Objective: This study explored the level of expertise and acceptability of water birth among Chinese women in Taian City, Shandong Province. Methods: A descriptive correlational research design was used. One hundred six women of reproductive age (18–35 years old) from a selected community in Taian City were surveyed using a validated Water Birth Knowledge Questionnaire and Water Birth Acceptability Questionnaire, both based on the Theory of Planned Behavior (TPB). Statistical tools such as frequency, percentage, mean, standard deviation, and Spearman’s rank correlation coefficient were applied for data analysis. Results: Findings revealed that most participants had moderate knowledge of water birth, particularly regarding its benefits, but lacked understanding of the risks and procedural details. Acceptability levels were generally positive, especially in attitude and behavioral intention. A significant correlation (p < 0.05) between knowledge and acceptability was found. Educational level and monthly income were significantly associated with higher learning and greater acceptability of water birth. Conclusion: Increased knowledge of water birth does not necessarily lead to greater acceptance; it may instead foster more cautious decision-making.