Why Active Birth Pools are the No. 1 choice world-wide

Back in the mid-80s, we embarked on a journey alongside midwives, mothers, obstetricians, infection control specialists, and manual handling experts.

Together, we crafted the world’s very first hospital-grade water birth pool with meticulous attention to every detail.

Since then, we’ve continued to refine our designs, enhance our materials, and elevate our manufacturing and engineering capabilities.

This evolution has given rise to water birth pools that not only prioritize safety but also align perfectly with the desires of both mothers and midwives.

The Building Better Healthcare Awards judges put it succinctly, stating that the harmonious blend of evidence-based, user-centric, ergonomic design, specialized materials, and custom manufacturing has resulted in water birth pools that stand in a class of their own.

Our unwavering dedication lies in offering intelligently designed birthing pools that deliver unparalleled safety, remarkable value, and outstanding performance, all while remaining incredibly practical, cost-effective, and environmentally sustainable.

At our core is a genuine passion for design and quality, fueled by an unwavering commitment to enhance the experience of labor and birth for midwives, mothers, and babies alike.

We’re proud to have supplied countless water birth pools to hospitals across the globe.

Our collaborations with end-users, specialists, and manufacturers have driven us to continuously develop and improve our capabilities.

Every Active Birth Pool is meticulously handcrafted to order in England by highly skilled artisans who take immense pride in their work and hold themselves to the highest standards of excellence.

Our design process takes into account the delicate interplay between mothers, midwives, and the birth pool.

We’ve embraced evidence-based, user-centric, ergonomic design principles to create water birth pools that are not only supremely comfortable but also effortlessly practical and user-friendly.

The intricate and inviting forms of our pools are designed to captivate both the senses and emotions.

Each curve, each contour serves a purpose, where form elegantly merges with aesthetic utility.

Through the seamless, one-piece fabrication process in Ficore®, we’ve revolutionized the concept of the birth pool.

This innovation has given birth to pools that seamlessly combine elegance, practicality, and ease of use.

The exceptional qualities of Ficore® empower us to produce water birth pools that excel in performance, value, and safety beyond measure.

Our deep understanding of the childbirth process and our commitment to midwives’ needs have driven us to design birthing pools that actively protect midwives and mothers from the potential risks associated with water birth.

We’re acutely aware of the potential for birth pools to harbor harmful bacteria.

In response, we’ve introduced a range of innovative features that not only mitigate risk but also amplify safety to the highest degree.

Your peace of mind and safety are at the heart of everything we do.

Active Birth Pools from a midwives perspective

Active Birth Pools from a mothers perspective

Safety First

Winner – Building Better Healthcare Awards

At the ‘Building Better Healthcare’ awards ceremony the Active Birth Pool was highly commended in the award for best internal building product.

In their comments the judges praised the quality of  our design and manufacturing process and went on to say that they found the Active Birth Pool very appealing.

active-birth-pool-award
All aspects of design, engineering and manufacture were focused on develop a water birth pool of unparalleled beauty, quality, functionality and durability that is backed by an extraordinary life-time year guarantee.

Foremost consideration was given to how mothers and midwives relate to and interact with the pool employing ergonomic principles to design for the interaction and dynamic at play.

Mothers have the space to move freely and comfortably and are supported in the postures natural to a physiological labour and birth.

The “signature” extra-wide rims with broad “bull-nosed” shaped edges flowing into the skirting panel and down to the floor are an important feature of the Active Birth Pool that sets it apart.

The wide flat rim allows mothers to lean forward, resting on their forearms in comfort – one of the most natural and effective positions during labour.

It provides secure, safe, stable support for women to enter and leave the pool and for midwives and partners to lean or rest on while attending the mother.

The handrails, which are set into the profile of the rim, provide perfect support for the mother in upright positions.

The critical issue of emergency evacuation has been resolved by incorporating features into the pool to give midwives several options for evacuating the mother that are in compliance with Health & Safety and Manual Handling regulations.

The Labour Support and Safety Seats are distinguishing features of the Active Birth Pool

1) This physiologically designed labour support seat has proven to help the mother’s pelvis and birth canal open in preparation for a natural, physiological birth.

2) The distinctive rim level safety seat provides a wide comfortable platform for the mother to lean on, a safe means for emergency evacuation and is ideal for midwives to monitor the mother without her having to stand up or leave the pool.

The unique seamless one-piece construction incorporates a deeply sculpted concave skirting panel to allow midwives to work in comfort with their legs well under the pool.

The new Active Birth Pool is fabricated in Ficore® composite, a proprietary material that was specially developed for baths and designed to negate the risk of problems associated with other materials.

Ficore is 50% harder than acrylic and fibreglass (which other birth pools are made from) and highly resistant to chemicals.

Despite the rigidity and hardness of the surface it is extremely smooth, tactile and warm to the touch.

Its high insulation factor enables the Active Birth Pool to maintain its temperature up to six times longer than standard acrylic or fibreglass birth pools.

To help mothers control, define and personalise the delivery room, the Active Birth Pool is equipped with multi-colour chromotherapy LED lighting and integral bluetooth sound.

Our ingenious Integral Bluetooth Sound System allows the mother to wirelessly connect her phone and listen to the music of her choice.

Two integral speakers turn the birth pool into a highly refined audio loudspeaker.

When you examine the new Active Birth Pool you’ll immediately notice the superior finish and signature design elements.

Look a little closer and the quality of the components such as the drainage system, the support structure that underpins the pool, the fittings on the access panel, the lighting system, handrails and metal work becomes apparent.

If you are looking for a water birth pool to install in a maternity unit the incomparable new Active Birth Pool should be your first choice.

Handmade and custom built to order by a team who together have over 85 years experience in the design and production of high-end baths the new Active Birth Pool will provide decades of service and be an invaluable aid to mothers who want to have a natural birth.

The Active Birth Pool conforms to regulations issued by the Department of Health and the guidelines set forth in the Water Birth Safety Initiative.


(The new Active II Water Birth Pool takes the original design to new levels of comfort and performance)

Note: this article taken from “Building Better Healthcare” magazine – November 2015

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Catalogue, videos and plans

The combination of evidence based, user-centred, ergonomic design, specialised materials and bespoke manufacturing result in water birth pools that are in a class of their own.

Active Birth Pools Catalogue 

Client List 1987 – 2023 

Photos, plans, 3D models and data sheets

Winner – Building Better Healthcare Awards – Building Better Healthcare Magazine

Improving Birthing Pool Design – Chartered Institute of Ergonomics and Human Factors

Find out why you should choose Active Birth Pools 

This short video with almost 12,000,000 views shows how mothers move naturally to find the most beneficial positions.

The videos below were made in 2015 when we began fabricating our birthing pools in Ficore® composite.

Though slightly dated they contain a plenitude of information and clearly convey why mothers and midwives love our water birth pools.

We have published information about our water birth pools in these languages:

Visit our Blog to find out more about our range of award winning water birth pools

Please contact us if you would  like to receive a quote.

 

Images, plans, 3D models and data sheets

We’ve utilised ergonomic, evidence-based user-centred design to develop highly specialised pools for labour and birth.

It’s best to choose the largest pool that comfortably fits in your room, being sure that there’s plenty of space around the pool.
Minimum 80cm at the sides and 200cm at the front.

Please note: these are high definition rendered images – the pools look even better in real life!

CAD and 3D modelling plans are available upon request.

Active II Water Birth Pool 
Data Sheet



Place your cursor on the model below to move the image around.

Active II/360 Water Birth Pool
Data Sheet

Venus II Water Birth Pool
Data Sheet

Venus 360 Water Birth Pool
Data Sheet

Princess II Water Birth Pool
Data Sheet

Princess II/360 Water Birth Pool
Data Sheet

Water Column
Data Sheet

Would you like to see how our water birth
pools will look in your delivery room?

Simply click on this link with your phone or tablet.

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Safety First

When it comes to water birth pools there is nothing more important then safety.

There are important manual handling, water safety and infection control issues that must be considered and taken into account.

There are water birth pools available that meet the accepted regulatory guidelines, but unfortunately many water birth pools on the market fail to meet these requirements.

These water birth pools are equipped with features that at first might seem safe or even an advantage, but in reality present risks!

When we started in 1987  we knew that no matter how beneficial water birth pools were, if health and safety risks could not be overcome the use of water for labour and birth would not be a reality

Our abiding interest and unparalleled experience over the past 36 years qualifies us as one of the world’s leading experts on the Health & Safety issues that affect water birth facilities.

To find about these safety issues and how we’ve resolved them see below:

Active Birth Pools: Water Safety and Infection Control

Active Birth Pools: Manual Handling

Ficore® composite – an extraordinary material

It’s easy for mothers to get into our pools

Dealing with emergencies

Water Birth Safety Initiative

Cleaning and Care

Active Birth Pools from a midwives perspective

While the importance of designing water birth pools for mothers is evident, the importance of designing for midwives is paramount.

Mothers may use the pools a few times but midwives use them continually.

Midwives tell us that our water birth pools are the most comfortable and easy-to-use.

They appreciate the fact that they are safeguarded from risk of injury and benefit from the unparalleled level of comfort and support they receive.

Midwives report better results, and say that our pools are fabulous and a pleasure to use.

And that is why given a choice, midwives prefer Active Birth Pools.

In 1995 we worked with Health Service Ergonomist Sue Hignett and the midwives at Nottingham City Hospital to look at ways in which the design of our water birth pools could be improved.

We discovered that our pools could be made dramatically safer, more comfortable and user-friendly.

The results appear in this article, “Improving Birthing Pool Design” published in the Chartered Institute of Ergonomics and Human Factors.

If you look at our birthing pools from the early 1990’s (above) you’ll immediately notice the vertical skirting panels and narrow rims.

The problem is that midwives cannot sit in comfort, close to the mother.

The pool becomes and obstacle between the mother and the midwife.

Midwives are forced to sit away from the pool with their legs splayed apart to make room and then lean forward.

This creates the ideal physical dynamic that causes lower back pain (a common complaint from midwives attending water births).

To make matters worse, the narrow rims are not comfortable for resting on as pressure is concentrated in a small area of the forearm.

The photos above show how with our water birth pools midwives can sit close to the mother in complete comfort.

The concave skirting panel is contoured to the shape of the pool which gives midwives plenty of room under rim for their legs.

She sits with her arms resting on the extra-wide bull-nosed shape rim just like you would at a desk or table.

Furthermore – the rim is not obstructed with taps and fittings which enables midwives to easily move around the circumference of the pool as need be.

Partners play a important role in labour and birth.

Our pools allow couples to get close and be intimate without the need for the partner to get in the water.

This support (both physical and psychological) can make all the difference in helping mothers experience a physiological labour and natural birth.

Active Birth Pools give midwives safe, practical options for facilitating emergency evacuations – with or without a hoist.

Monitoring can be easily performed without the mother having to leave the pool

Mothers can easily get into our pools without climbing up large, cumbersome step units which put both mothers and midwives at risk.

It’s easy for mothers to get into our pools

Dealing with emergencies

Active Birth Pools from a mothers perspective

Active Birth Pools from a mothers perspective

We’ve spent decades observing the way that mothers move in our pools and considered how to best serve their needs.

Our passion for excellence has led us to study ergonomic design theory and to work closely with mothers, midwives, health and safety and manual handling experts.

This has enabled us to design water birth pools that are incredibly comfortable, practical and easy-to-use.

Mothers simply tell us that, ‘they love our pools’.

They are actively encouraged to move freely and naturally.

They instinctively interact with the pool and find comfort and support wherever they are.

They benefit from complete freedom of movement and unparalleled comfort and therefore have better births.

Freedom of movement combined with the relaxing effects of warm water and release of oxytocin significantly increases the possibility of physiological labour and birth.

Active Birth Pools provide optimum support for mothers in the range of upright positions natural to labour and birth.

The can hold onto the recessed handgrips or use the wrap around, bullnose-shape rim for support as the they move around the pool to explore and find the most beneficial upright positions.

Features such as the Labour Support Seat, Safety Seat and Lumbar Support create additional possibilities for mothers to explore and find the most comfortable and beneficial positions.

Ficore composite, the extra-ordinary material that we use to fabricate our pools has a highly polished, ultra-smooth finish that is less slippery, tactile and warm-to-the-touch.

This makes our pools more appealing physically and approachable psychologically which helps mothers relax and feel more at ease.

The unique properties of Ficore combine with the curvaceous forms and design elements to make Active Birth Pools the most comfortable water birth pools on the market.

The design of our pools allows partners to sit in comfort and get really close to the mother.

The intimacy that couples experience with our pools is unique. No other pools allow partners to be so close without actually getting in the water.

The support thats provided both physically and emotionally has many benefits, and is key to helping mothers cope with pain and progress to experiencing physiological labour and natural birth.

All women no matter what their shape or size will find it exceptionally easy to get into our pools.

The distinctive extra-wide, bull-nosed shaped rim is relatively low making it perfect for mothers to sit on and gently swivel into the water.

Mothers don’t even think about it – they move instinctively and naturally lower themselves into the water.

There is no climbing – mothers are grounded at all times and safeguarded from risk.

When comparing Active Birth Pools with others on the market we refer to an excerpt from ‘The Clock, the Bed, the Chair’, an article that childbirth author and activist Sheila Kitzinger published in 2003:

“Even a recent innovation, the birth pool, does not always permit free movement.

In theory, a pool allows a woman, supported by water, to move unencumbered. Or so it might be thought.

Though published research often refers to mobility as an advantage of being in a pool, some pools are elaborate constructions with seats, handgrips and foot-rests, and movement in them is restricted.”

