If a water birth is part of your plan, your birth plan needs to work harder than usual. Pool access in Australia depends on your hospital, which midwives are rostered, and what else is happening when you arrive.
A written plan helps you secure what you need, communicate your preferences clearly, and prepare for the realistic possibility that things may unfold differently.
This guide covers where water birth is available, who is eligible, what your plan should include, and how to have a useful conversation with your care team before labour begins.
What water birth involves
Water birth means labouring, birthing, or both in a warm water pool. The two are different, and many Australian hospitals offer one but not the other.
Labouring in water means spending part of your first stage in the pool for pain relief and mobility. The warmth relaxes muscles, the buoyancy reduces pressure on your pelvis, and the privacy of the pool can help you feel safe and contained. You may then exit the pool for the birth itself.
Birthing in water means your baby is born underwater and brought to the surface immediately. This is the complete water birth.
Both options require access to a pool, a midwife accredited in water birth care, and your eligibility criteria to be met throughout labour.
If circumstances change, including your baby's heart rate needing continuous monitoring, wanting an epidural, or developing a complication, you will be asked to leave the pool.
The 2018 Cochrane Review, covering 15 randomised trials and over 3,000 women, found that labouring in water reduced the use of pharmacological pain relief and epidurals, with no increase in adverse outcomes for low-risk mothers or babies. Evidence on the safety of actually birthing underwater is less conclusive, which is why policies vary between hospitals.
Where water birth is available in Australia
Access is significantly more limited than most parents assume. Understanding the landscape before you write your plan saves disappointment on the day.
Public hospital birth centres are the primary setting for water birth in Australia. Most have one to three pools in dedicated birth rooms, midwife-to-patient ratios that support continuous care, and a philosophy aligned with minimal intervention. Eligibility is strict, waiting lists for birth centre places fill quickly, and pool availability on the day depends on who else is labouring. Birth centres do not offer epidurals: if you need one, you transfer to the main hospital ward.
Public labour wards in some hospitals also have pools, but availability is less reliable. The pool may be used for hydrotherapy rather than birth, and accredited midwives may not always be rostered on. Ask specifically whether the pool in the labour ward is available for birth, not just for hydrotherapy.
Private hospitals have very limited water birth access. Most private hospitals in Australia do not have birthing pools. Notable exceptions include Northern Beaches Hospital and John Flynn Private Hospital on the Gold Coast. If a water birth is important to you and you are in private care, confirm directly with your hospital before assuming it is possible. Our guide to public vs private hospital birth plans covers how these settings differ in more detail.
Home birth is where water birth is most reliably available, because you hire the pool yourself. If you are planning a home birth, pool hire becomes part of your preparation rather than something you negotiate with a hospital.
Who is eligible
Most hospitals and birth centres apply similar criteria, though policies vary. The general eligibility requirements for water birth are:
- Low-risk singleton pregnancy
- No previous caesarean (most birth centres; some hospitals consider VBAC in water on a case-by-case basis, see our VBAC birth plan guide for more on this)
- No meconium (green or brown fluid) in the waters
- No requirement for continuous fetal monitoring
- No epidural
- Gestational age of 37 to 42 weeks
- Baby in a head-down position
These are general criteria. Your hospital sets its own policy, which may be more or less flexible depending on clinical circumstances. Ask your midwife or obstetrician directly about your specific situation.
What your water birth plan should include
A water birth plan has the same core sections as any birth plan, plus specific additions covering pool access, what you want in the water, and what happens if you need to leave.
Requesting pool access
Put your water birth preference at the top of your plan, not buried in a list. Something like: “We are planning a water birth. Please prioritise pool access on arrival if available.”
On busy days, the pool goes to the person who arrives in active labour and asks for it. If you arrive early in labour and do not state your preference, you may find the pool has been allocated to someone else by the time you need it.
Monitoring in the water
Standard water birth requires intermittent auscultation: a handheld waterproof doppler used to check your baby's heart rate at regular intervals. This is compatible with the pool and with your mobility.
If continuous CTG monitoring becomes necessary at any point, you will need to leave the pool. Wireless CTG monitors exist but are not yet available at all hospitals. Your plan should include: “If continuous monitoring is required, please discuss wireless monitoring options before I leave the pool.”
Pain relief before getting in
An epidural is not compatible with water birth. If you want an epidural, you cannot use the pool. Your plan should reflect what you want to try first.
Gas (nitrous oxide) is compatible with water birth and can be used in the pool. TENS machines must be removed before entering the water but can be used during early labour. Heat packs, movement, breathing techniques, and hypnobirthing are all compatible with labouring in water. If you have been doing hypnobirthing preparation, include your language preferences and environment requests alongside your water birth preferences.
Environment in the pool
The same principles that apply to any birth environment apply in the pool: dim lighting, music, minimal interruptions, quiet voices. Note these in your plan. Also include:
- Temperature preference: Most pools are maintained at 36 to 37.5°C. If you have a preference, state it.
