Myth: The Baby Will Drown
This is the first thing almost everyone asks. It sounds logical — baby, water, breathing — and it comes from a place of genuine concern. If you’ve wondered about this, you’re in very good company.
Why it feels true
We associate submerged faces with danger because, for adults and older children, it is dangerous. Our instinct is to project that onto a newborn. But a baby being born into water is in a fundamentally different physiological state from a person falling into a pool. The baby has never breathed air. It doesn’t know how to try.
What actually prevents it
Three mechanisms work together to keep the baby from breathing underwater.
The first is the dive reflex. When a newborn’s face is submerged, the larynx closes automatically. This reflex is present in all mammals and is especially strong in newborns. It seals the airway.
The second is the absence of a breathing trigger. A baby’s first breath is prompted by a specific combination of stimuli: air touching the face, a temperature change between the warm water and the cooler air, and the physical sensation of being handled. None of these happen while the baby is underwater. The baby simply has no reason — and no signal — to attempt a breath.
The third is chemical. Prostaglandin E2, produced by the placenta and present in the baby’s bloodstream while the cord is functioning, actively inhibits respiratory effort. As long as the cord is intact and the baby is submerged, this chemical brake is on.
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What the evidence shows
The POOL study — the largest to date, covering 87,040 women across 26 NHS organisations — found no increase in respiratory complications, no increase in low Apgar scores, and no increase in neonatal death for babies born in water. A 12-year study tracking over 2,000 water births reported zero cases of water aspiration or aspiration pneumonia.
Isolated cases of water aspiration have been reported in medical literature, but they are extremely rare and almost always associated with a baby left submerged too long after birth or a baby already in distress before delivery — situations where standard practice wasn’t followed.
The practical safeguard
The midwife brings the baby gently to the surface within seconds of birth. Once the face meets the air, the first breath happens naturally. After that, the baby is not re-submerged. That’s it. These are standard, routine practices — not special precautions.
The verdict
False. The physiology is well understood, the safety record across tens of thousands of documented water births supports it, and the largest studies find no increased risk. This is the most common fear about water birth, and it’s the one with the clearest answer.