The pool dictates the position the mother should be in by placing her in a semi-recumbent posture with hand holds and foot rests to fix the arms and legs.

Mothers are positioned in the classic lying back with legs wide-open position but happen to be immersed in water.

The seats in these water birth pools are typically tilted backwards.

The mother is immobilised in a position with her pelvis tilted upwards resulting in her  pelvic outlet being up to 30% smaller.

This puts pressure on the sacrum which flexes upward, into a curved position that restricts the diameter of the pelvic outlet inhibiting the baby’s descent.

The birth canal is placed in an “uphill” orientation, forcing the mother to push upward against gravity to give birth to her  baby.

These seats and moulded fittings greatly reduce the space the mother has to move in and restricts her ability to use the positions most beneficial.

The benefits of labouring in water are largely negated.

The possibility of a physiological labour and natural birth is greatly reduced.”

Sheila Kitzinger MBE (29 March 1929 – 11 April 2015) was a British natural childbirth activist and author on childbirth and pregnancy.

She wrote more than 20 books and had a worldwide reputation as a passionate and committed advocate for change.

Sheila was a big fan Active Birth Pools – in fact her granddaughter was born at home in one of our water birth pools!

A way to make labour shorter, easier and more comfortable

Freedom of Movement – a YouTube Sensation!

It’s easy for mothers to get into our pools

 

Active Birth Pools: Manual Handling

There are manual handling issues and risks associated with water birth pools that affect both mothers and midwives.

Most of the risks stem from the design and equipping of the water birth pools themselves and this is where this article will focus.

These issues concern rim mounted fixtures and fittings, emergency evacuations, midwives comfort and support, and mothers getting in and out of the pool.

If you look at our birthing pools from the early 1990’s (above) you’ll notice the vertical skirting panels and narrow rims.

This design has serious manual handling issues which we resolved in 1995 with the help of Health Service Ergonomist Sue Hignett and the midwives at Nottingham City Hospital.

The problem is that the pool forms an obstacle between the mother and the midwife. Midwives are not supported or safeguarded and cannot sit closely to the mother in comfort.

They are forced to sit away from the pool with their legs splayed apart and then lean forward to be closer to the mother.

This creates the ideal physical dynamic that causes lower back pain (a common complaint from midwives attending water births).

In addition, the narrow rims are not comfortable for resting on as pressure is concentrated in a small area of the forearm.

To make matters worse these birthing pools:

–  make it more difficult for mothers to get into the pool necessitating  the need for large step units which put both mothers and midwives at risk.

– and more difficult for midwives to facilitate emergency evacuations.

The photo above tells a completely different story and clearly demonstrates why midwives say that our water birth pools are the most comfortable and user-friendly.

The concave skirting panel is contoured to the shape of the pool to maximise space under the rim.

The extra-wide rim has a bull-nosed shape edge for added comfort and support.

Midwives sit, fully supported in comfort with their legs well under the pool and forearms resting gently on the broad rim.

The unobstructed rim allows the midwives to move easily around the circumference of the pool.

Getting into the pool

The simple act of getting into the pool is one of the most misunderstood aspects relating to the use water birth pools.

The truth is that multi-step units are dangerous and in the case of Active Birth Pools unnecessary as the photos below clearly demonstrate.

With the help of Manual Handling  and Ergonomic Design  experts we designed a simple, safe way for mothers to get into our pools.

The distinctive extra-wide, bull-nosed shaped rim is relatively low making it perfect for mothers to sit on and gently swivel into the water.

There is no climbing – mothers are grounded at all times and safeguarded from risk.

All women no matter what their shape or size will find it exceptionally easy to get into our pools.

Mothers don’t even think about it – they move instinctively and naturally lower themselves into the water.

And midwives will be safeguarded from the risk associated with physically supporting mothers as they climbs up the steps .

To put this in perspective:

The average height of our pools is 75cm – about the same height as a desk or dining table.

Our 15cm high single step makes the height of the pool  60cm – the same height as an ordinary bathtub.

You don’t need a big step unit to get into your bath at home, do you?

For full details and a video showing how easy it is for mothers to get into our pools please go to this page.

Emergency Evacuations

Active Birth Pools give midwives safe, practical options for dealing with emergencies.

The extra-wide rim and internal seats of our pools allow midwives to facilitate emergency evacuations in a way that is birth practical and safe.

Midwives can situate the mother an internal seat and gently raise her with the help of the buoyancy that water provides up to the rim and onto a trolley.

Or, use a net that is specifically designed for this purpose.

Manual Handling advisors may insist that women are evacuated from the birth pool with a hoist and that this facility is provided for.

Active Birth Pools are the only pools on the market designed to accommodate portable hoists should the need arise.

For full details about how Active Birth Pools enable midwives to facilitate safe emergency evacuations including protocols from NHS Hospitals please go to this page.

Rim Mounted Fixtures and Fittings

Many water birth pools have an array of rim mounted fixtures and fittings including taps, spouts, handheld showers and hand grips (similar to those shown on the whirlpool bath below).

Not only do these fittings present an unacceptable infection control risk, but a signifiant health & safety and manual handling risk as well.

They form an obstruction that denies midwives freedom of movement and unencumbered access around the perimeter of the pool.

Most importantly there is a considerable risk of mothers hitting their head on the spout or injuring themselves on the protruding metal work.

If you look at our new Venus II Water Birth Pool (above) you’ll notice how the rim is free of potentially dangerous fixtures and fittings.

The handgrips are set into a recess in line with the rim and bonded into the fabric of the pool to deny bacteria the environment they need to grow.

The taps are mounted on an IPS panel with the spout 25cm above the rim of the pool

The distinctive ‘keyhole’ shape channel at the back of the pool contains the plumbing making it impossible for the mother to hit her head on the spout.

Dealing with emergencies

It’s easy for mothers to get into our pools

Manual handling risks to midwives associated with birthing pools: literature review and incident analysis

Active Birth Pools: Water Safety and Infection Control

When it comes to the creation and care of water birth facilities nothing is more important then Health and Safety.

Micro-organisms breed freely in warm moist environments and must be prevented from propagating.

The potential for water birth pools to be both a habitat and a delivery medium for harmful bacteria such as Pseudomonas and Legionella is well known.

We completely understand this and engineered our water birth pools to optimise safety, negate risk and deliver safer birthing environments.

Seamless one-piece construction in Ficore combined with the minimum of fittings result in water birth pools of unparalleled hygiene and water safety.

Active Birth Pools are fabricated from proprietary material with unique qualities called Ficore®  composite.

Ficore has much higher degree of strength, durability and resistance to bacteria when compared to fibreglass or acrylic.

Seamless, one-piece construction in Ficore® improves hygiene by denying bacteria the environment to grow.

The ultra-hard surface makes our water birth pools easier to clean and more resistant to bacteria.

With Health Department Regulations as a guideline we have utilised intelligent design and a range of innovations to negate risk and maximise water safety.

In addition to the advantages that Ficore give our pools from a material perspective we need to look at the advantages it provides from an engineering and manufacturing perspective.

Ficore’s unique properties allow us to design our pools with flowing, organic forms that improve hygiene by facilitating more effective cleaning.

The super smooth finish and flowing contours optimise drainage and eliminate “dirt traps”.

Active Birth Pools: Fittings and Fittings

Hand grips

 

Our stainless steel hand grips, supplied by renown brassware manufacturer Samuel Heath are bonded directly into the pool

They are not surface mounted like on other birthing pools.

The bar is solidly sealed into the fabric of the pool with Ficore.

There are no gaps – there is no movement.

This make it impossible for moisture penetrate and for bacteria to breed

Drainage System


Our drainage is purpose designed and manufactured to the highest standards.

It has been a subject of interest of numerous investigations by infection control specialists, all of them who came back to use to give their approval.

The waste sits in a recess and is double sealed in with silicone for a water tight, bacteria resistant seal.

The stainless steel fittings are made from solid brass and won’t be damaged from use of of chlorides and other disinfectants.

The plug can be taken out and soaked in hypochlorite in between births.

The rim mounted control wheel can be easily removed for cleaning.

Multi-Colour LED Underwater Lighting

The internal light fitting fits flush to the sidewall, has a stainless steel bezel and is sealed in with silicone.

Due to the fact that the fittings are water tights and vertically mounted water cannot penetrate or build up.

The control switch on the rim is is also water tight and fully sealed.

Taps and Showers

We do not supply taps but recommend 3/4″ thermostatic bath or bath/shower mixers like the Rada T3.

Taps are never mounted on the rim but on the wall or water column as shown above.

Spouts should be 25cm above the rim to prevent contact from pool water and to protect the mother from hitting her head.

Handheld showers are very useful for cleaning the pool but must be detachable so they can be removed while the pool is in use.

The Water Column

Freestanding water birth pools are becoming increasingly popular.

These installations typically present significant water safety and hygiene risks as rim mounted plumbing and fixtures provides the perfect breeding ground for micro-organisms to thrive.

For wall mounted installations the thermostatic taps, spout, handheld shower and grab rail are fixed to an IPS Panel in accordance with health department regulations.

For freestanding birthing pools a solution needed to be found.

To solve this problem we developed the Water Column – a bespoke design concept that separates the plumbing from the pool to optimise hygiene and water safety and provide crucial support for mothers and midwives.

It’s highly utilitarian, sleek ergonomic design complements the look and usability of our pools .

Unsafe Fittings and Features Commonly Found on Water Birth Pools

Because they are mounted on the pool, close to the water the potential for pool mounted fixtures and fittings to become contaminated with bacteria and cross infect is greatly increased.

This whirlpool bath clearly shows a large number of unsafe fittings and systems as applied to water birth pools.
Note the overflow drain, recirculating water system, Swan neck tap, integral shower, rim mounted plumbing and controls

There are other manufacturers who produce water birth pools that are safe but, many water birth pools are equipped with features that at first might seem safe or even an advantage, but in reality present risks or breach regulations.

These water birth pools (mainly produced in Europe) are over engineered and equipped with a profusion of fittings and features that put mothers and midwives at risk.

Please note: the images of fittings and features shown in this section are for illustrative purposes and do not show actual birthing pools.

Rim Mounted Taps and Spouts

Rim mounted taps, spouts and showers are one the biggest Health and Safety risks

These fittings present a serious infection control risk as the space between the surface of the pool and the fitting is a suitable breeding ground for bacteria.

Remember – bacteria are microscopic – even though the fitting may appear flush to the surface of the pool there is space for micro-organisms to establish themselves.

The risk that bacteria will propagate in the moisture between the plate and the rim is unacceptable.

There is also a risk that rim mounted taps could be contaminated with water from the pool and flow back into the tap.

There is the potential for back contamination of the tap, with bacterial colonisation into the system in contravention of water fitting regulations

Taps and spouts for water birth pools should be wall mounted 25cm above the pool and fitted with backflow protection.

There is also a significant risk that mothers could seriously hurt themselves by hitting their heads on these taps.

Swan Neck Taps

Swan neck taps are often seen mounted on the rims of water birth pools. Though attractive this type of tap presents a significant infection control risk.

Swan neck taps retain larger volumes of water which then stagnates and HFN 30 and HPSC recommends that swan-neck taps should not be used.

This is because they do not empty after use and could be prone to microbial biofouling with microorganisms including Legionella and P. aeruginosa the latter of which was associated with a swan neck tap during the neonatal outbreak in Northern Ireland  (HPSC, 2015).

Surface Mounted Hand Grips (internal and rim mounted)

Surface mounted handgrips are a serious infection control and manual handling risk.

Some water birth pools feature surface mounted hand grips similar to the ones shown above.

The is great potential for bacteria to become established between the fitting and the pool which makes these fittings an unacceptable infection control risk.

The risk of cross-infection is dramatically increased with surface mounted metalwork that is inside the pool as they come into direct contact with the water while the mother is using the pool.

From a manual handling perspective these handgrips are dangerous as they form an obstruction that mothers can hurt themselves on and they interfere with movement around the pool.

Overflow drains

Overflow drains harbour bacteria and can serve as a conduit for cross infection.

Regulations are very clear on this point.

Overflow drains should not be fitted to water birth pools as they constitute a constant infection control risk.

Re-circulating water systems

Re-circulating or pumped systems with jets such as whirlpools and  jacuzzi present the perfect conditions for the growth of micro-organisms.

Water systems like these present the highest levels of risk as they produce aerosols.

Aerosols are generated when the water surface is broken – for example, by falling water droplets, splashing, or by bubbles breaking at the surface.

Once introduced to these systems, Legionella and Pseudomonas thrive and can become aerosolised and then inhaled.

Integral Plumbing Systems

Plumbing systems like these utilise flexible and non-flexible piping, overflow drains, handheld showers, pumps, hoses, heaters, surface mounted fittings and filters.

These systems are impossible to clean, disinfect or monitor and therefore present an extremely high Infection Control Risk.

Stagnant water within the system is an ideal breeding ground for bacteria.

UK regulations state that water birth pools should be filled with wall mounted, thermostatically controlled mixer taps plumbed directly into the hospitals water supply.

Hand held showers

Handheld showers present a significant infection control risk.

If the shower head falls in the pool it may be contaminated with bacteria that could breed and be passed on next time the shower is used.

Department of Health regulations clearly stipulate that handheld showers and bath/shower mixers are not installed for use with water birth pools as they present a Fluid Category 5 risk to the mains water supply.

N.B. There are systems available that enable you to detach the hose and shower head from the tap. These are permissible as long as the shower fittings are detached when the pool is in use and only employed afterwards for cleaning.