- Who can be in the pool with you: Partners are usually permitted. Doulas typically stay poolside. Check your hospital's policy and note your preference.
- Swimwear: Note whether you plan to wear a bikini top or nothing. This is useful information for your midwife.
- Waterproof speaker: If you want music playing, note this. Most hospitals are fine with a Bluetooth speaker.
Labouring only vs birthing in water
Be explicit about whether you want to labour in water, birth in water, or both. “I would like to labour in water and, if all is well, birth in the water” is a clear statement. “I would like to use the pool for pain relief during first stage and exit for the birth” is equally clear. Neither preference is wrong: your midwife just needs to know.
Third stage and baby's first moments
Delayed cord clamping is fully compatible with water birth. You can hold your baby in the water for the first moments after birth before the cord is clamped. Note your preference.
The third stage (delivery of the placenta) typically happens out of the pool. Most guidelines recommend exiting the water for placental delivery. Note your preference for active or physiological third stage. Skin-to-skin in the pool or immediately on exit is possible and should be noted.
If you need to leave the pool
This is the section most water birth plans skip. It is the most important one.
Most water births in Australian hospitals involve at least some time outside the pool, and a significant number of parents who planned water births exit the pool before birth due to changes in labour. Write down what you want if this happens:
- If continuous monitoring is required: positions you prefer on the bed, or whether you want wireless CTG explored first
- If you want pain relief: your preferences for gas, pethidine, or epidural
- If a caesarean becomes necessary: your full caesarean preferences. Our caesarean birth plan guide covers what to include
Having this section written means you still have a voice if the birth takes a different path.
What to pack differently for a water birth
A few items are specific to water birth that your standard hospital bag may not include. Our hospital bag checklist covers the universal items.
- Swimwear (two sets): One to labour and birth in, one clean for after. A supportive bikini top is most practical.
- Waterproof hair tie or clip: Standard hair ties pull and slip when wet. Pack a purpose-made waterproof one.
- Your own large towel: Hospitals provide towels but a large, soft towel from home is worth having for immediate skin-to-skin on exit.
- Waterproof Bluetooth speaker: If you want music, a standard speaker is a risk near water.
- Thongs for the bathroom: You will likely be walking between the pool room and the bathroom multiple times. Non-slip footwear matters.
Talking to your care team
Confirm pool availability with your hospital at your 36-week appointment. Not just “do you have a pool”: ask how many birth rooms have pools, how often they are in use, what the peak demand times are, and what happens if the pool is unavailable when you arrive.
Ask whether the midwives on shift are all accredited for water birth, or whether accreditation depends on individual staff. In some hospitals, not every midwife has completed water birth training. Knowing this helps you understand your real odds.
Discuss your eligibility specifically. If there is anything in your medical history or pregnancy that might affect your eligibility, including gestational diabetes, a previous caesarean, or a small-for-gestational-age baby, have that conversation before labour rather than on the day.
BirthGuide's questionnaire covers water birth preferences as part of the full birth plan, including your environment, monitoring, pain relief, and caesarean backup preferences. It generates a one-page document your midwife can scan in seconds on arrival.
Create your birth planFrequently asked questions
Can I have a water birth in Australia if I have had a previous caesarean?
Most birth centres exclude previous caesarean from their eligibility criteria, because VBAC requires continuous monitoring which is incompatible with a pool birth. Some hospitals consider it on a case-by-case basis. Ask your care provider directly. Our VBAC birth plan guide covers the full picture.
What happens if the birth pool is occupied when I arrive?
If the pool is in use when you arrive, you will be allocated a standard birth room. Some hospitals have a waiting list system; others work on a first-come, first-served basis. Ask your hospital how they manage pool allocation. Having your water birth preference clearly stated at the top of your birth plan means staff know to flag pool availability for you as soon as it changes.
Is water birth safe? What does the research say?
The 2018 Cochrane Review found that labouring in water during first-stage labour reduced use of pain medication and epidurals with no increase in adverse outcomes for low-risk mothers and babies. Evidence on birthing underwater specifically is more limited, which is why individual hospital policies vary. The consensus among Australian midwifery bodies supports water birth for low-risk pregnancies attended by accredited midwives.
Can I use gas (nitrous oxide) in the birth pool?
Yes. Gas is compatible with water birth and is commonly used in the pool. TENS machines must be removed before entering the water, though they can be used in early labour before you get in.
Can my partner get in the pool with me?
In most Australian hospitals, yes. Check your hospital's policy, as some limit the pool to the labouring person only. Note your preference in your birth plan so your midwife knows to expect it.
What if I want to labour in water but not birth in water?
This is a completely valid preference and common in Australian hospitals. Many parents use the pool for pain relief during first-stage labour and exit for the birth. State this clearly in your plan: “I would like to use the pool for labour but plan to exit for the birth.”