How Common are Water Births at Hospitals in the Twin Cities, Minnesota?

Note: This post will be updated whenever we receive new information. If you work at a local hospital and would like to have your stats added or updated, please email Bria at: bria@thereclaimedvillage.com. If you're part of a group improving birth outcomes for underserved communities, please send us your donation link!

Let's talk about water birth! There is growing desire amongst pregnant people to experience a water birth, and we're here for it.

What is a water birth exactly?

Water birth is when babies are actually born into a tub or pool of water. This is different from hydrotherapy: using a shower or immersing yourself in a tub during labor for pain relief (though, that's cool too!). We note the difference because we often hear from clients that their OB provider "doesn't allow water birth" but often those same providers DO support laboring in water. We've seen hydrotherapy provide great pain relief for our clients in active labor and transition.

Clients choose water birth for a variety of reasons. Studies show there are lots of benefits to water birth, such as:

• Lower pain scores for the birthing person

• Less use of pain medication

• Less use of Pitocin

• Shorter labors

• Fewer perineal tears

• Increased likelihood for a hands-off delivery (meaning: the care provider does not routinely touch the birther's perineum as the baby is coming out)

• Greater satisfaction with the birth

Despite all the benefits listed above, anecdotally we see most hospital providers in the Twin Cities are still fearful of water birth.

Water birth is one of the biggest examples of "bait and switch" that we see with our clients who are planning hospital births. Our clients are told by their providers that "absolutely you can have a water birth at our facility!", and many hospitals advertise the option (see: Allina, HCMC, and Lakeview). But when the client shows up in labor, all of the sudden this changes for XYZ reason (high BMI, meconium in the waters, need for continuous fetal monitoring, induction, hospital policy, the tub/provider just isn't available, etc.). These reasons aren't all evidence-based, and we don't see the same restrictions at birth centers or with home birth midwives.

One way to help suss out if your provider is truly water birth friendly (not just tolerant, or aspiring) is to ask them: "when is the last time you caught a baby in the water?". Their answer to this question is much more telling, than asking them: "do you support water birth?". You can also ask them to provide you with a printed list of things that would risk you out of a water birth, so you're not surprised in labor.

A second way to help understand their friendliness toward water birth is to ask them their statistics: "what percentage of your clients gave birth in water last year?". Keep in mind that your provider might be water birth friendly, but they're one person in a giant system. Will they be on call the day you go into labor? Will the nurses at your birth know how to support your water birth plan? Does your hospital require that the provider be water birth certified, and are all the providers on your team? How familiar is your birth location with water birth? <--- to help answer this question, see the stats below for Twin Cities hospitals.

Water Birth Rates at Twin Cities Hospitals:

Northfield Hospital: 7%

This information was provided on 1/17/2023 by one of Northfield's midwives. The water birth rate at Northfield in 2022 increases to 27% when you look only at births attended by the midwife team (OBs don't attend water births at Northfield).

Ridgeview Medical Center (Waconia): ~3%

This information was provided by the hospital Nurse Manager, and is current as of 8/21/2021. Only the midwives from the Western OB/GYN team attend water births.

Allina Hospitals: <1%

This information was provided on 1/18/2023 by Abbott hospital's Patient Care Manager for Labor and Delivery, Triage and Antepartum. She did not specify how many total births were done in 2022, however we can estimate it was around 12,000+ based on previous data. There were 30 attempted water births.

Breakdown by location:

1. Abbott Mother Baby Center (Minneapolis): 13 attempted water births, 61% successful

2. United Mother Baby Center (St. Paul): 12 attempted water births, 50% successful

3. Mercy (Coon Rapids): 4 attempted water births, 50% successful

4. St. Francis (Shakopee): 1 attempted water birth, 100% successful

Hennepin County Medical Center (Minneapolis): <1%

HCMC has seen 6-10 water births per year since 2017 according to their Director of Nurse Midwife Service and Division on 1/28/2023. Water birth is only available with the midwives. The team noted that they're very supportive of water birth, but their stats also reflect that they serve a highly diverse population of birthers.

