About a third of new moms in the United States today spend part of their labor in a birthing pool of some kind. Statistics are less clear about how many actually deliver their babies in water — but new guidelines from the American College of Obstetricians and Gynecologists now advise against that.

Many hospitals provide birthing pools for women during labor because warm water can help soothe pain and stress. The added buoyancy also promotes more efficient contractions and improves circulation and oxygenation of muscles.

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“Immersion in water during the first stage of labor may offer some benefits: It may shorten labor and is associated with a decreased use of epidurals,” said Dr. Joseph Wax of Portland, Maine, in a media release. He chaired the committee that developed the recommendations.

But there’s a big difference between laboring in water and actually giving birth in water. The new guidelines clarify that giving birth in the pool can lead to grave health complications for mother and baby. If the tubs in the birthing centers and hospitals aren’t cleaned properly, they can spread infection. Babies born in the water also experience a higher risk for deregulated body temperature, umbilical cord damage, respiratory distress, and asphyxia.

Nicole Hansen, of Draper, Utah, knows all about the complications. She gave birth to her first son in a tub at a birth center. She hadn’t planned on having her baby in a birthing pool — but it was her first pregnancy and she didn’t have a feel for how quickly she would deliver. She began labor at home, and after her husband rushed her to the birth center, her cervix had already dilated to a full 10 centimeters.

Because she thought she would need to push for hours, she climbed into the tub almost immediately once she got to the center. “It was totally worth it. The second I got in the tub, I felt so much better. The pain from the contractions was, of course, still there but somehow it was more bearable,” Hansen told LifeZette.

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But Hansen’s labor went quickly — 90 minutes from start to finish. Before she knew it, she’d given birth to a healthy baby boy. Unfortunately, he began vomiting blood and amniotic fluid shortly afterward. He had to stay five days in the neonatal intensive care unit (NICU) at the local hospital and continued to throw up for a while because he had swallowed some liquid during birth.

“Nothing is harder than seeing your brand-new baby in the NICU, attached to wires and throwing up blood,” Hansen said.

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Nurse-midwives have been helping women give birth in tubs for decades, and they are a little more skeptical of the latest guidelines. A 2012 review of 12 trials, which included 3,243 women, showed that water immersion significantly reduced the need for epidurals without affecting neonatal well-being.

However, the authors of the review conceded the studies were variable and that outside factors could have been influencing the results.

For now, concerned mothers can feel safe laboring in the water. But they may want to steer clear of birthing pools when it comes to the actual delivery of their babies.