Pumped heating systems

Heating systems for water birth pools are not necessary and present unacceptable infection control risks.

Water is pumped through a heat exchanger and then back into the pool creating the ideal environment for bacteria to breed.

These systems present one of the highest infection control risks and should not be utilised.

Bacteria filters and disinfection systems

Some water birth pools are equipped with these devices in an attempt to mitigate the risk of infection and bacteria infestation that are inherent in built-in plumbing systems.

Bacteria filters and disinfection systems can not be relied upon and will not guarantee adequate hygiene standards.

Doors

There is no reason for a water birth pool to have a door and many reasons why they should not.

Doors are mistakenly used for two reasons:

  1. To facilitate emergency evacuations
  2. To help mothers get in and out of the pool

Doors present an extremely high risk of infection and should be banned from use in water birth pools for this reason alone.

The door seal (typically foam or rubberised material) is the perfect breeding ground for bacteria.

From manual handling perspective doors are not practical or fit for purpose. They actually complicate emergency evacuations and put mothers and midwives at risk.

Ficore® composite – an extraordinary material

Winner – Building Better Healthcare Awards

Water Birth Safety Initiative

Active Birth Pools: Long-Term Value and Sustainability

Active Birth Pools deliver superior value, better results and unrivalled long term satisfaction.

They outperform all others all others in the market in terms of safety, hygiene and end user satisfaction.

Our water birth pools are built to last for decades and guaranteed for life.

hospital birth pools client list

Midwives at the Royal Berkshire Hospital celebrate the 25th anniversary of their water birth facility.
This early model supplied in 1992 is still going strong.

Other birthing pools have a life span of 7-10 years and are not guaranteed for life.

Over time they’ll cost far more as you’ll end up replacing them 3 – 4 times before you need to think about replacing an Active Birth Pool.

This yields significant savings  – up to £20,000 over the life of the pool!

And, you’ll also not have to experience the disruption, disturbance and additional cost that refurbishment brings.

Midwives at the `Bronte Birth Centre celebrate the opening of their water birth facility in their new Venus Pool

As our water birth pools have such a long life span you will not need to think about replacing them for 25 years or more.

Along with the cost of replacing the birthing pools you’ll need to consider the amount of waste material that will be generated by refurbishing the room and the impact its disposal will have on the environment.

Active Birth Pools are also easier to maintain (less chemicals) and more energy efficient (less hot water) which results in additional savings on labour, energy and materials.

When taken together as whole all of these factors demonstrate why Active Birth Pools are the most sustainable on the market -by far!

The use of water for labour and birth is often promoted as a means of empowering women and is consistent with the current agenda of normalising birth

When an Active Birth Pool is installed in a maternity unit it becomes the focus of attention. Mothers have been known to choose a unit with one of our pools over units that have competitors pools.

Midwives tell us that our pools are fab and a pleasure to use. They say that Active Birth Pools are the most comfortable and safest to work with.

When compared to other birthing pools mothers who use our birthing pools have a  greater possibility of experiencing physiological labour and natural birth.

Hospitals report that mothers who use our pools have easier, more straightforward births and  spend less time in hospital which translates into savings both economically and environmentally.

Click here to find out more about our range of award winning water birth pools.

 

Freedom of Movement video hits 12,000,00 views on YouTube!

This short video with over 12,000,000 views shows that mothers have room to move freely in the postures natural to labour and birth.

How they instinctively relate to our water birth pools and move naturally to find the most comfortable and beneficial positions.

Freedom of movement combined with the relaxing effects of warm water enhance the release of oxytocin which significantly increases the likelihood for mothers to experience physiological labour and natural birth.

 

Ficore® composite – an extraordinary material

Superior material results in superior performance.

Choice of material is fundamental to the success of a water birth pool.

Active Birth Pools are fabricated in Ficore® composite, a proprietary material of extraordinary properties that was developed to minimise problems associated with other materials.

ficore

A cross section of FICORE® composite

Ficore® composite data and specification

If you compare Ficore with Acrylic or Fibreglass you’ll notice the difference.

Ficore is a composite of eight different elements chemically fused during manufacturing, then heat cured at high temperature to create a material that is light in weight but ‘heavy’ in performance.

 Ficore® composite has many advantages:

  1. Superior heat retention
  2. Much higher degree of strength and durability
  3. Less slippery
  4. More tactile
  5. Warm to the touch
  6. Easily repaired if damaged
  7. More resistant to bacteria

Warm to the touch

You’ll notice a significant difference in temperature between Ficore  and the other materials.

Ficore is warmer due to the fact that it is composite resin that is much denser than acrylic and fibreglass.

Due to Ficore’s high insulation factor and double-wall construction Active Birth Pools maintain water temperature up to 7 x longer.

Structural and engineering advantages

If you hold two equivalent size samples of commonly used material in your hands and compared them you’d notice that the sample of Ficore is heavier, harder and much more rigid.

The surface of Ficore is isophthalic neo-pentyl-glycol that is 50% harder (stronger) than the materials other birth pools are made from.

Active Birth Pools fabricated in Ficore have an extremely high degree of structural integrity and will not flex, buckle, bow, or change shape under pressure.

Ficore’s unique qualities allow us to manufacture intricately shaped pools that fully serve the needs of mothers and midwives.

Extremely smooth and tactile 

The finish of our pools is highly polished, ultra-smooth, tactile and very pleasant to touch.

This makes them more appealing physically and approachable psychologically which  helps mothers relax and feel more at ease.

Incredibly high adhesion factor

When we talk about adhesion factor we are referring to slip resistance.

Run your fingers across the surface of an Active Birth Pool and you’ll immediately be impressed with how ‘sticky’ it is.

Compared to other materials Ficore® has a significantly higher adhesion factor.

Given the circumstances and environment this gives our water birth pools a crucial advantage.

Durability

Ficore is more impervious to damage than other bath materials.

However, if it is damaged, it can be completely repaired as new – unlike many alternative materials.

Ficore is able to withstand both continuous heat or hot water and thermal shock of alternating hot and cold water.

An Active Birth Pool manufactured in Ficore meets or exceeds all relevant regulations and will withstand the rigours of heavy hospital use and disinfection with caustic chemicals.

Ficore® composite data and specification

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Getting in and out of the pool

The simple act of getting into the pool is one of the most misunderstood aspects relating to the use water birth pools.

The truth is that multi-step units are dangerous and in the case of Active Birth Pools unnecessary as the photos below clearly demonstrate.

Health and Safety and Manual Handling experts strongly advise against the use of multi-step units as they present unacceptable safety risks.

They say that, “mothers in strong labour should not climb up and over the rim of the pool and down onto a submerged plinth because it is not safe or practical”.

In addition these bulky step unit take up too much space, obstruct movement around the pool and are a trip hazard.

With the help of Manual Handling  and Ergonomic Design  experts we designed a simple, safe way for mothers to get into our pools.

The distinctive extra-wide, bull-nosed shaped rim is relatively low making it perfect for mothers to sit on and gently swivel into the water.

There is no climbing – mothers are grounded at all times and safeguarded from risk.

All women no matter what their shape or size will find it exceptionally easy to get into our pools.

Mothers don’t even think about it – they move instinctively and naturally lower themselves into the water.

And midwives will be safeguarded from the risk associated with physically supporting mothers as they climbs up the steps .

To put this in perspective:

The average height of our pools is 75cm – about the same height as a desk or dining table.

Our 15cm high single step makes the height of the pool  60cm – the same height as an ordinary bathtub.

You don’t need a big step unit to get into your bath at home, do you?

 

 

 

 

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The Benefits of Water Birth for Overweight Women

Pregnancy is a transformative journey, and every woman deserves the best possible experience. Overweight or obese women often face unique challenges during pregnancy and childbirth.

However, the option of water birth has emerged as a promising alternative for these women, offering a range of benefits that can contribute to a more comfortable and empowering birthing experience.

In this article, we will explore the advantages of water birth for overweight women and why it might be a suitable choice.

Weight Support and Buoyancy

One of the primary benefits of water birth for overweight women is the buoyancy provided by being in warm water.

This buoyancy helps alleviate the strain on the joints and supports the weight of the body, making it easier for women carrying excess weight to move and change positions during labor.

This can be particularly beneficial during the first stage of labor when women often need to walk or change positions to encourage the progression of labor.

Pain Relief

Warm water has been found to be an effective natural pain reliever during labor.

It can help overweight women manage the discomfort and pain associated with contractions.

The warm water relaxes the muscles, reduces tension, and promotes a sense of calm, which can be especially helpful for women with added weight, as they might experience increased pressure on their joints and muscles.

Improved Blood Circulation

Overweight women are at a higher risk of developing conditions like gestational diabetes and high blood pressure during pregnancy.

Water immersion can improve blood circulation, which, in turn, can help regulate blood pressure.

The increased circulation can also aid in oxygenating the baby, reducing stress on the cardiovascular system during labor.

Reduced Stress and Anxiety

Labor can be an emotionally and mentally challenging process, and overweight women may have concerns or fears related to their weight and the birth process.

Being in a warm, soothing environment can help reduce stress and anxiety, leading to a more positive birthing experience.

Water birth promotes relaxation, encourages the release of endorphins, and fosters a sense of control over the birthing process.

Increased Mobility

Water birth allows for increased mobility and freedom of movement.

Overweight women may have difficulty moving comfortably on land due to the added weight, but buoyancy in the water makes it easier to change positions, squat, or kneel.

These positions can be beneficial for facilitating the baby’s descent and easing the passage through the birth canal.

Painful Perineum Relief

Overweight women may be concerned about the potential for perineal tears during childbirth.

The warm water of a birthing pool can help relax and soften the perineum, reducing the risk of tears.

Additionally, water can provide relief and comfort to the perineal area after childbirth, aiding in the healing process.

Promotes Natural Birth

Water birth aligns with the principles of natural childbirth.

It encourages women to trust their bodies and follow their instincts during labor.

This approach can empower overweight women to have a more active role in their birthing experience and reduce the need for medical interventions.

Conclusion

Water birth can offer numerous benefits for overweight women during pregnancy and childbirth.

The buoyancy, pain relief, improved circulation, reduced stress, increased mobility, and natural childbirth principles make water birth an attractive option.

However, it’s important for overweight women to consult with their healthcare providers to determine if they are good candidates for water birth and to ensure that their pregnancy and labor are appropriately monitored.

Ultimately, the goal of water birth for overweight women, as for all expectant mothers, is to provide a safe and positive birthing experience that prioritizes their comfort, well-being, and the health of their baby.

The benefits of labouring in water for overweight and obese mothers

Nothing helps mothers cope with pain in labour more effectively

We’re uniquely qualified to be of service

We’ve been dedicated to designing highly specialised pools for labour and birth since 1987.

We helped pioneer the use of water for labour and birth by providing the pools that made this revolution in maternity care possible.

We’ve achieved success by keeping things simple and focusing on our core principles of Safety, Value and Performance.

A passion for excellence and commitment to supporting midwives and helping mothers have a better experience of labour and birth defines our approach.

We’ve supplied 1,000’s of pools over the past 35 years and worked with end-users, specialists and manufacturers to develop and improve our capabilities.

Our unrivalled knowledge and wealth of experience enable us to provide water birth pools that minimise risk, optimise results and maximise value.

Mothers and midwives love our water birth pools.

Mothers benefit from complete freedom of movement and unparalleled comfort and support .

Midwives report better results, and say that our pools are fabulous and a pleasure to use.

Buyers like the fact that they’re the safest on the market, built to last for decades and guaranteed for life.

We have achieved success by caring about every detail and keeping things simple.

The combination of highly specialised design and superior materials make Active Birth Pools the No.1 choice world-wide.

Our pools are packed in sturdy wooden crates in accordance with international shipping regulations and always arrive in perfect condition.
Over the decades we have developed the ability to provide first class after sales service world-wide.
Our plumbing and lighting systems utilise components that are familiar to electricians and plumbers world-wide.
We guarantee that you will be delighted with your birthing pool and appreciate the support and service that we provide.
But don’t take our word for it, find out what clients have to say  by clicking here.

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Optional Equipment – Lighting, Sound and Step

Light and sound have a profound affect on the atmosphere and ambiance of the birth room.

Our new light and sound systems provide you with a simple way of transforming the environment, making it more conducive for physiological labour and natural birth.

Our multi-colour LED allows users to cycle through a range of colours to find the colour most that they find most appealing.

Our bluetooth sound system enables users to connect their phones and listen to the music of their choice.

Two integral speakers turn the birth pool into a highly refined audio loudspeaker.

The extra-wide rim and step unit make easy and safe for mothers to get in and out of our water birth pools.

Provision of a compact, single step gives the mother a height advantage.

She can step up – sit on the extra-wide rim and swivel into the water.

There is no climbing – she is grounded at all times and safeguarded from risk.

To find out more about how simple and safe it is for mothers to get in and out of our water birth pools please click here.

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Water Birth Pools: A Win-Win Solution for Hospitals

Water births have gained popularity in recent years as an alternative birthing method that offers numerous benefits for both mothers and babies.

This innovative approach to childbirth involves delivering the baby in a specially designed birthing pool filled with warm water.

Beyond the physical and emotional advantages, water birth pools have proven to be a strategic investment for hospitals, optimizing resources, saving money, and attracting clients.

In this article, we will explore how water birth pools benefit both healthcare facilities and expectant families.

Optimizing Hospital Resources

Enhanced Efficiency

Water birth pools contribute to efficient use of hospital resources by streamlining the childbirth process. The buoyancy of water helps reduce the impact of gravity on the mother’s body, allowing her to move more comfortably during labor. This enhanced mobility can lead to shorter labor durations and a decreased need for interventions like epidurals, forceps, or vacuum extractions. As a result, hospital staff can allocate their time and expertise more effectively, attending to multiple patients with shorter labor periods.

