Water birth 'provides the safest form of pain relief'

All expectant mothers should be offered the chance to have a water birth because it provides the safest form of pain relief, the Government's health watchdog says.

A birthing pool is not necessary and climbing into a bath at home or in hospital during labour can be just as effective, according to the National Institute for Health and Clinical Excellence (Nice).

In guidance to be published today, Nice says extending the use of water births could improve the experience of maternity care for thousands of women.

A spokeswoman said: "Getting into a warm bath is a very effective method of pain relief and there are no side effects as with drugs or gas and air. You can do it at home or in hospital in an ordinary bath. It does not always have to be a birthing pool."

Giving birth should be a normal process which ends with a spontaneous vaginal delivery where mother and baby are healthy afterwards, the guidance says. But too often, it has become a medical procedure because doctors and midwives – and mothers – become anxious about letting nature take its course.

"In some cases women have had medical interventions they did not need. This guidance is about putting together best practice to ensure it is as normal a process as possible," the spokeswoman said.

The number of Caesareans has doubled in a generation and more than half of births now involve some form of intervention – forceps, ventouse (suction) or other instrumental delivery. Doctors, midwives and women's groups have become alarmed that mothers are being denied a natural birth and the NHS is spending millions without reducing the risks.

Alan Johnson, the Secretary of State for Health, pledged yesterday to increase the number of midwives. He told the Labour Party conference: "We have initially planned an extra 1,000 midwives by 2009. If birth rates continue to rise we will need to train more."

Nice says women should receive one-to-one care during labour and clinical intervention should be avoided where labour is progressing normally. Women should be warned about the risks and benefits before being given an epidural and instrumental birth should be undertaken with "tested effective anaesthesia". Women should also be given the choice of a home birth.

Maureen Treadwell of the Birth Trauma Association said: "There is no 'right' way to give birth... However, where women receive excellent support, good information and feel in control of what is going on, and where analgesia for medical procedures is adequate and effective, then a complicated birth need not be a traumatic one, but a positive experience."

The Royal College of Obstetricians said it supported normal birth but warned that complications could occur in as many as 30 per cent of first-time mothers assessed as low risk.