July 2025 | Doulas of Baltimore

Hydrotherapy in Labor: Can Water Make Birth Less Painful?

Imagine sinking into warm water as intense contractions peak, like a warm and comforting hug. Many birthing individuals are curious about Hydrotherapy in labor for their birthing experience. Hydrotherapy (or the use of water in a therapeutic manner) is as simple as using a tub of water for immersion or a shower for pain relief. This safe, simple, and readily accessible tool is a great one to ensure you have in your toolbox.

Walk with us as we explore the benefits of using water for pain relief, how it can offer support before and during birth, and some tips and tricks from our experts at Doulas of Baltimore.

What Exactly Is Hydrotherapy in Labor?

Hydrotherapy put simply is using water as a therapeutic tool. This isn’t relegated to labor alone, as water is used in healing modalities for all sorts of situations from everyday people taking a shower during a migraine to professional athletes using cold water to limit swelling after injuries. During labor the most common uses are showers, birth pools, and baths.

Using water during labor is not just relaxing, it’s non-medical pain management. With roots in ancient civilizations for both health and spiritual reasons, using water as a treatment goes back centuries. Science has now caught up with the extensive use and offers us explanations for why historically this worked.

Why Water Works Wonders: Science-Backed Benefits

Physical Benefits

When discussing a birth pool or tub, the phyiscal benefits are measurable! By submerging in water, our bodies experience buoyancy which eases movement and reduces the stress on our muscles and joints. Even outside of labor, harnessing this power by floating in a pool can increase comfort during pregnancy.

The warmth of the water used during labor helps to increase blood flow and relax the muscles. This can ease the discomfort of contractions as muscles that are already tight become tighter as contractions increase. The relaxation can help allow your body to do what it needs to do to move baby down.

The pressure of the water (called Hydrostatic pressure) also can help to reduce swelling and support the peineum.

Emotional Benefits

Beyond physical comfort, emotional comfort can also emerge from the use of Hydrotherapy. Water creates a physical barrier, offering comfort whether in the shower or tub. Especially when giving birth in a less familiar setting (such as a hospital room), this can give a huge amount of security to the birthing person.

Water has been shown to help aid in the release of endorphins and lowering of stress hormones. During labor this can directly translate to pain reduction. Using Hydrotherapy also offers the birthing person a sense of control during active labor. Handing this control back to them can be the difference betwween stress and safety in their birthing experience.

Labor Progress

While the evidence is limited, there is data out there that suggests that immersion in water during labor can help shorten the duration of that labor. There is also evidence to suggest that use of Hydrotherapy as a tool during labor can potentially decrease the usage of epidurals or other medical pain management tools. This might be of particular interest for pregnant individuals who do not wish to or cannot use medical pain interventions for any reason.

When & How to Use Hydrotherapy in Labor

Timing

Early Labor – great for using showers as a distraction and pain relief

Active Labor – great time for using warm water in a birth pool or bath

Transition – this is when you’d want to exit the water if you’re not planning a waterbirth

Tip: water is also a great tool to use for both stalled labor and back labor. Submerge into warm water and allow your muscles to relax!

Techniques

Showers are great for leaning against the wall with the warm water running over your back. If the shower is equipped with a handheld shower head, you could also hold the warm water running over your back or belly, depending on where you’re feeling the tightness of your contractions.
When setting up the birthing pool, the ideal water level is at least 18 inches of water to ensure the birthing person experiences the benefits of buoyancy and to ensure the baby is fully submerged if they emerge in the water. Ideally, the water would be over the birthing person’s abdomen, just under their chest. Any higher can limit movement and cause instability.
The ideal water temperature is between 97°F–100°F. It’s important not to go too far above or below that range for the safety of baby.
In your birthing pool there are many positions you might try. Consider squatting, leaning over the side while on your knees, or floating on your back.
Partner Pro Tip: help with your partner’s relaxation by performing temperature checks, pouring warm water over their back or belly, keeping their cool water fresh, and offering or switching cool washcloths for their head or neck.

Safety & Considerations

Safety First

Some hospitals have a policy of avoiding submerging in water if your water has been broken for longer than 24 hours. This varies by facility and the best practice here is to keep in touch with your provider and doula once your membranes have ruptured. The concern here is introducing any bacteria into the placenta, this is definitely one to defer to your doctor on.

It’s important to pay attention to how you’re feeling and exit the water immediately if you begin to feel dizzy, overheated, or if baby shows signs of distress. At home you doctor may suggest a kick count to keep track of how baby is handling labor.

Since there is an open site for epidurals and you won’t be able to feel anything below that site, Hydrotherapy isn’t an option if you choose to recieve an epidural. It’s also often not an option for those who have recieved IV medication, though showers are often allowed! Make sure you touch base with your care providers on what is available to you.