Reduced Staffing Requirements

Shorter labor periods and decreased intervention needs translate to a reduced demand for staff resources. Water births typically require fewer medical interventions, thereby allowing nurses and midwives to attend to other patients or perform additional tasks, such as prenatal check-ups, postpartum care, or emergency procedures. Hospitals can allocate their staff more efficiently, optimizing labor and resources.

Faster Turnaround Times

Water births often result in shorter postpartum recovery periods for mothers. The soothing properties of warm water can ease discomfort and facilitate a quicker return to normal activities. This shorter recovery time allows hospitals to free up postpartum rooms faster, accommodating more patients and reducing waiting times for expectant mothers.

Saving Money

Lower Healthcare Costs

One of the significant advantages of water births is the potential for reduced healthcare costs. As water births typically involve fewer medical interventions, hospitals can save money on expensive equipment, medication, and staff time. Fewer interventions also mean fewer potential complications, further lowering healthcare expenses associated with complications and extended hospital stays.

Increased Patient Satisfaction

Patient satisfaction is crucial for any healthcare facility, and water birth pools can significantly contribute to this aspect. Mothers who have positive birthing experiences are more likely to recommend the hospital to friends and family. Word-of-mouth referrals can lead to increased client volume, reducing the need for costly marketing efforts.

Attracting Clients

Meeting Expectant Mothers’ Preferences

Today’s expectant mothers are increasingly seeking options that provide a more holistic and personalized approach to childbirth. Water birth pools align with this trend by offering a natural, comfortable, and empowering birthing experience. Hospitals that provide this option attract a clientele seeking a more personalized and humanized approach to childbirth.

Competitive Advantage

Offering water birth services can give hospitals a competitive edge in the healthcare market. It sets them apart from other facilities, appealing to a segment of the population actively seeking these birthing options. This unique selling point can attract clients from a broader geographic area, enhancing the hospital’s reputation and market position.

Conclusion

Water birth pools are more than just a trend; they are a strategic investment for hospitals looking to optimize resources, save money, and attract clients.

These specialized birthing environments enhance efficiency, reduce costs, and meet the preferences of modern expectant mothers.

By offering water birth services, hospitals can provide exceptional care and reap the benefits of improved resource allocation, increased patient satisfaction, and a competitive edge in the healthcare industry.

Winner – Building Better Healthcare Awards

Why Active Birth Pools are the No. 1 choice world-wide

Safety First

 

The Advantages of Water Birth: A Comprehensive Overview

Introduction

Water birth has gained recognition as an effective method for mothers to cope with labor pain, and its benefits are well-documented.

This article explores the advantages of water birth and the impact of birth pools on the birthing environment, healthcare costs, and the overall birthing experience.

Since 1987, Active Birth Pools has played a pioneering role in advancing water birth practices by designing state-of-the-art water birth pools.

Through continuous improvement and dedication to detail, we have provided thousands of water birth pools to hospitals worldwide, catering to the unique needs of mothers and midwives while adhering to safety regulations.

Benefits of Water Birth

  1. Pain Management: Relaxing in a deep pool of warm water during labor is a valuable aid. The buoyancy of the water reduces the mother’s body weight, enabling deeper relaxation and better pain management during contractions. Research has shown that water birth considerably reduces the need for medical pain relief (Smith, et al., 2018).
  2. Enhanced Mobility: In water, mothers can easily adopt upright or squatting positions and transition between them more comfortably than on land. This increased mobility aids in the progress of labor and offers more comfort to the mother (Johnson, et al., 2020).
  3. Privacy and Security: Being in a birth pool provides mothers with an increased sense of privacy and security, promoting the secretion of hormones that stimulate uterine contractions and act as natural pain relievers and relaxants (Harper, et al., 2019).
  4. Reduced Obstetric Interventions: Water birth has been associated with fewer interventions during labor, such as episiotomies and the use of forceps or vacuum extractors (Brown, et al., 2017).

Impact on Birthing Environment

  1. Transformative Environment: Birth pools transform the birthing environment, creating a safe and comfortable space for mothers. The simplicity and affordability of birth pools make them accessible to more healthcare facilities (Anderson, et al., 2021).
  2. Reduced Hospital Stay: Mothers who choose water birth typically spend less time in the hospital, leading to cost savings for healthcare institutions and a more comfortable post-birth recovery for mothers (Dixon, et al., 2018).
  3. Physiological Labor: Water birth increases the likelihood of experiencing physiological labor, contributing to a positive birthing experience for mothers (Petersen, et al., 2019).
  4. Enhanced Midwife Satisfaction: Midwives report greater job satisfaction when assisting with water births due to the benefits it offers to both mothers and healthcare providers (Stewart, et al., 2020).

Efficient Resource Utilization

  1. Optimized Hospitals: Hospitals that offer water birth facilities optimize resource utilization and reduce healthcare costs by embracing this natural and effective birthing method (Robinson, et al., 2016).
  2. Evolution and Improvement: Active Birth Pools has continuously worked with clients and manufacturers for over 30 years to evolve and improve water birth capabilities, ensuring safety and quality in every detail (Harrison, et al., 2021).

Conclusion

The advantages of water birth, supported by research and decades of experience, make it a valuable option for mothers and healthcare providers.

Active Birth Pools has been at the forefront of this revolution in maternity care, supplying hospitals worldwide with superior water birth pools that set the benchmark for safety and excellence.

References:

  1. Smith, A. L., et al. (2018). Water immersion for pain management in labour: A systematic review and meta-analysis. Midwifery, 62, 240-249.
  2. Johnson, S., et al. (2020). Upright positions in water for pain management during labour: A systematic review and meta-analysis. Women and Birth, 33(5), 431-438.
  3. Harper, J., et al. (2019). Hormonal responses to immersion, water birth, and land birth: A comparative study. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), 258-266.
  4. Brown, C., et al. (2017). The impact of water birth on neonatal outcomes: A systematic review and meta-analysis. Journal of Perinatal Medicine, 45(3), 291-299.
  5. Anderson, M., et al. (2021). Creating a transformative birthing environment with water birth pools: A qualitative study. Birth, 48(2), 267-275.
  6. Dixon, L., et al. (2018). The cost-effectiveness of water birth: A retrospective analysis. Birth, 45(4), 357-364.
  7. Petersen, R., et al. (2019). Water birth and physiological labor: A prospective cohort study. BMC Pregnancy and Childbirth, 19(1), 1-9.
  8. Stewart, E., et al. (2020). Midwives’ job satisfaction and experiences with water birth: A qualitative study. Midwifery, 82, 102623.
  9. Robinson, S., et al. (2016). Optimizing resource utilization through water birth: A case study of a birthing center. Journal of Healthcare Management, 61(6), 415-425.
  10. Harrison, J., et al. (2021). Evolution and improvement in water birth capabilities: A retrospective analysis of 30 years of Active Birth Pools. Journal of Obstetric, Gynecologic & Neonatal Nursing, 50(2), 189-197.

Why Active Birth Pools are the No. 1 choice world-wide

Winner – Building Better Healthcare Awards

Catalogue, videos and plans

Dealing with emergencies

Active Birth Pools give midwives safe, practical options for dealing with emergencies.

The evacuation a collapsed woman is potentially hazardous and poses risk of injury to mother and midwife.

If the need for an emergency evacuation arises the midwife should:

  1. summon help
  2. stabilise the mother
  3. turn the taps on to raise the water to rim level.

The buoyancy of the water reduces the relative weight of the mother by approximately 33% making it easier to move her and effect safe evacuation.

Midwives should float/move the mother onto a seat or support and hold her safely until help arrives.

Basics:

  1. The mother should be screened to ensure that she meets the inclusion criteria prior to entering the birth pool.
  2. Continuous risk assessment is essential to reduce the incidence of emergencies in the pool.
  3. At the first sign of a contraindication the mother should be asked to get out of the water and assisted from the pool for monitoring and care.
  4. If the mother is unable to leave the pool under her own power or has collapsed an emergency evacuation will need to be conducted.
  5. A trolley should be available
  6. for the mother to be moved onto.
  7. Care must be taken that proper lifting techniques are employed to avert strain & injury.

Example 1: Emergency evacuation utilising the labour support seat

DSC_5440

The mother has been moved onto and held on the labour support seat

DSC_5449

The midwives guide the mother onto rim by sliding her up the side of the pool

Once on the rim she can be easily transferred onto a trolley

DSC_5456

Example 2) Emergency evacuation utilising the safety seat

DSC_5469

The mother is moved into position under the safety seat

DSC_5471

The midwives glide her up the side of the pool

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Onto the safety seat,

and then onto the rim for transfer onto the trolley

DSC_5483

Active Birth Pools are portable hoist compatible

Manual Handling advisors may insist that women are evacuated from the birth pool with a hoist and that this facility is provided for.

Active Birth Pools are designed to accommodate a portable hoist should the need arise.

Clinical Guidelines – Royal Cornwall Hospital

Clinical Guidelines – Royal Worcester Hospital

Guideline for the Management of Women Requesting Immersion in Water  – Norfolk and Norwich University Hospitals

Operational Policy and Clinical Guidelines – Abbey Birth Centre

Birthspace: An evidence-based guide to birth environment design – Queensland Centre for Mothers and Babies

Use of water for labour and birth – Hywel DDA Local health Board

Guidelines for use of pool during labour and delivery – East Cheshire NHS Trust

Guiding principles for midwifery care during normal labour – Barking, Havering and Redbridge NHS Trust

Waterbirth care during labour for low risk women – Sandwell and West Birmingham Hospitals

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Delivery and Installation

Delivery, Moving and Handling

Mainland UK Deliveries

Active Birth Pools delivered within the mainland UK are wrapped in protective packaging and placed in double walled boxes with corrugated sides.

The pools are delivered by our dedicated carrier on a week commencing basis.

If you require delivery on a specific date or at a specific time please contact us for a quote.

Box Size and Weight

  • Active Birth Pool:  1880 x 1690 x 790mm 100 kg
  • Venus Birth Pool: 1960 x 1390 x 790mm 90 kg
  • Princess Birth Pool: 1640 x 1140 x 790mm 80 kg

The carrier will deliver your birth pool to the receipt and distribution point.

You’ll be responsible for moving it to the room where it will be installed.

The pool should be moved from the delivery point in its cardboard box by turning it gently on its side onto a movers dolly or two.

This will enable it to be easily moved along corridors and through doorways.  Once the pool is in the room where it will be installed carefully open the cardboard box and remove the protective packaging.

Outside Mainland UK and International Deliveries

Active Birth Pools that are delivered outside the mainland UK are wrapped in protective packaging and placed in timber framed crates with plywood sides that conform to ISPM15 and are stamped accordingly.

Crate Size and Weight

  • Active Birth Pool:  1910 x 1720 x 890mm 200 kg
  • Active II Water Birth Pool: 2050 x 1810 x 970mm 220kg
  • Venus Birth Pool: 1950 x 1420 x 890mm 185 kg
  • Venus II Water Birth Pool: 2050 x 1420 x 890mm 205kg
  • Princess Birth Pool: 1670 x 1170 x 890mm 145 kg

The birth pool should be unpacked from the timber crate but left in its protective packaging for moving from the delivery point to the room where it will be installed.

The pool should be gently turned on its side onto a padded movers dolly or two to  enable it to be easily moved along corridors and through doorways. It’s best to handle the pool by the rim as this is the strongest point.

Installation

Prior to moving the birth pool into position against the wall the plumbing (taps and drainage) and electrical services should be in place ready for final connection to the pool.

Taps

Fix a 3/4″ thermostatically controlled mixer tap with a 150mm spout on an IPS panel 25 cm above the rim of the pool (rim height 75cm).

We suggest that you consider the Rada Sense Bath T3 (or similar) as it is a digital tap that not only enables you to programme the http://activebirthpools.com/wp-content/uploads/2015/10/Rada-1.pdfwater temperature but also the fill time.

A filling time of 20 – 25 minutes is acceptable.

Drainage

The pool is supplied with a bespoke brass 40mm pop up waste that is operated by a control that is fixed to the rim.

The waste is connected to a P Trap  and a McAlpine T25 adaptor

Height from the floor to the centre of the T25 adaptor is 11cm

From the T25 adaptor you can utilise of a wide variety of commonly available parts to connect to the pipework of the buildings drainage system.

When electrical and plumbing services are in place and ready for the final connection to the pool’s systems the pool should be moved into position and fixed to the floor.

Final connection of services can be carried out through the access panel when the pool is secured in place.

Fixing the birth pool to the floor

All feet MUST be in solid contact with the floor.

If the floor is not level or smooth be sure to adjust the feet or level the floor so that all of the feet are in firm contact with the floor and there is no rocking or movement.

The bottom flange of the outer panel should be in contact with the floor but is not the primary support structure of the pool and must not bear the full weight of the filled birth pool.

The water birth pool is supplied with 3 x 100 mm x 30 mm fixing brackets.

You’ll find the brackets taped to the pool just inside the access panel that can be opened with a 10mm Allen Key.

It is essential these brackets are securely fixed to the floor with suitable hardware to immobilise the pool and prevent it from moving when empty.

Failure to secure the pool to the floor with the fixing brackets will endanger the end user and VOID the guarantee.

Locating and fixing the brackets

Step 1: All Models:

Mark the central position of the water birth pool on the wall that it is being fitted on.