M Health Fairview Hospitals: <1%

Breakdown by location, provided by the Nurse Managers at each of the hospitals on 2/1/2023:

1. Riverview, University of Minnesota (Minneapolis): 0.3% - 6 water births

2. Southdale (Edina): 0.1% - 3 water births

3. Ridges (Burnsville): 0

4. St. John's (Maplewood): 0.7% - 17 water births

5. Woodwinds (Woodbury): 0.7% - 14 water births

North Memorial Hospitals: 0%

Breakdown by location:

1. North Memorial Hospital (Robbinsdale): Water birth is not an option, per L&D on 1/27/2023.

2. Maple Grove Hospital (Maple Grove): Water birth is not an option, per L&D on 1/27/2023.

HealthPartners Hospitals:

We have been unable to find the right contact for this information from HealthPartners, and will update when we do.

1. Regions Hospital (St, Paul):

2. Methodist Hospital (St. Louis Park):

3. Lakeview Hospital (Stillwater):

Water Birth Rates at Twin Cities Birth Centers and Home Births:

A freestanding (out-of-hospital) birth center is a birth location that is not attached to a hospital setting. They're rare, and not found in every state. Only 0.6% of Americans gave birth in a birth center in 2020 (1.3% at home, and 98% in a hospital - read more about community birth settings in this report from National Partnership for Women & Families). We're lucky to have four freestanding birth center options in Minneapolis and St. Paul, giving families an alternative to hospital birth:

1. Roots Birth Center (Minneapolis)

2. Willow Birth Center (Minneapolis)

3. Twin Cities Birth Center (St. Paul)

4. Minnesota Birth Center (two locations: Minneapolis & St. Paul)

We also have quite a few home birth midwives who serve the Twin Cities area and catch babies in the birthing person's home. Home birth midwives are legal in Minnesota, which is important because it means birthing families can choose this option without fear of persecution for themselves or their midwife in the event they need to transfer to the hospital for extra medical support. Read more about home birth safety here.

We refer to birth centers and home birth as: out of hospital birth (OOH).

While we still see some restrictions on water birth in OOH birth, we don't see nearly the same fear that hospital providers emit. Twin Cities OOH water birth rates range from 44% - 95%, depending on the provider and practice.

If you are low risk, and desire a water birth, your chances of meeting that goal are significantly higher with OOH care. Consider interviewing an OOH midwife to see if you're a candidate.

OOH Birth Disparities:

While we believe that OOH care is usually the best place for low risk birthers who desire an unmedicated birth, we also want to recognize that it is not equally accessible to all families in Minnesota. The stats listed above indicate providers are comfortable with water birth, but they ALSO reflect the average person seeking OOH care. The average home birther in Minnesota is white, heterosexual, and middle to high income, and that privilege impacts birth outcomes in positive ways.

Home birth midwives generally don't take insurance, and some of the birth centers have limitations on Medicaid clients. This creates a huge financial barrier to OOH care.

We also have to consider the other social determinants of health, and how they affect birth. Economic stability, access to quality education & health care, experiencing racism and/or other discrimination, neighborhood safety, and more all affect people's general wellbeing, and their ability to access services that increase the likelihood of OOH birth.

To read more about the disparities, please see this post by @metromidwiferymn / @bhbimn on Instagram.

All families deserve access to quality perinatal care. To help increase access, please consider donating to these organizations:

1. Black Home Birth Initiative led by Vida Midwifery (donate here) serving the Twin Cities

2. Roots Community Birth Center in Minneapolis

3. Queer Birth Project serving the Twin Cities

4. Snuggle House Foundation in Minneapolis

Your provider and your birth location will have an impact on your birth.

If you don't know your options, you don't have any.

Empower yourself to make an informed decision about your birth team by taking our childbirth education class! Our Lamaze-style class is evidence based, with zero influence from hospital policies. Check out the offerings here: Preparing for Childbirth, and sign up today!