In a heartbreaking case in Victoria, Australia, a newborn nicknamed “Baby E” tragically died hours after being born in a home birthing pool rented via an Instagram influencer promoting ‘freebirths’, births without medical or midwife assistance. The coroner concluded the death might have been preventable with proper antenatal care or hospital birth support.
But what does science say about water births in general? Are birthing pools always dangerous, or is the risk tied to how and where they are used?
The tragic death of Baby E: The case that sparked concern
In December 2022, Baby E was born at home, unsupported by any medical professional. The labor was prolonged, and the mother couldn't deliver the placenta until the next morning. When the baby was later found unresponsive and pale, paramedics tried CPR but could not revive her. A forensic pathologist determined the cause was complications from the delayed delivery, complications that, in a hospital or with proper midwife support, likely would have been prevented. The coroner stressed that this outcome might have been avoided with professional medical assistance.
What is ‘freebirth’?
Freebirth, also known as unassisted birth, refers to the deliberate decision to give birth at home or elsewhere without the presence of a healthcare professional, such as a midwife or doctor. It is a planned home birth where the birthing person chooses not to have any medical assistance or monitoring during labor and delivery.
Navigating the risks: The ‘to-do’ list
Freebirths, births without any medical or midwifery oversight, are not the same as planned home births with professional support. If considering freebirth, prioritize thorough preparation, including researching potential risks and complications, creating a detailed emergency plan, and ensuring access to immediate medical care if needed. Open communication with healthcare providers, even if you plan to freebirth, is crucial for addressing individual risk factors and making informed decisions.
In the case of going ahead with the plan of freebirth, consulting resources like antenatal classes and seeking information from midwives or other healthcare professionals is recommended. Furthermore, one should talk to your healthcare provider about potential complications that might require hospital transfer and develop a clear plan for how to manage these situations.
Additionally, there must be a detailed emergency plan in place that outlines how to recognize and respond to potential complications, including how to transport yourself to a hospital and what support is available in the area.
In Baby E’s case, there was no antenatal education, monitoring, or readiness to escalate to a hospital during complications. The coroner emphasized that promotional materials for water births don’t apply to unsupervised, home-based situations.
What does research say about freebirths
For low-risk pregnancies, research offers reassuring news under proper medical control:
A UK study published in
The Guardian of over 73,000 births found no higher risks in water births supported by NHS midwives. Complication and mortality rates were similar to those of land births.
A large-scale US and birth-center study, published in the
British Journal of Obstetrics and Gynecology, of 35,060 matched pregnancies found water births led to fewer maternal hemorrhages and hospital visits, with no increase in newborn death rates, when supervised by skilled midwives. Minor risks like umbilical cord issues were noted but managed effectively.
These findings suggest water births can be safe under well-supported, low-risk, and medically supervised conditions.
What do professionals say about freebirths
Despite these positive findings (and the massive online popularity), major medical bodies like the
ACOG (American College of Obstetricians and Gynecologists) urge caution.
What are the potential dangers associated with waterbirth?
Umbilical cord avulsion: Cord snapping might happen when the baby is lifted quickly, though rare and usually manageable.
Infection risk: Particularly from waterborne bacteria like
Legionella, especially if the pool isn’t properly cleaned or contains recirculating water.
Water aspiration or respiratory complications: In compromised newborns, the “diving reflex” may not protect against full inhalation, which can lead to respiratory distress.
ACOG’s guidelines note that while water immersion during early labor may offer benefits like pain relief, there's insufficient evidence regarding safety during actual delivery underwater (second stage of labor). Concerns include infection risks, water aspiration, and cord avulsion, all of which demand strict protocols and oversight.
Ultimately, the difference between safe and unsafe water birth often lies in the planning and professional support. A planned home birth with a skilled midwife, who can monitor mother and baby and transfer to the hospital if needed, carries far lower risk than unassisted, influencer-driven births.
Disclaimer: This article is for informational purposes only and does not provide medical advice. Birthing methods, including water births, carry potential risks and should always be discussed with a qualified healthcare professional. Readers should not base medical decisions solely on this article and are encouraged to seek guidance from licensed medical providers.