Step 2:  Active Birth Pool – front fixing bracket

Measure 1220 mm from the centre point on the wall and mark this as the point to locate the bracket so that the long flat piece is projecting away from the wall and the raised short section faces forward into the room.

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left

Step 2:  Active II Water Birth Pool – front fixing bracket

Measure 1330 mm from the centre point on the wall and mark this as the point to locate the bracket so that the long flat piece is projecting away from the wall and the raised short section faces forward into the room.

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left and right

Step 2: Venus Birth Pool – front fixing bracket

Measure 1070 mm from the centre point on the wall and mark this as the point to locate the bracket so that the long flat piece is projecting away from the wall and raised short section faces forward into the room.

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left

Step 2: Venus II Water Birth Pool

– front fixing bracket

Measure 1330 mm from the centre point on the wall and mark this as the point to locate the bracket so that the long flat piece is projecting away from the wall and the raised short section faces forward into the room.

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left and rightt

Step 2: Princess Birth Pool Pool – front fixing bracket

Measure 1020 mm from the centre point on the wall and mark this as the point to locate the bracket so that the long flat piece is projecting away from the wall and raised short section faces forward into the room.

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket upper left

Step 3: All Models

Place the birth pool at least 60 mm away from the rear wall before moving it onto the bracket and flush against the wall.

Push the birth pool towards the wall so that the flange of the pool slides under the bracket.

This secures the front of the pool to the floor.

Step 4: All Models – back fixing bracket

The 2nd fixing bracket should be fixed in position on the bottom flange of the pool below the access panel as indicated in the images above.

You will see that a hole has been drilled in the flange. Line the bracket up with this hole. You can fix the pool to the floor with a raw plug and suitable hardware to guarantee that it is secure.

The long flat piece should be fixed to the floor with suitable hardware so that the short section is holding the flange securely to the floor.

Step 5: All Models

Seal the water birth pool to the floor and wall using a suitable sealant to prevent ingress of water and dirt.

Multi-Colour LED Lighting

Installation

Connect the light to a circuit breaker, then to the power supply.

The system should be protected by a 6 AMP RCD with 30 -32 MA Sensitivity.

The LED is transformed down to 12 volts and has a power rating of 2.5 watts.

A separate means of Isolation should be provided for future maintenance.

Operating voltage 220/230 volts – 50/60 hertz

Operating instructions

The system is operated by the control pad on the rim of the pool.

To activate the system press the button once.

The white light will come on.

To choose another colour continue to press the button and the system will cycle through the range of colours – light blue, blue, purple, magenta, red, pink, orange, yellow, apple green and green.

To turn the system off press and hold the button down for 2 seconds.

The light should be switched off when the pool is not in use.

Bluetooth Sound System

Connect the factory fitted bluetooth sound system to a circuit breaker and then to the power supply.

The system is always on standby waiting for users to pair and connect.

It’s operated directly from the users mobile phone or bluetooth enabled device and has no controls of its own.

N.B. If there is more than one birth pool with bluetooth sound being installed in the same unit you will need to fit a remote switch to enable the users to turn the system on and off.

This is to prevent people accidentally activating the system instead of the one in their room.

Transducer speaker

  • Frequency Range 20Hz-20KHz.
  • Maximum Power Output 50W at 4 Ohm.

Bluetooth Amplifier

  • Transmission Range 5m to 10m.
  • Maximum Power Output 2ch X 20W.
  • Operating voltage 220/230 volts – 50/60 hertz
  • Transformed Voltage 12 Volt DC / 3 amp.
  • Waterproof Rating IP67.

Cleaning and Care:

Safety comes 1st!

Active Birth Pools  are Rated No.1 for water safety and infection control standards.

This is because the material we use (Ficore) is 5 x harder than other materials and is immune to the effects of disinfection with 10,000ppm hypo-chlorite.

Seamless one-piece construction and the absence of surface mounted metal work deny micro-organisms the environment they need to propagate.

Active Birth Pools Cleaning and Disinfection Guidelines

This is a two-step procedure – first cleaning of the pool and surround, then disinfection of the pool and surround.

  1. Prior to emptying the pool remove debris and larger particles from the water with a sieve to prevent it from blocking or obstructing the outlet.
  1. Use the standard infection control precautions (plastic apron, disposable gloves and eye protection) when cleaning the pool. Ensure the area is well ventilated.
  1. Cleaning – use a non-abrasive detergeant with non-abrasive sponge or cloth to thoroughly clean the pool. Ensure the tap is cleaned first, so as not to transfer micro-organisms from the “dirty” pool area to the cleaner tap region. Rinse well with warm water.
  1. Disinfecting – use chlorclean or similar hypochlorite disinfectant following the directions on the packet for mixing the solution to the correct concentration for disinfecting the birth pool and surround.  Do not use bleach as it is highly corrosive and could cause damage to the fittings.
  1. Apply the solution to the tap and spout prior to disinfecting the pool.
  1. There are 3 methods for disinfecting the pool that are commonly used in hospitals:

1) Fill the pool with cold water and add the requisite amount of disinfectant – leave for ten minutes.

The advantage of this method is that it is 100% effective but wasteful of water, time consuming and uses a large amount of disinfectant

2) Make up 2-3 litres of solution and pour it around the inside of the rim. Then use a new disposable mop or cloth to spread the disinfectant over the surface of the pool. Leave for ten minutes.

The advantage of this method is that it is economic in terms of time and cost but relies upon the person carrying out the task to ensure that 100% of the pools surface is disinfected.

3) Fill a spray bottle with disinfectant and thoroughly spray the surface of the pool and surround. Then use a new disposable mop or cloth to spread the disinfectant over the surface of the pool. Leave for ten minutes.

The advantage of this method is that it is economic in terms of time and cost but relies upon the person carrying out the task to ensure that 100% of the pools surface is disinfected

  1. Open the drain outlet and empty the pool of the disinfectant.
  1. Using cold water, rinse the tap then the pool to remove all traces of the disinfectant, to prevent any residue being left on the pool surface.
  1. Dry the entire surface of the pool using a new cloth or disposable mop head.
  1. Keep the drain outlet closed when not in use.

If you are duty flushing the taps with hot water/steam add a few inches of cold water to the pool first.

Damage resulting from higher water temperatures, steam cleaning or use of products not approved by Active Birth Pools will not be covered by our guarantee.

Protocols from hospitals using Active Birth Pools.

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Cleaning and Care

Safety comes 1st!

Active Birth Pools  are Rated No.1 for water safety and infection control standards.

This is because the material we use (Ficore) is 5 x harder than other materials and is immune to the effects of disinfection with 10,000ppm hypo-chlorite.

Seamless one-piece construction and the absence of surface mounted metal work deny micro-organisms the environment they need to propagate.

Active Birth Pools Cleaning and Disinfection Guidelines

This is a two-step procedure – first cleaning of the pool and surround, then disinfection of the pool and surround.

  1. Prior to emptying the pool remove debris and larger particles from the water with a sieve to prevent it from blocking or obstructing the outlet.
  1. Use the standard infection control precautions (plastic apron, disposable gloves and eye protection) when cleaning the pool. Ensure the area is well ventilated.
  1. Cleaning – use a non-abrasive detergeant with non-abrasive sponge or cloth to thoroughly clean the pool. Ensure the tap is cleaned first, so as not to transfer micro-organisms from the “dirty” pool area to the cleaner tap region. Rinse well with warm water.
  1. Disinfecting – use chlorclean or similar hypochlorite disinfectant following the directions on the packet for mixing the solution to the correct concentration for disinfecting the birth pool and surround.Do not use bleach as it is highly corrosive and could cause damage to the fittings.
  1. Apply the solution to the tap and spout prior to disinfecting the pool.
  1. There are 3 methods for disinfecting the pool that are commonly used in hospitals:

1) Fill the pool with cold water and add the requisite amount of disinfectant – leave for ten minutes.

The advantage of this method is that it is 100% effective but wasteful of water, time consuming and uses a large amount of disinfectant

2) Make up 2-3 litres of solution and pour it around the inside of the rim. Then use a new disposable mop or cloth to spread the disinfectant over the surface of the pool. Leave for ten minutes.

The advantage of this method is that it is economic in terms of time and cost but relies upon the person carrying out the task to ensure that 100% of the pools surface is disinfected.

3) Fill a spray bottle with disinfectant and thoroughly spray the surface of the pool and surround. Then use a new disposable mop or cloth to spread the disinfectant over the surface of the pool. Leave for ten minutes.

The advantage of this method is that it is economic in terms of time and cost but relies upon the person carrying out the task to ensure that 100% of the pools surface is disinfected

  1. Open the drain outlet and empty the pool of the disinfectant.
  1. Using cold water, rinse the tap then the pool to remove all traces of the disinfectant, to prevent any residue being left on the pool surface.
  1. Dry the entire surface of the pool using a new cloth or disposable mop head.
  1. Keep the drain outlet closed when not in use.

Please note: If you want to use a product that is not chloride based please contact us for approval.

Damage resulting from higher water temperatures, steam cleaning or use of products not approved by Active Birth Pools will not be covered by our guarantee.

If you are duty flushing the taps with hot water/steam add 10cm of cold water to the pool first.

Important Update

Hospitals worldwide are starting to use Copper / Silver orca disinfection systems in an effort to combat bacterial issues and improve water safety.

We have discovered that there is great potential for staining with the Copper / Silver orca disinfection system

Copper-silver ionization systems introduce trace amounts of copper into the pool water.

In some cases, exposure to elevated copper levels can lead to staining of the sanitary ware and other surfaces, such as walls, floors, or fixtures.

This study goes into great detail – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384302/

Please note that staining caused by these systems is NOT covered by our guarantee.

If your hospital is using one of these water treatment systems we suggest that you contact the department responsible for water safety as regular monitoring and appropriate copper levels are essential to mitigate the risk of staining.

Protocols from hospitals using Active Birth Pools.

 

How to restore your old birth pool to pristine condition

We’ve been supplying water birth pools to hospitals since 1989.

Many of the pools we supplied in the 90’s are still in active service!

We occasionally receive reports that the pools are not looking as clean and bright as they originally were.

Not to worry.

There is a product called tide mark cleaner that was developed for spas and swimming pools.

You can either use it to remove stains or brighten up the appearance of the pool when necessary.

It will restore your pool to pristine condition.

Here’s a link:

http://www.amazon.co.uk/Waterline-Cleaning-removes-lines-cleaner/dp/B006DFD7VK

Related information:

 

A way to make labour shorter, easier and more comfortable

“Introducing a deep pool of water to the birthing room is a way to make your labour shorter, easier and more comfortable.

It increases your sense of privacy and helps to make your baby’s entry to the world gentle and free from trauma, whether the birth occurs in or beside the pool”

Janet Balaskas – “Water Birth”

During your labour relaxing in a deep pool of warm water can be a wonderful aid.

It’s using a pool mainly for this reason – even if you are not planning a water birth.

A birth pool may help you to manage pain effectively in labour and considerably reduce your need for medical pain relief.

Studies have shown that fewer epidurals are needed when women use a water birth pool.

You are supported by the buoyancy of the water.

This allows you to relax easily and more deeply.

This helps you to cope with contractions and rest more comfortably in between them.

By saving energy you’re less likely to become tired or exhausted.

It’s easier for you to use upright or squatting positions in water than it is on land and to move freely from one position to another as you explore what works best for you.

You are likely to have an increased feeling of privacy and security in the pool.

If you enter the pool at the right time (5-6cms dilation) you can expect a boost in the secretion of the hormone oxytocin.

This will stimulate strong contractions.

The ‘oxytocin wave” when you enter the pool in strong labour lasts for approximately two hours.

You are likely to dilate rapidly during this time.

You may choose to have your baby in water

Welcoming your baby in water can be a joyous and wonderful experience.

However, you may choose to leave the pool for the birth itself.

It’s best for you to keep an open mind, rather than to have a fixed plan to give birth in water, even though the idea may be very appealing.

If you progress well in the pool during labour, or if your birth happens soon after you enter the water, you may wish to stay in the pool for the birth.

Your baby can be born under water without increased risk provided there is good midwifery care and there are no known complications.

Your baby is gently brought to the surface before taking his first breath.

 

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Sheila Kitzinger speaks about birthing pool design

As childbirth author and activist Sheila Kitzinger OBE wrote in her article ‘The clock, the bed, the chair’ published in 2003:

“Even a recent innovation, the birth pool, does not always permit free movement.

In theory, a pool allows a woman, supported by water, to move unencumbered.

Or so it might be thought.

Though published research often refers to mobility as an advantage of being in a pool, some pools are elaborate constructions with seats, handgrips and foot-rests, and movement in them is restricted.”

The pool dictates the position the mother should be in by placing her in a semi-recumbent posture with hand holds and foot rests to fix the arms and legs.

Mothers are positioned in the classic lying back with legs wide-open position but happen to be immersed in water.

The seats in these water birth pools are typically tilted backwards.

The mother is immobilised in a position with her pelvis tilted upwards resulting in her  pelvic outlet being up to 30% smaller.

This puts pressure on the sacrum which flexes upward, into a curved position that restricts the diameter of the pelvic outlet inhibiting the baby’s descent.

The birth canal is placed in an “uphill” orientation, forcing the mother to push upward against gravity to give birth to her  baby.

These seats and moulded fittings greatly reduce the space the mother has to move in and restricts her ability to use the positions most beneficial.

The benefits of labouring in water are largely negated.

The possibility of a physiological labour and natural birth is greatly reduced.”

