the safety of the mother and baby.

Admission to the clinic and initial assessment of the mother and fetus.
Assessment of suitability for water labor and discussion of the plan with the patient.
Preparation and checking of the birthing pool and maintenance of a safe temperature.
Transfer into the water during active contractions if there are no contraindications.
Monitoring of contractions and adapted/modified fetal monitoring.
Presence of the physician and midwife, with possible participation of the partner as permitted.
Discussion of pain relief options; anesthesiologist consulted if necessary.
Pushing stage: the baby may be born in the water, or the mother may be transferred out of the pool if indicated.
Immediate initial assessment of the newborn and first skin-to-skin contact.
Transfer of the mother and baby to the postpartum ward for observation and care.

This is a typical scenario, but decisions during labor may change for clinical reasons to ensure the safety of the mother and baby.

Pain relief during labor with hydrotherapy

Discussion of pain relief options should ideally take place in advance to account for the clinical situation and organizational details. Options are selected based on the condition of the mother and fetus; an anesthesiologist may be involved for consultation and planning if necessary. Some pain relief methods may be limited while the mother is in the water, so all questions should be addressed before and during labor.

Discuss pain relief options during the prenatal consultation.
Consult an anesthesiologist when planning epidural or pharmacological support.
Non-pharmacological methods: relaxation, breathing, movement, and the warmth of the water.
Pharmacological methods: systemic analgesia and epidural anesthesia when indicated.
Compatibility of methods with hydrotherapy should be discussed in advance and on an individual basis.
The choice of method depends on the condition of the mother, the fetus, and the progress of labor.
The pain relief plan may be adjusted during labor for medical reasons.
Complete absence of pain cannot be guaranteed; the goals are to reduce discomfort and ensure safety.

Discuss any questions with your doctor and anesthesiologist before labor to understand possible limitations and alternative scenarios. The final decision is made jointly, with a focus on the safety of the mother and baby.

How safety and monitoring are ensured

During water births the team pays attention to both comfort and the mother’s and fetus’s well‑being. Monitoring combines clinical assessment with monitoring tools adapted for the water environment. This allows timely detection of changes and adjustment of the management plan if necessary.

Monitoring by the obstetrician and midwife of the mother’s overall condition and vital signs.
Assessment of the fetal heart rate on admission and during labor.
Cardiotocography (CTG) performed as indicated or for periodic fetal checks.
Monitoring contraction frequency, the strength of pushing efforts, and the progress of cervical dilation.
Readiness of the team to transfer to land‑based care or to perform operative intervention.
Control of the birthing pool’s temperature and hygiene.
Involvement of a neonatologist if needed to assess the newborn immediately after birth.

Monitoring is a routine part of labor and does not always indicate a problem. When necessary, the birth plan may be changed to ensure the safety of the mother and baby.

If labor doesn't go according to plan

A birth plan is a guideline, especially during water births, but it may change as labor progresses. Changes are made not on a whim but for clinical reasons and for the safety of the mother and baby. The team will explain the situation and offer options based on examination and monitoring.

Enhanced monitoring of the mother and fetus to rapidly assess progress.
Moving out of the water to the surface when necessary for more complete control.
Providing additional therapy or stimulating labor when indicated.
Deciding on urgent operative delivery (cesarean section) if required.
Limiting or being unable to provide epidural anesthesia for medical reasons.
Temporarily suspending the partner’s presence for organizational or infection-control reasons.
Involving an anesthesiologist and a neonatologist to address emergency clinical issues.

Changing the plan is not a sign of failure but a normal part of clinical care; all decisions are made for the safety of the mother and baby. The team will try to explain the next steps and options in detail.

Possible risks and limitations of water-assisted childbirth (hydrotherapy)

Every birth format has its limitations, and hydrotherapy-assisted births are no exception. Risks and limitations depend on the condition of the mother, the fetus, and the course of the pregnancy, so they are assessed individually. Your doctor and midwife will explain in advance in which cases the plan may change and what options are available.

Format limitations: water-assisted labor is not always possible in the presence of complications.
Risk depends on the condition of the mother and fetus and on how the pregnancy is progressing.
Possibility of needing interventions: induction or augmentation of labor, or operative delivery (instrumental delivery or cesarean).
Analgesia/anesthesia limitations: some pain‑relief methods are incompatible with remaining in the water.
Organizational or infection‑related reasons that may lead to cancellation of a water birth.
Other women’s experiences can be helpful but do not guarantee the same outcome in your situation.
Safety first: the plan will be changed if necessary for the wellbeing of the mother and baby.

Discuss possible limitations in advance with your doctor and midwife — the care team will explain the criteria for changing tactics and the alternatives available.