FAQs

“Can the baby breathe underwater?” – Healthy babies have what is called a “Dive Reflex” where they do not breathe until exposed to cooler temperatures or air. For this reason, it’s important to monitor the temperature of the water and ensure it is kept warm. It’s also important to keep baby submerged if a water birth occurs until they’re fully emerged from the birth canal or that a birthing individual does not squat back down into the water once baby’s head has emerged. Immediate Surfacing, or bringing baby directly up for air and not submerging them again, is best practice for waterbirths. Follow the directions of your care provider in this instance.
“Does it increase infection risk?” – Studies have shown little to no evidence that Hydrotherapy in labor increases the risk of infection during labor. There was a slight increase in risk of infection after birth.
“What if I deliver in water?” – If you accidentally deliver in water your care team will guide you through the safest manner of getting you and your baby to safety. Sometimes this involves staying in the water, others this means you’ll exit the water. Waterbirth is also a viable birth option, though it’s rare to find in a hospital setting. If you desire a waterbirth, consider looking into a waterbirth-friendly birth center or a certified homebirth Midwife.

Planning for Hydrotherapy in Labor

Birth Setting Options

Remember that not all hospitals have access to birthing pools or baths. Most will have showers in the rooms. Birth centers are often equipped with birthing bathtubs designed for laboring. Homebirths will require a birth pool rental unless your provider clears the tub you’re birthing in as large enough. Check with your provider if your plan for Hydrotherapy is going to work for your birth space.

Prep Checklist

Discuss your desire for Hydrotherapy with your care provider early in your pregnancy. This is important to ensure that they’re both comfortable with your plan and that they have the capability to offer it to you in your birthing space.
Pack essentials for being in water in your birth bag. Make sure you bring a comfortable sports bra or bathing suit top, soft towels, and a water bottle to keep nearby. Consider also bringing extra washcloths.
If you’re renting a birth pool for your home, make sure you do a test run before labor begins! Ensure you have it inflated well before labor is imminent, know how you’ll fill it (will you be bringing a hose inside?), and know how you’ll empty it.

Conclusion

An incredible tool in any birthing person’s toolbox, Hydrotherapy is a perfect, non-medical comfort measure to try. Remember that not all birthing individuals like the same things and the tools you use can even shift during labor. Remember to chat with your care team and make arrangements ahead of time. Your comfort matters during your birth! Let water be a helpful friend that offers you comfort as you ride the waves of labor.

Summer in Baltimore Family Bucket List

Baltimore, Family

For many Baltimore families, the arrival of summer in Maryland means tons of sun & fun!

However, adding a baby to your warm-weather adventures can seem overwhelming. Keeping up with naps and feeding, monitoring sun exposure, and all the extra ‘stuff’ you’re suddenly hauling everywhere can make exiting your home feel more like a chore and less like an enriching experience.

Never fear! Having a baby doesn’t mean you have to skip all the amazing things Baltimore has to offer this summer. You might even find out that watching your little one take in the world around them in new ways is the very best part of each outing. Check out our Summer in Baltimore Family Bucket List! And when you’re done then head over here for tips on how to get out of the house with a baby without hauling everything (and the kitchen sink).

Attend a Summer Festival

Various dates

Baltimore is booming with festivals this summer! Whether you’re looking to enrich yourself in heritage and culture, check out the local flavors, or get some shopping in- there’s a festival for you. Come and enjoy the sights, then leave when baby has had enough. Baltimore Pride, Cherry Hill Art & Music, Baltimore Washington One Caribbean Carnival, and AFRAM are a few of our favorites!

Relax at the Movies

Thursdays in July | 9:00 PM | Federal Hill Park

Going to see a movie is one thing new parents usually remove from their repertoire fairly quickly. Summer in Baltimore means outdoor movie nights, opening a world of possibilities to families! Flicks on the Hill is put on by the American Visionary Art Museum and is FREE to the public. Plan to arrive a little early and bring your own blanket. Movie choices range from the classics like Raiders of the Lost Ark to family favorites like The Princess and
the Frog, so there’s something for everyone! Plus visit the museum for free from 5-9pm!

Visit a Museum

Various

One of the biggest benefits of living in a city as diverse as Baltimore is the variety of museums available to us! When you’re ready to get inside out of the heat (or rain as it so often happens), visiting a museum is a great idea for all ages. Try wearing your baby in a carrier and leaving the stroller at home for this one – you’ll navigate the exhibits more easily and keep curious fingers safely away from anything not meant for exploring! Bonus: Most Baltimore area museums are free admission for the under-two crowd! Check out the Baltimore Museum of Art and grab brunch at Gertrude’s while you’re there, take a ride on a streetcar at the Baltimore Streetcar Museum, or enjoy drop-in art sessions at the Walters Art Museum.

Bask on the Beach

All summer | 8:00 AM – Sunset | Gunpowder Falls State Park: Hammerman Area

One thing Marylanders do well is the beach! While our beloved OC is a favorite for many, the long drive and busy nature of this beach can make it a no-go for families with babies. Get your fix of sun & sand by visiting a state park this summer instead! Hammerman beach is a beautiful strip of sand on the Chesapeake.