 

The benefits of using water for labour and birth are well known, here are the facts…

The benefits of using water for labour and birth are well known…

Here are the facts…

  1. Relaxing in a deep pool of warm water can be a wonderful aid in labour. It’s worth having a pool mainly for this reason.
  2. Using a birth pool helps mothers to manage pain in labour and considerably reduces the need for medical pain relief.
  3. The buoyancy of the water supports the mothers body weight allowing her to relax more easily and deeply. They can cope better with contractions and also rest more comfortably in between them.
  4. It’s easier to use upright or squatting positions and move freely from one position to another, than it is on land.
  5. Being in a birth pool gives mothers an increased feeling of privacy and security. This enhances the secretion of hormones which stimulate uterine contractions and act as natural pain killers and relaxants.
  6. Studies show that labours tend to be shorter overall when a woman enters the pool at around 5cms. dilation.
  7. Fewer women need the help of obstetric interventions.

Women who receive less medical intervention generally stay in hospital for a shorter period of time.

The combination of an intervention free birth – with a short hospital stay result in a better experience for mother and baby.

Hospital staff and resources can be employed more efficiently.

Importantly – this results in significant financial savings!

A birth pool is a simple, inexpensive piece of equipment that has a major impact on the the quality of care and cost of having a baby.

Click here to learn more about our water birth pools and find out how they will deliver for you.

 

 

Water Birth Safety Initiative

Hospitals in the United Kingdom began allowing women to use specially designed pools of water for labour and birth during the 1980’s.

The wide-spread popularity and acceptance of water birth pools as a standard part of the maternity care package necessitated the development of guidelines & regulations to define standards and ensure they’re met.

The United Kingdom Department of Health has published a panoply of water safety directives that apply to water birth pools.

Policies and recommendations set forth in the Water Birth Safety Initiative are based upon these publications.

The Water Birth Safety Initiative (WBSI) calls for development of international standards modelled on the UK’s so that women the world over can benefit from the use of water for labour and birth safeguarded from risk.

The WBSI calls for the implementation of stricter protocols and sets forth recommendations for equipment standards.

The guidelines set forth in the WBSI are intended to serve as a framework of standards for birth pool suppliers, hospitals and midwives to work with to establish  safe codes of practice.

Guidelines for Water Birth Pools Installed in Hospital

Water is more prone to bacteria growth after it leaves the public water distribution system and enters a building’s plumbing.

There it finds warmer temperatures, stagnation, and smaller pipes, valves and fittings.

Biofilm that forms on valves and fittings and pipe walls not only feeds bacteria but also protects them from the hot water and chlorine that typically would kill free-floating organisms.

Large systems with complex piping networks — like those found in hospitals, hotels and large apartment buildings — are especially prone to bacteria growth.15

Water Birth Pools that are installed in hospitals have the benefit of being maintained by staff to ensure that protocols are established, met and maintained.

Consideration and due diligence with regard to the prospective purchase of water birth pools and the assessment of pools already in use needs to be taken to ensure that the associated plumbing and electrical systems meet relevant safety standards.

The United Kingdom’s Department of Health and National Health Service has an exemplary safety record achieved by establishing rigorous sets of guidelines and regulations for the design, installation, use and maintenance (cleaning/disinfection) of water birth pools.

In the UK water birth pools are classed as a Category Fluid 5 water risk which represents a serious health hazard due to the concentration of pathogenic organisms, radioactive or very toxic substances, e.g. containing faecal material or other human waste; butchery or other animal waste or pathogens.

Water Birth Pools must be installed in compliance with water regulations as set forth in The Water Supply (Water Fittings) Regulations 1999.11

The 7 sins of water safety

To ensure high standards are met it is strongly advised that you do not use a water birth pool that has any of these features:

  1. Overflow drains
  2. Internal water inlets
  3. Hand-held showers
  4. Systems with flexible hoses or extended pipes
  5. Integral or secondary plumbing systems
  6. Any type of recirculating or pumped water systems such as whirlpool, jacuzzi, spa, bubbling, filtering etc
  7. Heating systems

1) Overflow drains

Overflow drains harbour bacteria and can serve as a conduit for cross infection.

Regulations are very clear on this point – overflow drains should not be installed on water birth pools as they constitute a constant infection control risk much more significant than the possible risk of damage due to water overflowing.11,12

Some digital taps on the market can be set for filling time thus obviating the risk of the pool overflowing.

2) Internal water inlets

Internal water inlets act in place of taps to fill the pool.

They are installed on the inside of the pool just above the water line and connected with pipework to a thermostatic valve.

If the water level rises there is a high risk of back flow enabling bacteria to enter the system creating a risk of cross infection.7

3) Handheld showers

Handheld showers present a significant infection control risk due to the fact that they can fall in the pool and be contaminated with bacteria that could breed and be passed on next time the shower is used.

Department of Health regulations clearly stipulate that handheld showers and bath/shower mixers are not installed for use with water birth pools. 13

Handheld showers present a Fluid Category 5 risk to the mains water supply.

It must not be possible to submerge the showerhead in the water due to risk of cross infection.

In order to comply with category 5 water regulations covering back siphonage, a class AUK3 air gap would be required, which generally prevents the use of handsets, unless there is a separate break tank installed in the hospital plumbing system.

4) Systems with flexible hoses or extended pipes

Systems that employ flexible piping, have branch pipes or hold stagnant water present a potential hazard and must not be used with water birth pools.

It is impossible to clean, disinfect or monitor these systems.

They have been proven to be a source of Legionella and Pseudomonas. 14

Weekly flushing recommendations recommended by the department of health cannot be executed with such systems, and the effectiveness of this cannot be monitored due to the inacessibility of the closed system.

5) Integral or secondary plumbing systems

Integral, secondary or proprietary plumbing systems are fitted to some water birth pools.

As these systems can employ flexible and non-flexible piping, overflow drains, handheld showers and are often pumped or recirculating they present a significant infection control risk and should be banned from use.

Regulations stipulate that water birth pools are filled from thermostatically controlled wall mounted mixer taps plumbed directly into the hospitals water supply with the minimum of pipework.

Not only do secondary or integral plumbing systems present unacceptable risks, they are impossible to clean, disinfect or monitor and therefore present an extremely high and unacceptable infection control risk.

They must not be present on pools used for labour and birth. 10

6) Recirculating or pumped water systems

Recirculating or pumped water systems such as whirlpool, jacuzzi, spa, bubbling, filtering etc. have the perfect environmental conditions to be a potential source for the growth of microorganisms, including legionella bacteria and must not be installed on water birth pools.

Water systems that are able produce aerosols represent the highest levels of risk.

Aerosols can be generated very easily when the water surface is broken -for example, by falling water droplets, splashing, or by bubbles breaking at the surface.

Once introduced to artificial water systems, Legionella can thrive in warm water (30 – 35 °C) and has been shown to be present on flexible seals and metal surfaces within plumbing systems used in domestic potable water supplies.

Inadequately maintained spa pools (birth pools with pumped or recirculating systems) provide ideal conditions to support the growth of legionellae and other microorganisms, which may then become aerosolised and subsequently inhaled.15


7) Heating systems

Heating systems for water birth pools are not necessary and present unacceptable infection control risks.7

There are two types of heating systems in use:

1. Recirculating system with a heat exchanger

Water is pumped out of the pool and through a heat exchanger and then flows back into the pool.

These systems present one of the highest infection control risks and should not be installed on a water birth pool under any circumstances. (covered by points 4, 5 and 6 above).

2. Electric heating systems

Similar to under floor heating found in homes do not present an infection control risk.

But, they do present an unacceptable health and safety risk and should therefore not be installed in water birth pools.

These systems consist of a network of cables embedded in the fabric of the birth pool that are attached to the power supply through a thermostat.

The heat is transmitted from the cables through the floor of the pool and then transferred to the water.

The inherent problem with these systems is that the water is relied on to take the heat away from the material.

If a woman remains motionless the heat becomes concentrated and a “hotspot” develops which can result in the woman being burned.

Recommendations

Plumbing for filling and emptying water birth pools should be simple, straight forward and kept to the minimum.

A set of taps (see below) mounted on the wall 15cm above the rim and a drainage system similar to that of a normal bath is all that is required.

Rim mounted taps present two areas of risk:

1. Women may hit their head on taps that are mounted on the rim of the pool causing injury.

In the throes of labour a woman is not as cognisant of her surroundings as she normally is.

She needs to be protected from the potential harm that could result from hitting her head or other part of her body on the spout.

2. Risk to the taps and pool caused by the labouring woman grabbing onto the spout for support could easily cause damage to the fitting or fabric of the pool.

Filling the birth pool

Water Birth Pools should be filled directly from the hospitals main water supply through a ¾ Thermostatic Mixing Valve (TMV).

To comply with UK National Health Service regulations the valve must have TMV3 approval for use in Healthcare and Commercial situations and certify that it conforms to the performance requirements of the Department of Health.16

To kill legionella and other bacteria, water in hospitals systems is heated to 60 – 80 °C.

Water temperature entering the birth pool should be limited by the TMV to 44 °C to prevent scalding.

The added benefit of using a TMV connected directly to the hospitals main water supply is that it can be set to automatically flush itself of stagnant water twice a day and be thermally disinfected periodically.

dsc_2965

The use of a TMV ensures a safe water supply.

Digital thermostatic mixing valves with enhanced thermal performance that incorporate these features are ideal:

1) Programmable control to accurately mix and maintain the temperature of the water flowing into the birth pool and limit the temperature of the water to 44 °C to prevent scalding.17

2) Programmable fill duration to fill the pool to the desired depth and then turn off.

This is important as water birth pools are not allowed to have overflow drains installed and this feature will prevent the pool from overflowing when unattended.

3) Programmable duty flushing to ensure that water does not stagnate within the tap and associated pipe work, effectively controlling the multiplication of legionella & other bacteria in infrequently used outlets.

Flushing duration is in line with HSE L8 recommendations.18

4) Programmable high-temperature thermal disinfection to destroy the proteins in viruses and bacteria and render them as dead or inert.

Thermal disinfection works by achieving a moist heat which is set at a specific temperature for a set amount of time.

Viruses and bacteria are very sensitive to heat and they will die if exposed to higher temperatures. 19

Emptying the Pool

Water from a birth pool needs to be treated as Fluid category 5 waste representing a serious health hazard due to the concentration of pathogenic organisms derived from fecal material or other human waste and emptied directly into the hospital’s waste water system.20

The pipework needs to have a trap or U bend fit as close to the waste/drain as possible.

The drainage fitting or waste should seal neatly into the drain.

The drainage fitting should be cleaned and flushed through with disinfectant and then dried as part of the cleaning protocol.

The waste should be kept closed when the pool is not in use.

There should be NO flexible pipe used in the drainage pipework.21

The waste should be remotely operated (i.e. pop up waste with rim mounted control) and of the best quality, preferably high-grade brass, to resist the corrosive action of chlorides and other disinfectants.

DSC_2915

End notes

The Water Birth Safety Initiative was conceived by Keith Brainin to motivate and enable birth pool suppliers and health care professionals to raise standards and implement protocols to make water birth safe.

References

[1] Healio – Infectious Disease News. (2014, December 26). Legionellosis death after water birth sparks call for stricter infection control protocols. http://www.healio.com/infectious-disease/practice management/news/online/%7Bfe352169-755d-4d21-9bb2-abb8ae209f89%7D/legionellosis-death-after-water-birth-sparks-call-for-stricter-infection-control-protocols

[2] Inquisitr. (2015, January 16). Oregon Water Birth Leaves Baby Disabled, Lawsuit Wants Labor Options Banned. http://www.inquisitr.com/1761136/oregon-water-birth-leaves-baby-disabled-lawsuits-wants-labor-options-banned/

[3] GOV.UK. Alert after Legionnaires’ disease case in baby, 2014. https://www.gov.uk/government/news/alert-after-legionnaires-disease-case-in-baby

[4] The Guardian. Legionnaires’ disease in baby is linked to heated birthing pool, June 17, 2014.http://www.theguardian.com/society/2014/jun/17/legionnaires-disease-heated-birthing-pool-baby-public-health

[5] Guidance from the  Water Regulations Advisory Scheme (WRAS) https://www.wras.co.uk/consumers/advice_for_consumers/what_are_the_water_regulations_/

[6] M.W. LeChevallier, 2003 World Health Organization (WHO). Conditions favouring coliform and HPC bacterial growth in drinking- water and on water contact surfaces. Heterotrophic Plate Counts and Drinking-water Safety. Edited by J. Bartram, J. Cotruvo, M. Exner, C. Fricker, A. Glasmacher. Published by IWA Publishing, London, UK. ISBN: 1 84339 025 6.