What happens immediately after birth

In the first minutes and hours after delivery, the team helps establish contact between the mother and baby and assesses their condition. At our clinic, CTG (cardiotocography) and an examination of the newborn by a neonatologist are always performed. Further actions depend on the condition of the mother and baby and may differ for each pair.

First skin-to-skin contact between mother and baby, if the condition of both allows.
CTG and a mandatory examination of the newborn by a neonatologist are carried out shortly after birth.
A quick initial assessment of the newborn: evaluation of breathing, muscle tone and skin color.
Assistance with the first latch and support for the start of breastfeeding.
Monitoring the mother's condition: checking for bleeding, blood pressure and general wellbeing.
If necessary — additional assistance or transfer to the operating room to address clinical needs.
Transfer of the mother and baby to the postpartum ward for further monitoring and recovery.

Each mother–baby pair goes through this stage differently, and the team will explain in detail what is happening and why. Additional measures are taken when necessary to ensure the safety of mother and baby.

Role of the physician and the team during childbirth

Birth is managed by a coordinated team, not a single person, and this is especially important during water births. The physician and midwife assess the condition of the mother and fetus, monitor the progress of labor, and explain each decision to the patient. If necessary, an anesthesiologist, neonatologist and operating team join the care.

- Assessment of risks and making clinical decisions in real time.
- Monitoring the dynamics of labor and adjusting management as indicated.
- Explaining to the patient what is happening and the possible courses of action.
- Obstetrician‑gynecologist — coordination of care and medical responsibility.
- Midwife — monitoring in the delivery room, support, and performing procedures.
- Anesthesiologist — assessment and organization of pain relief/anesthesia if needed.
- Neonatologist and operating team — readiness to assist the newborn and the mother.

The team works to ensure the safety of the mother and baby and to support you through the process. The birth plan is discussed jointly and may change for medical reasons.

How this format is convenient for the patient

Labor with hydrotherapy can give the patient a more predictable, pre-discussed plan of action while maintaining medical oversight. This format allows you to voice preferences in advance, clarify team roles, and understand what actions are possible if the situation changes. The team helps organize the process so that it is clear and comfortable for you.

A clear birth plan discussed in advance with the doctor and midwife.
The opportunity to state preferences ahead of time and reduce feelings of uncertainty.
Comfortable positions and freedom of movement in the water to relieve tension.
Monitoring of the mother’s and baby’s condition in an adapted manner.
Availability of pain-relief options and discussion of them before labor.
The ability to arrange partner presence and logistical details in advance.
The option to choose and arrange for a specific doctor to be present, if permitted.

This format helps you prepare better and feel calmer, but final decisions are made during labor for the safety of the mother and baby.

How the pre-delivery consultation works

A pre-delivery consultation is a structured meeting in which the team reviews your situation and agrees on a realistic management plan. During the appointment they assess your medical history, review your maternity record and test results, and discuss your expectations. If you are considering a water birth, the compatibility of that option with your current condition will be discussed separately. The consultation helps you understand possible scenarios and answers important questions.

Taking medical history: previous deliveries, chronic illnesses, and surgical interventions.
Reviewing the maternity record and up-to-date ultrasound results, tests, and examinations.
Discussing your preferences for the birth (format) and the role of your partner.
Explaining possible limitations and scenarios in which the plan may need to change for medical reasons.
Helping you choose a safe delivery option given the clinical picture.
Talking about when to go to the clinic once labor begins.
Clarifying whether a consultation with an anesthesiologist or other specialists is needed.
Answering questions and agreeing on next steps and contact details.

Sometimes multiple appointments or additional examinations are required to make a final decision. Come to the consultation with your maternity record and a list of questions — this will speed up the discussion.

Please note that online consultations are available for patients from other cities. We often receive requests from Zaporizhzhia, Pavlohrad, Kamenskoye (Dniprodzerzhinsk), Novomoskovsk (Samar), Kryvyi Rih, Nikopol, Marganets, Sinelnikovo, Pokrov, Zhovti Vody, and other cities.

Preparation for admission for childbirth

A brief practical check can help you arrive at the maternity ward prepared and calm, especially if you are planning a water birth. Try to gather the main documents and up-to-date medical information in advance, and discuss the specifics of your scenario with your doctor. The exact list may vary depending on the team's recommendations and the clinical situation.

Documents: passport, insurance policy, and medical referrals if available.
Pregnancy/maternity record with monitoring notes and your doctor's recommendations.
Up-to-date ultrasound results and laboratory tests that you bring to appointments.
Items for the mother: basic personal belongings for the hospital stay.
Items for the baby: essential basics for after birth.
Partner’s items and documents, if their presence has been agreed upon in advance.
A list of regularly taken medications, with discussion of their use with your doctor.
Doctor’s contact details, the route to the clinic, and guidance on when it’s best to go to the maternity ward.

Confirm the final list at your prenatal (pre-delivery) consultation — the team will tell you what is important in your particular situation.

