Course Content
Course Introduction: Start here!
We are pleased to welcome you to this comprehensive professional training program in waterbirth. Whether you are newly incorporating water immersion into your practice or seeking to advance your clinical expertise, this course provides the essential knowledge and certification required to safely and confidently support families choosing waterbirth. Grounded in current evidence and best practices, it is designed to strengthen your clinical decision-making and elevate your care as a birth professional. Developed and taught by Waterbirth International Director and renowned birth care educator Barbara Harper, this course reflects over four decades of clinical experience, research, and global teaching. In addition to training thousands of midwives, nurses, and physicians, Barbara has served as a consultant for hospitals and birth centers around the world—advising on clinical protocols and supporting the design and implementation of new waterbirth facilities. Her work continues to shape safe, respectful birth practices across diverse care settings. So let's get started!
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Course Breakdown & Materials
05:24
Part I: Foundations of Water Birth (Lessons 1-3)
Safety, Eligibility & Practical Considerations Part I lays the essential groundwork for understanding waterbirth as a safe, evidence-based option for low-risk pregnancies. Through three detailed lessons, you’ll explore the clinical rationale, research, and practical protocols necessary for safe implementation in any birth setting. Lesson 1: Labor and Birth in Water An in-depth look at the safety, history, and physiological benefits of waterbirth. This lesson covers maternal and neonatal outcomes, provider advantages, global C-section rates, and key research findings supporting the use of water immersion during labor and birth. Lesson 2: Inclusion Criteria and Contraindications This lesson defines eligibility and outlines both absolute and relative contraindications. It includes U.S. and U.K. hospital criteria, guidance on variations of normal physiology, VBAC considerations, informed consent protocols, and current positions from ACOG and ACNM. Lesson 3: Practical Matters Covers real-world applications and protocols such as fetal heart rate monitoring, water temperature, hydration, timing of immersion, and physiologic responses to water. You'll also examine hormonal effects, case studies like the Cluett trial, and best practices for recognizing and supporting normal physiological birth in water.
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Lesson 1 : Introduction to Labor and Birth in Water
01:12:18
Lesson 1: Labor and Birth in Water
Lesson 2: Inclusion Criteria and Contraindications
01:12:42
Lesson 2: Inclusion Criteria and Contraindications
Lesson 3: Practical Matters in Waterbirth
01:04:27
Lesson 3: Practical Matters in Waterbirth
Part II: The Physiology of Birth: Sensory, Neurological, and Neonatal Adaptation
Part II explores how the unique environment of water influences the sensory system, neurological function, and neonatal adaptation at birth. Through three thought-provoking lessons, you'll dive into the ways water immersion impacts the brain, body, and newborn transition—supporting safer, more instinctive, and more peaceful birthing experiences. Lesson 4: Sensory System Stimulation Discover how water immersion stimulates the parasympathetic nervous system, promoting comfort, peace, and relaxation during labor. This lesson explores the Blue Mind theory, sensory perception, the "Pyramid of Comfort Techniques," and how being surrounded by water changes the brain’s chemistry to support a smoother birth process. Lesson 5: How the Brain Works in Labor This lesson offers a deep understanding of the laboring brain, focusing on hormonal changes, pain perception, and neurological adaptations during waterbirth. You’ll learn how to support the natural instincts of labor through an environment that encourages oxytocin release, emotional safety, and optimal physiological function. Lesson 6: Keeping Baby Safe: Fetal Breathing Explore the mechanisms that protect the newborn during waterbirth, including fetal breathing suppression, the dive reflex, and how the baby transitions from fluid to air. This lesson provides clear explanations of neonatal safety, addressing common concerns and emphasizing the science behind waterbirth as a safe option for healthy newborns.
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Lesson 4: Sensory System Stimulation
39:31
Lesson 4: Sensory System Stimulation
Lesson 5: How the Brain Works in Labor
44:56
Lesson 5: How the Brain Works in Labor
Lesson 6: Keeping Baby Safe – Fetal Breathing Inhibitors
50:46
Lesson 6: Keeping Baby Safe: Fetal Breathing Inhibitors
Protected: Comprehensive Guide to Water Birth with Barbara Harper
About Lesson

Please use this link if the video won’t play: https://youtu.be/CADghUI9ljw

Lesson 3 shifts from theory to hands-on practice, providing participants with the essential clinical protocols and physiological considerations for managing labor and birth in water. From auscultation guidelines to water temperature, Barbara Harper outlines how to safely support laboring people in the pool—minute by minute and stage by stage.

The lesson begins with specific fetal monitoring protocols based on stage of labor, reinforcing when and how to listen to fetal heart tones, including indicators that may require exiting the water. Participants will also learn the importance of maintaining optimal water temperature, maternal hydration, and comfortable ambient conditions to support both mother and baby.

Barbara addresses the timing of immersion, affirming that there is no “right” centimeter—individual comfort and physiological signals should guide when a person enters the water. She also presents research findings, including the Cluett Study, which supports the effectiveness of water immersion in reducing labor duration and the need for interventions.

A powerful section of the lesson explores the hormonal impact of waterbirth, sometimes called the “ecstatic hormonal cocktail”—oxytocin, beta-endorphins, prolactin, and catecholamines—which contribute to pain relief, maternal bonding, and smoother labor progression.

To complete the lesson, Barbara reminds providers to “know what normal looks like,” encouraging awareness of physiological birth patterns, traditional midwifery skills, and the subtle signs of maternal wellbeing. The accompanying UK birth video serves as a visual reinforcement of clinical techniques discussed.

By the end of Lesson 3, participants will have a detailed understanding of the day-to-day clinical considerations of waterbirth, empowering them to support physiologic birth in water safely, confidently, and intuitively.

Exercise Files
WBI Provider Course 2025 Lesson 3 workbook.pdf
Size: 3.03 MB
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