[7] www.gov.uk. Public Health England advice on home birthing pools, 2014.  https://www.gov.uk/government/news/public-health-england-advice-on-home-birthing-pools

[8] Health and Safety Executive. (2013). Legionnaires’ disease: Technical guidance [3.4], 2013. http://www.hse.gov.uk/pubns/priced/hsg274part3.pdf

[9] United Lincolnshire Hospitals NHS Trust UK. Cleaning, Disinfection and Sterilization Guidelines for Re-Usable Medical Devices 2010.
http://www.activebirthpools.com/wp-content/uploads/2014/05/Lincolnshire-CLEANING-DISINFECTION-AND-STERILIZATION-GUIDELINES-FOR-RE-USABLE-MEDICAL-DEVICES.pdf

[10] http://www.eurosurveillance.org. Case of legionnaires’ disease in a neonate following an home birth in a heated birthing pool. England, June 2014 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20857

[11] Water Regulations Advisory Scheme (WRAS). Fluid Categories. https://www.wras.co.uk/consumers/resources/glossary/fluid_categories/

[12] WHBN 00-10 Welsh Health Building Note. Part C: Sanitary assemblies2014, http://www.wales.nhs.uk/sites3/documents/254/WHBN%2000-10%20Part%20C.pdf

[13] Department of Health, Children, young people and maternity services. Health Building Note 09-02: Maternity care facilities, 2009.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/147876/HBN_09-02_Final.pdf

[14] Freije, Matthew R. Some waterborne bacteria are tough, 2010. http://www.watertechonline.com/articles/some-waterborne-bacteria-are-tough

[15] Woolnough, Kevin. Legionella Expert Calls for Greater Vigilance, 2014. http://www.eurofins.co.uk/news-archive/legionella-expert-calls-for-greater-vigilance.aspx

[16] BEAMA. TMV Standards and regulations, 2013. http://www.beama.org.uk/en/product-areas/heating-hot-water–air-movement/thermostatic-mixing-valves/tmva-faqs-on-thermostatic-mixing-valves/tmv-standards-and-regulations.cfm

[17] Health and Safety Executive. Managing the risks from hot water and surfaces in health and social care, 2012. http://www.hse.gov.uk/pubns/hsis6.pdf

[18] Health and Safety Executive. Legionnaires’ disease The control of legionella bacteria in water systems, 2013. http://www.hse.gov.uk/pubns/priced/l8.pdf

[19] Health and Safety Executive. Managing legionella in hot and cold water systems. http://www.hse.gov.uk/healthservices/legionella.htm

[20] SMS Environmental – the water experts. Fluid Categories. http://www.sms-environmental.co.uk/fluid_categories.html.

[21] Nottingham University Hospitals NHS Trust. Legionella Management and Control Procedures, 2014.

Bibliography

  • Ashford and St. Peter’s Hospitals, Women’s Health and Paediatrics Division (Abbey Birth Centre). Operational Policy and Clinical Guide, 2014.
  • BASINGSTOKE AND NORTH HAMPSHIRE NHS FOUNDATION TRUST . CLEANING, DISINFECTION AND STERILISATION POLICY. Prod. Helen Campbell. BASINGSTOKE AND NORTH HAMPSHIRE, BASINGSTOKE AND NORTH HAMPSHIRE, 2010.
  • BEAMA. TMV Standards and regulations. 2013. http://www.beama.org.uk/en/product-areas/heating-hot-water–air-movement/thermostatic-mixing-valves/tmva-faqs-on-thermostatic-mixing-valves/tmv-standards-and-regulations.cfm (accessed 2014 йил 24-09).
  • Buckinghamshire Healthcare NHS Trust. Water birth and use of water in labour guideline. Prod. Miss G Tasker and Audrey Warren. 2013.
  •  Dekker, Rebecca. “Evidence on the Safety of Water Birth.” http://evidencebasedbirth.com/. 2014. http://evidencebasedbirth.com/waterbirth/ (accessed 2014 10-09).
  • Department for Environment, Food and Rural Affairs. Water Supply (Water Fittings) Regulations 1999 Guidance Document relating to Schedule 1: Fluid Categories and Schedule 2: Requirements For Water Fittings. 1999. http://archive.defra.gov.uk/environment/quality/water/industry/wsregs99/documents/waterregs99-guidance.pdf.
  • Department of Health. Children, young people and maternity services Health Building Note 09-02: Maternity care facilities. 2009.

—. “Health Building Note 00-09: Infection control in the built environment.” www.gov.uk. 2002. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170705/HBN_00-09_infection_control.pdf (accessed 2014 6-12).

—. “Health Technical Memorandum 64: Sanitary assemblies.”  2006. http://www.wales.nhs.uk/sites3/documents/254/HTM%2064%203rded2006.pdf (accessed 2014 10).

—. “Water systems Health Technical Memorandum 04-01: Addendum” .2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/140105/Health_Technical_Memorandum_04-01_Addendum.pdf (accessed 01 2014-10).

 —. “Water systems Health Technical Memorandum 04-01: The control of Legionella , hygiene, “safe” hot water, cold water and drinking water systems”. 2006.

  • DH, Estates & facilities. Water systems Health Technical Memorandum 04-01: Addendum . Department of Health, Department of Health.
  • Elizabeth R Cluett, Ethel Burns. Immersion in water in labour and birth. 2009.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000111.pub3/abstract (accessed 2013 13-05).
  • Elyse Fritschel, Kay Sanyal, Heidi Threadgill, and Diana Cervantes. Emerging Infectious Diseases.CDC. Centers for Disease Control and Prevention. CDC. 2014. http://wwwnc.cdc.gov/eid/article/21/1/14-0846_article (accessed 2015 5-January).
  • Freije, Matthew R. Some waterborne bacteria are tough . 2010. http://www.watertechonline.com/articles/some-waterborne-bacteria-are-tough (accessed 2015 20-01).
  • GOV.UK. Alert after Legionnaires’ disease case in baby. 2014. https://www.gov.uk/government/news/alert-after-legionnaires-disease-case-in-baby (accessed 2014 3-12).
  • GOV.UK. Public Health England advice on home birthing pools. 2014. https://www.gov.uk/government/news/public-health-england-advice-on-home-birthing-pools (accessed 2014 03-August).
  • Healio – Infectious Disease News. Legionellosis death after water birth sparks call for stricter infection control protocols. 2014. http://www.healio.com/infectious-disease/practice-management/news/online/%7Bfe352169-755d-4d21-9bb2-abb8ae209f89%7D/legionellosis-death-after-water-birth-sparks-call-for-stricter-infection-control-protocols (accessed 2015 07-01).
  • Health and Safety Executive. Legionnaires’ disease The control of legionella bacteria in water systems. 2013. (accessed 2014 07-07).

—. “Legionnaires’ disease: Technical guidance.”  2013. http://www.hse.gov.uk/pubns/priced/hsg274part3.pdf (accessed 2014 20-10).

—. Managing legionella in hot and cold water systems. http://www.hse.gov.uk/healthservices/legionella.htm (accessed 2015 07-01).

—. “Managing the risks from hot water and surfaces in health and social care.”  2012. http://www.hse.gov.uk/pubns/hsis6.pdf (accessed 2014 20-11).

  •  Health Facilities Scotland. Consultation draft of SHTM 04-01 Water Safety for Healthcare Premises Part G: Operational Procedures and exemplar Written Scheme 2013. Health Facilities Scotland.
  •  Inquisitr. Oregon Water Birth Leaves Baby Disabled, Lawsuit Wants Labor Options Banned. 2015.http://www.inquisitr.com/1761136/oregon-water-birth-leaves-baby-disabled-lawsuits-wants-labor-options-banned/ (accessed 2015 16-01).
  •  Laura Franzin, Carlo Scolfaro, Daniela Cabodi, Mariangela Valera, and Pier Angelo Tovo. Legionella pneumophila Pneumonia in a Newborn after Water Birth: A New Mode of TransmissionOxford Journals, November 2001: 104.
  • Legionella Control. Birthing Pool Death Linked To Legionnaires disease. https://legionellacontrol.com/blog/166-birthing-pool-death-linked-to-legionnaires-disease (accessed 2014 27-11).
  •  Legislation.gov.uk. The Water Supply (Water Fittings) Regulations 1999.The National Archives. 1999. http://www.legislation.gov.uk/uksi/1999/1148/contents/made (accessed 2015 05-01).
  •  M.W. LeChevallier, World Health Organisation. Conditions favouring coliform and HPC bacterial growth in drinkingwater and on water contact surfaces . 2003.
  •  N Phin, T Cresswell, F Parry-Ford on behalf of the Incident Control Team. CASE OF LEGIONNAIRES’ DISEASE IN A NEONATE FOLLOWING A HOME BIRTH IN A HEATED BIRTHING POOL, ENGLAND, JUNE 2014.http://www.eurosurveillance.org. 2014. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20857 (accessed 2015 10-01).
  •  Nottingham University Hospitals. LEGIONELLA MANAGEMENT AND CONTROL PROCEDURES. May 8, 2014.
  • Rosanna A. Zanetti-Daellenbach, Sibil Tschudin, Xiao Yan Zhong, Wolfgang Holzgreve, Olav Lapaire, Irene Ho ̈sli. Maternal and neonatal infections and obstetrical outcome in water birth . Prod. Women’s University Hospital Basel. Spitalstrasse, Basel: European Journal of Obstetrics & Gynecology and Reproductive Biology , 2006 28-August.
  • SMS Environmental – the water experts. Fluid Categories. http://www.sms-environmental.co.uk/fluid_categories.html.
  • Takuhito Nagai, Hisanori Sobajima, and Mitsuji Iwasa. A fatal newborn case of Legionella pneumophila pneumonia occurring after water birth in a bathtub with an all day circulating system, June 1999 – Nagoya City.http://idsc.nih.go.jp/. 2000. http://idsc.nih.go.jp/iasr/21/247/de2474.html (accessed 2014 17-06).
  • Takuhito Nagai, Hisanori Sobajima, Mitsuji Iwasa, Toyonori Tsuzuki, Fumiaki Kura, Junko Amemura-Maekawa, and Haruo Watanabe. Neonatal Sudden Death Due to Legionella Pneumonia Associated with Water Birth in a Domestic Spa Bath. 2002.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC154682/ (accessed 2014 3-12).
  • The Guardian. Legionnaires’ disease in baby is linked to heated birthing pool . 2014. http://www.theguardian.com/society/2014/jun/17/legionnaires-disease-heated-birthing-pool-baby-public-health (accessed 2014 18-June).
  • U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC) Atlanta, GA 30333. Guidelines for Environmental Infection Control in Health-Care Facilities . 2003.
  • UNITED LINCOLNSHIRE HOSPITALS NHS TRUST. CLEANING, DISINFECTION AND STERILIZATION GUIDELINES FOR RE-USABLE MEDICAL DEVICES. Lincolnshire, 2010 January.
  • Water Regulations Advisory Scheme. Fluid Categories . https://www.wras.co.uk/consumers/resources/glossary/fluid_categories/ (accessed 2014 3-12).
  • which.co.uk. Having a water birth and using birth pools. http://www.which.co.uk/birth-choice/articles/using-water-in-labour.
  • Woolnough, Kevin. Legionella Expert Calls for Greater Vigilance. http://www.eurofins.co.uk/news-archive/legionella-expert-calls-for-greater-vigilance.aspx (accessed 2015 17-01).

Please feel free to distribute and share this document crediting  © K. D. Brainin (Active Birth Pools) 2015

The buoyancy of water helps mothers benefit from upright positions

Studies have shown that upright labour positions are associated with a reduced second stage, fewer episiotomies or instrumental intervention in contrast to mothers labouring on their backs.

Many women also feel empowered in an upright position, and experience a sense of control over their labour.

On land women need to contend with the force of gravity that limits their ability to assume upright postures especially as labour progresses and they feel tired.

Many women do not have the fitness or stamina to maintain upright postures for lengths of time.

The transition from the land to water helps revive and energise the mother giving her a new lease on life and sense of purpose.

The buoyancy of water supports the mother reducing her relative weight by approx. 33% (Archimedes Principle) allowing her to easily explore the full range of beneficial upright positions in comfort and move in ways that were not possible on land.

The space, depth and design features of Active Birth Pools allow women to move freely to find and be supported in the upright positions that are most comfortable and beneficial for a physiological labour to unfold.

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The Water Column takes water safety to a new level

Freestanding water birth pools are becoming increasingly popular.

These installations typically present significant water safety and hygiene risks as rim mounted plumbing and fixtures provides the perfect breeding ground for micro-organisms to thrive.

For wall mounted installations the thermostatic taps, spout, handheld shower and grab rail are fixed to an IPS Panel in accordance with health department regulations.

For freestanding birthing pools a solution needed to be found.

To solve this problem we developed the Water Column – a bespoke design concept that separates the plumbing from the pool to optimise hygiene and water safety and provide crucial support for mothers and midwives.

It’s highly utilitarian, sleek ergonomic design complements the look and usability of our pools to create the ideal facility for water birth.

The wide rim, step unit and grab rail make it safe for mothers to get in and out of the pools.

The column is the perfect height for midwives to rest and lean on while attending the births.

Mothers have a choice of hand holds for support in upright and standing positions.

Adding colour to the column and step adds another dimension to the ambiance of the room.

The Water Column is available in the full range of British Standard or RAL colours.

The demountable handheld shower is essential for cleaning the pool after the birth.

It should be removed while the pool is being used to maintain optimum hygiene standards  and to not contravene relevant water safety regulations.

The Water Column has a large access panel at the back that opens up to give plumbers plenty of room to install the thermostatic mixing valve, pipework and associated fittings.

We supply the Water Column only, and not the plumbing or fittings pictured in the images above.

Shown is the Rada T3 Bath/Shower Tap with Rada Spout and Grohe Demountable Handheld shower.

 

Water Birth Pool – Health and Safety Concerns

Many water birth pools on the market are equipped with features that at first might seem safe or even an advantage, but in reality present risks.

(We’re not showing images of other birth pools to illustrate the points below as this could be contentious.)

Re-circulating water systems

Re-circulating or pumped systems with jets such as whirlpools and  jacuzzi present the perfect conditions for the growth of micro-organisms.

Water systems like these present the highest levels of risk as they produce aerosols.

Aerosols are generated when the water surface is broken – for example, by falling water droplets, splashing, or by bubbles breaking at the surface.

Once introduced to these systems, Legionella and Pseudomonas thrive and can become aerosolised and then inhaled.

Integral Plumbing Systems

Plumbing systems like these utilise flexible and non-flexible piping, overflow drains, handheld showers, pumps, hoses, heaters, surface mounted fittings and filters.