Conditions of the maternity unit and organization of care

A brief overview of how the maternity unit is organized and how care is arranged during labor, especially if you are considering a water birth (hydrotherapy). The unit combines medical supervision and organizational provisions for different forms of labor management. Before arrival, check the rules and requirements at the antenatal consultation.

Delivery rooms equipped for standard and water-assisted births.
Postnatal rooms for rooming-in (mother and baby staying together).
24/7 availability of a neonatologist for initial newborn examination.
Availability of an anesthesiologist for consultations and emergency decisions if needed.
Possibility of partner-supported births, subject to medical and organizational requirements.
Individual care by a physician and a midwife during labor.
Monitoring of mother and fetus, including cardiotocography (CTG) as indicated.
Basic postpartum care and support during the first hours after birth.

Confirm specific conditions and rules for partner presence at the antenatal consultation. If clinically necessary, the birth plan may be changed for safety.

When to seek urgent medical help

If you notice sudden or marked changes in how you feel, do not wait for a scheduled appointment — contact the maternity hospital. It is especially important to respond to signs that may threaten the mother or fetus, including situations related to water births. Below are the main signals that require urgent attention.

Bloody or heavy vaginal discharge that is different from usual.
Your waters have broken or you notice leaking of amniotic fluid.
Regular, increasingly strong contractions that interfere with normal activities.
Severe, unusual abdominal or pelvic pain.
A noticeable decrease or absence of fetal movements compared with usual.
A sudden rise in blood pressure or a feeling of pressure in the head.
Severe headache that does not go away after rest or changing position.
Visual disturbances: flashing lights, spots, or temporary loss of vision.
Marked weakness, difficulty breathing, or confusion.
Fever and clear signs of infection.
Any sudden, severe change in how you feel that causes concern.

If any of these signs occur, contact your doctor or go to the maternity hospital. It is important to act promptly — the care team will assess the situation and recommend appropriate steps.

Frequently Asked Questions

Question: Can I plan a water birth (hydrotherapy) in advance?
Answer: Yes, the format can be discussed and planned in advance, but the final decision depends on assessment of the mother’s and fetus’s condition during labor.
Question: Are water births suitable for all women?
Answer: No, not for everyone; water births are considered only if there are no contraindications and after clinical evaluation of each pregnancy.
Question: Can I change the plan during labor if I feel I want something different?
Answer: Yes, the plan is discussed and adjusted during labor depending on condition and indications; some changes may require a medical decision.
Question: How do I discuss birth format and organizational details in advance?
Answer: At the antenatal appointment, discuss your wishes, indications, limitations, and prepare your maternity record (antenatal card) and questions for the team.
Question: Can my partner be present during a water birth?
Answer: Usually yes; partner presence is possible if medical and organizational requirements are met—check rules at the consultation.
Question: Can I have an epidural during a water birth?
Answer: The possibility of epidural analgesia is discussed individually; some pain-relief methods have limitations when in water and require consultation with an anesthesiologist.
Question: Who decides on pain relief?
Answer: The decision is made by the patient together with the obstetrician and the anesthesiologist, taking into account the clinical picture and labor progress.
Question: What if the chosen method of analgesia turns out to be undesirable or impossible?
Answer: The team will offer alternatives or change tactics during labor; the final decision will be based on safety and medical indications.
Question: When is it best to go to the clinic when labor starts or if my waters break?
Answer: Generally, come when contractions are regular, when your waters break, or if worrying symptoms appear; get exact recommendations from your doctor.
Question: What should I take to the maternity hospital and which documents are needed?
Answer: Take your passport, maternity record (antenatal card), up-to-date test results, and basic personal items; ask for the specific list and rules at admission.
Question: Can I arrive with already completed tests and ultrasound results?
Answer: Yes, bring all current investigations—this speeds up assessment and planning of the birth format.
Question: What happens if a cesarean section is required during labor?
Answer: The plan changes and a cesarean section is performed if indicated; the team will explain the reason and the next steps.
Question: I had a cesarean before — can I consider a water birth?
Answer: The possibility depends on the type of previous surgery and the current clinical situation; this is discussed individually at consultation.
Question: How long do mothers usually stay in the clinic after delivery?
Answer: Length of stay depends on the condition of the mother and baby and is agreed individually; your doctor will give guidance at discharge.
Question: What happens immediately after the baby is born?
Answer: Usually skin-to-skin contact, neonatal examination by a neonatologist, and monitoring of the mother; specific actions depend on the condition of both.
Question: Can I meet the doctor in advance and discuss the plan?
Answer: Yes, meeting at an antenatal consultation is possible and recommended to agree on the plan and questions.
Question: How can I prepare my partner to take part in the birth?
Answer: Discuss their role and presence rules in advance, and complete a brief clinic safety and hygiene briefing.