You’ll have to leave Baltimore for this one, but the drive to this treasure off of Route 40 is under an hour. Easy parking and large bathroom/shower facilities are both located mere steps from the actual beach, making this an easy day trip even if you’re hauling a lot of beach necessities along. Grab a snowball at the snack bar or pack a picnic and eat in the (ample) shaded picnic areas. Early mornings and weekdays are often the least busiest times to visit this beach, but weekends feature a shop with paddleboards and kayaks for rent. Kids in car seats are always free admission!

No matter what you decide to do this season, get out and about in and around Baltimore and have fun! Getting into the habit of bringing baby along for activities sets you up for a lifetime of memory making. Little ones may not always remember the things we do at this age, but you’ll never regret the time spent together.

Weaning Safely, for Body & Mind

Breastfeeding

Weaning is deeply personal. Regardless if you have used milk made by your body to feed your child or not, choosing to help your body slow, then stop, the production of breastmilk can be fraught with emotion.

You are going to feel those emotions.
You. Not anyone else, so you get to choose what is going to be best at this point in your life.

Safe weaning is not just referring to keeping your body healthy from infection, but also sharing the reality that anxiety and depression can creep into a relationship thought to be “established.”

Weaning is not an overnight process. Even if the need to end the breastmilk production connects to an extreme emotional loss or tragic event, your breasts are not a faucet that can be turned off. They need time. Your body requires patience, even if in giving it, you get bombarded by emotions that feel overwhelming.

Knowing the very basics of breastfeeding are helpful to know for the weaning period. When your breasts are routinely emptied completely, ideally, your body responds by making more milk. So in very basic terms, to begin weaning, you begin to change how often, or how completely, you empty your breasts of the milk they produce.

If you want/need your breasts to stop producing milk:

Wear a supportive bra day and night that applies firm pressure on the breasts
As your breasts feel full, hand express or pump only to the point of relief, to not overstimulate the further creation of milk
Wear breast pads to absorb leaked liquid
Your breasts may become tender, and using mild pain medication can help, as well as cooling packs. Placing fresh cabbage leaves inside your bra may also help. Sage tea may also help with weaning.
Understand that even if your desire exists, your breasts can continue to make milk months, or even years later. However, usually with limited milk expression, pressure, and time, your breasts will have gone through the most significant part of their transition within a couple of weeks.
Concerns of engorgement, blocked ducts, and mastitis is still relevant in the weaning period, and if you suspect one of these issues, address them promptly.
Reach out to us for lactation support.

Mental concerns associated with the end of breastmilk production

It has been a new topic of discussion, but there is a possibility for some who produce breastmilk that in ending the production, your body is triggered and responds by experiencing postpartum depression. Postpartum depression can occur at any time after rather birth of your baby, but it is discussed most in the first year of your child’s life, in association with the period directly after “the baby blues” end.

For some, it is surprising to have these new feelings and a desire to disconnect, have anger or rage, anxiety, loss of sleep and appetite, or reduced willingness to engage in activities that would typically be enjoyable. However, weaning depression is possible.

Be aware that the faster you wean, the more drastic a change your hormone levels will be, and the possibility for extreme sadness and depression increases.

If you have concerns about postpartum depression associated with weaning, we recommend:

Being in contact with support professionals: talk therapists and your OBGYN, as well as postpartum doulas.
Having an open dialogue with your inner circle of trusted friends and family, to help then know that you will be going through this change, and share how what you may need from them during this period.
Some examples of support your close friends can give are
- having more frequent phone or unperson conversations
- having a meal prepared
- acknowledgment of the immense change that is happening asking them to bravely be with you in your vulnerable times without judgment recognizing that weaning can be a time of loss or grief, and that grief is gone through- not around
- letting them know you may need help identifying what is happening, and that depression is often not self-diagnosed.

In some cases, it is possible that thoughts of harming yourself or your child accompany the hormonal changes, and in these instances, know that you are not alone, you are not a bad parent, and you do not have to feel the way you are feeling. Asking for help is not a sign of weakness or failure, but an incredibly brave thing to do. You are worthy of support, and you deserve it.

Know that if you have been able to bond with your child because of and during breastfeeding, you have already built trust that will help you bond in other ways. Bonding, closeness, and comfort will continue. Your love will not diminish with the end of your breastfeeding relationship.

Here are some ways you can help yourself during your weaning period:

Sleep – being intentional with getting the rest your body needs
Exercise – taking a walk, or moving in any way you feel enrichment from (yoga, swimming, classes, etc.)
Eat nutrient-rich food
Cultivate relationships for joy and connection
Practice positive self-talk and gratitude – your body is incredible and is so strong. It is perfect just the way it is and is worthy of love. Thank your body for being in the place with you.
Stimulate other positive hormones, like oxytocin, through positive touch and bonding – hugging, eye contact, snuggling, time with close friends, and orgasm
Breathe – deep belly breaths to help you feel grounded