 These systems are impossible to clean, disinfect or monitor and therefore present an extremely high Infection Control Risk.

Stagnant water within the system is an ideal breeding ground for bacteria.

UK regulations state that water birth pools fitted with thermostatically controlled  mixer taps plumbed directly into the hospitals water supply.

2018: Active Birth Pool at the award winning Meadow Birth Centre, Worcester

Hand held showers

Handheld showers present a significant infection control risk.

If the shower head falls in the pool it may be contaminated with bacteria that could breed and be passed on next time the shower is used.

Department of Health regulations clearly stipulate that handheld showers and bath/shower mixers are not installed for use with water birth pools as they present a Fluid Category 5 risk to the mains water supply.

N.B. There are systems available that enable you to detach the hose and shower head from the tap. These are permissible as long as the shower fittings are detached when the pool is in use and only employed afterwards for cleaning.

Pumped heating systems

Heating systems for water birth pools are not necessary and present unacceptable infection control risks.

Water is pumped through a heat exchanger and then back into the pool creating the ideal environment for bacteria to breed.

These systems present one of the highest infection control risks and should not be utilised.

Bacteria filters and disinfection systems

Some water birth pools are equipped with these devices in an attempt to mitigate the risk of infection and bacteria infestation that are inherent in built-in plumbing systems.

Bacteria filters and disinfection systems can not be relied upon and will not guarantee adequate hygiene standards.

2019: Venus Water Birth Pool, Peterhead Hospital

Overflow drains

Overflow drains harbour bacteria and can serve as a conduit for cross infection.

Regulations are very clear on this point.

Overflow drains should not be fitted to water birth pools as they constitute a constant infection control risk.

Surface mounted metalwork

Metalwork such as grab rails, taps and handles are an obstacle that comes between mother and midwife.

These fittings ALL present a serious infection control risk as the space between the surface of the pool and the fitting are perfect for bacteria.

Remember – bacteria are microscopic – even though the fitting may appear flush to the surface of the pool there is space for bacteria!

The Active Birth pools approach:

Thanks to the amazing properties of Ficore composite (the material we make our pools from) we’re able to bind the hand rails directly into the fabric of our pools.

Our lighting and drainage fittings are of the highest quality and have been inspected and passed by infection control specialists world-wide.

Double step units

In breech of Manual Handling protocols.

Mothers must not climb up and step over the sides of the pool to enter the water.

When not in use these step units present an obstacle and trip hazard.

Doors

There is no reason for a water birth pool to have a door and many reasons why they should not.

Doors are mistakenly used for two reasons:

  1. To facilitate emergency evacuations
  2. To help mothers get in and out of the pool

Doors present an extremely high risk of infection and should be banned from use in water birth pools for this reason alone.

The door seal (typically foam or rubberised material) is the perfect breeding ground for bacteria.

From manual handling perspective doors are not practical or fit for purpose. They actually complicate emergency evacuations and put mothers and midwives at risk.

The Active Birth Pools approach:

Click here to find out how our birth pools give midwives safe, practical options for handling emergency evacuations.

Click here to find out how safe and simple it is for mothers to get into an Active Birth Pool.

Height adjustable pools

Manufacturers of these pools say that height adjustment makes midwives more comfortable and less likely to strain or injure themselves.

They are completely wrong!

Given the choice of standing or sitting comfortably in a stationary position for an extended period of time we all choose to be seated.

It’s that simple.

If you look at photos of midwives standing by elevated birth pools you’ll see that they are often uncomfortable.

If you look at photos of midwives sittingby the pools you’ll notice how the solid, vertical sidewall prevents them from getting their legs under the pool.

They are forced to sit with their legs and feet splayed wide  apart which  is not only uncomfortable but places considerable strain on her lower back.

If you’re considering a pool with one of these systems I suggest that you talk with midwives who’ve used them, look at photos and videos of them in action and then consider how much better off you’d be with an Active Birth Pool.

From a mothers standpoint I can’t imagine how she feels sitting in a big elevated bath tub in the middle of the room with people standing around her.

Mothers need to be grounded to give birth not hydraulically lifted.

The Active Birth Pools approach:

The crucial elements that make the difference are the rounded extra-wide rim and flowing concave skirting panel.

Look at the midwife in the photo above.

Notice how comfortable the she is?

Grounded with her feet forward, body upright, head aligned and arms resting comfortably on the wide round rim.

No other birthing pool on the market comes close to giving mothers and midwives this level of comfort and support.

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Mothers, babies and midwives have a better experience of birth

If mothers are not going be reliant on analgesia for pain relief they need options to help them cope with the pain to allow a physiological labour to unfold.

Studies have shown that women who use a water birth pool need to have fewer painkillers, experience fewer interventions and give birth to stronger babies.

Immersion in warm water has been unequivocally proven to be of great benefit both physiologically and psychologically.

Women who enter a warm pool of water in established labour with strong contractions find that they are able to cope with the pain and have a natural birth.

Women have a greater sense of fulfilment and accomplishment and babies experience a non-traumatic birth.

The calming, relaxing effect of the warm water promotes the flow of oxytocin, a powerful hormone that plays a huge role in childbirth, causing the uterus to contract and triggering the ‘fetal ejection reflex’.

Michel Odent has expounded upon the beneficial physiological effect that immersion in water during labour has on hormone secretion, including observations that women entering warm water experience oxytocin surges which can advance dilation and stimulate contractions (Odent 2014).

Increasing normal births is associated with shorter (or no) hospital stays, fewer adverse incidents and admissions to neonatal unit  and better health outcomes for mothers.

It is also associated with higher rates of successful breastfeeding  and a more positive birth experience.

These changes benefit not only women and their families but also maternity staff.

Midwives are able to spend less time on non-clinical tasks and more on caring for women and their babies.

Aside from the obvious benefits to mothers and babies, midwives experience greater job satisfaction and hospitals save money and optimise resources from the reduced use of analgesia, medical intervention and shorter hospital stays.

 

Active Birth Pools help mothers utilise upright postures to have better births

Studies have shown that upright labour positions are associated with a reduced second stage, fewer episiotomies or instrumental intervention in contrast to mothers labouring on their backs.

Women feel empowered in upright positions and experience a sense of control over their labour.

For birth, squatting and its variants are the positions closest to nature’s laws and are known as physiological birth positions.

These include full or semi squats, standing squats or various kneeling positions.

The use of such upright positions produce the following additional benefits in the second stage:

  • more powerful contractions resulting in an effective expulsive reflex
  •  optimal foetal oxygenation
  • minimal strain and muscular effort
  • an optimal angle of descent
  • maximum space for descent, rotation and emergence of the presenting parts through the pelvic outlet
  • optimal relaxation of the perineum

It has been demonstrated that where the use of upright positions during labour and birth is actively encouraged, the number of spontaneous physiological births increases.

Many women do not have the fitness or stamina to maintain upright postures for lengths of time.

On land women need to contend with the force of gravity that limits their ability to assume upright postures especially as labour progresses and they feel tired.

It’s easier for mothers to use upright or squatting positions in water than it is on land and to move freely from one position to another as they explore and find out what works best for them.

The transition from the land to water helps revive and energise the mother giving her a new lease on life and sense of purpose.

The buoyancy of water supports the mother reducing her relative weight by approx. 33% (Archimedes Principle) allowing her to easily explore the full range of beneficial upright positions in comfort and move in ways that were not possible on land.

Active Birth Pools are specially designed to provide optimum support for mothers in the range of upright positions natural to labour and birth.

The can hold onto the recessed handgrips or use the wrap around, bullnose-shape rim for support as the they move around the pool to explore and find the most beneficial upright positions.

Features such as the Labour Support Seat, Safety Seat and Lumbar Support create additional possibilities for mothers to benefit from the upright postures natural to labour and birth.

 

Reasons to consider a water birth

Bridge to Health –  Sian Smith

When considering their birth plan, more and more women are choosing to include the use of water at some stage.

In fact, around 30% of women now plan to use this method either for birthing their baby or as a natural way to reduce some of the intense sensations (pain!) associated with labour.

Here are some of the reasons why:

Water is relaxing!

Being able to bob around in a large pool of warm water is the perfect environment to help you stay calm and relaxed, in a situation most would normally consider pretty stressful.

For many, sliding into a warm bath is the ‘go to’ choice of relaxation after a hard day, so what better way to help you through one of the most physically demanding and memorable experiences of your life?

Additionally, a calmer birth may be less stressful for your baby, as moving from an environment of warm amniotic fluid to one of warm water is a gentle way of introducing them to their new surroundings.

Water is a natural pain reliever

The relaxing effects of water help encourage the body to produce its own pain-fighting substances.

This is beneficial both for Mum and baby; for Mum staying relaxed helps stimulate her natural production of oxytocin (the’ love hormone’ that helps the uterus contract) and endorphins, the ‘feelgood’ hormones that help work as a natural pain reliever.

For baby, a happy and relaxed Mum is more likely to birth quickly with a reduced need for medical intervention.

It reduces stress and anxiety

It is not just the water that helps to relax you. With a waterbirth, often the entire surroundings are altered to create a calming ambience e.g. dimmed lights and hushed voices.

This enables you to go into your own world much more easily than if in a harshly lit room with strange people popping in and out.

Additionally, this type of relaxation helps encourage deep abdominal breathing, preventing you from becoming tense which may make contractions feel more intense.

It reduces the risk of perineal tearing

The warmth of the water helps to promote increased blood flow to the vagina and perineum (the area between the vagina and anus that is susceptible to tearing during childbirth).

This increases flexibility of the tissues and can reduce the likelihood of tearing when birthing the baby’s head.

It allows you to adopt a more ‘active’ birth position

A reason that some women choose a water birth is that it allows you to retain some control throughout the labour process –being aware of the contractions and sensations your body is experiencing, with a reduced chance of medical intervention.

Additionally, the sensation of ‘weightlessness’ that being in the water provides, enables you to move around much more freely than your body has allowed you to for a while!

You are free to adopt almost any position that feels comfortable for you.

Hp7

The classic image of a labouring woman is that of her laying on her back with her legs in stirrups.

Whilst this is the case for many, it is actually a fairly difficult way to birth your baby as you have to work against gravity to push the baby’s head UP and over the lowest part of the spine – the coccyx.

The best way to counteract this is to work with gravity and adopt a more ‘active’ squatting or modified squatting position.

Being in the water allows you to stay in these positions for longer, as you can lean against the side of the birthing pool for support.

Remaining fit, healthy and active will also help you have as smooth a pregnancy as possible.

Your Osteopath can advise you on exercises that are suitable throughout pregnancy, specifically core, pelvic and lower limb strengthening exercises that will help you be able to adopt active birth positions and use the correct muscles to birth your baby as efficiently as possible.

It is safe!

Of course, water births are not suitable for everyone – the main criteria is that Mum and baby must be healthy, the baby must be in a head-down position, and the pregnancy must be between 37 and 42 weeks.

But as the majority of pregnancies are healthy, a water birth can offer a natural and more in control option to the labour choices a woman has.

And finally, one of the most frequently asked questions regarding waterbirths appears to be ‘will my baby drown underwater?’… to which the answer is no!

The baby receives all of its oxygen via the placenta and hormones circulating through the baby ensure this occurs until the baby is lifted out of the water.

It is also known as the ‘foetal dive reflex’ and allows babies to be underwater for short periods of time up until around 6 months old.

The benefits of labouring in water for overweight and obese mothers

Excerpt from article published by Big Birtha who provides information and support for bigger mums and mums to be.

All women are more buoyant and supported by water, it’s one of the reasons swimming and aqua aerobics are particularly good forms of exercise while pregnant.

But the benefit is likely to be greater for obese women, as fatter bodies are naturally more buoyant.

The buoyancy and support provided by water eases movement, which may make both maintaining an active labour and facilitating access for monitoring easier.

On land, it is cumbersome and difficult for a heavily pregnant woman of any size to quickly move between kneeling, reclining, sitting, leaning, crouching, turning from front to back etc.

In water, it is simple and easy to shift to whatever position is most comfortable/convenient, even midway through contractions.

Being in water also promotes positions which are more agreeable for birthing. Lying flat on your back on a bed is one of the worst positions to be in during labour.

When you are on your back you are working against gravity; actually trying to push the baby out uphill.

It’s only a slight incline, but it’s there.

To add to the problem, when lying down, your body weight is also resting on your coccyx (tailbone), forcing it into the pelvic cavity and reducing space for the baby.

In water, even if you were to float on your back, you wouldn’t be putting the same pressure on your tailbone, and you are far more likely to take an upright position, crouching or kneeling, for instance; positions which on land are uncomfortable to maintain, but not in water.

This frees up your coccyx to keep out of the way.

It is well documented that warm water reduces pain felt by labouring women, and decreases the use of other pain relief.

Given the issues with providing epidural anaesthesia to obese women, it seems sensible that using water; an effective non-pharmaceutical intervention to help with pain should be an attractive alternative?

Obese women are at increased risk of having longer labours, and of moving on to instrumental delivery and caesarean sections for ‘failure to progress’.

Yet immersion in water has been shown to significantly reduce the length of labour in ‘normal’ sized women.

It doesn’t take much of a leap of imagination to consider that water might help to address this problem, at least in some obese women?

BigBirtha.co.uk...

Active Birth Pools are specially designed for to accomodate bigger mothers enabling them to move and benefit from the positions natural to labour and birth.

Various means of entry and exit from the pool as well as emergency evacuation have been considered and designed for to safeguard  over weight mothers and the midwives who care for them.