Author: K.D.Brainin
Diving in: a dip in the water for labour and birth policy debate
Megan Cooper RM, BHSc (Honours), Jane Warland RM, PhD Helen McCutcheon RM, PhD.
Abstract
Water immersion for labour and birth is becoming an increasingly attractive option for women.
However, with what has been described as a paucity of research, water immersion policies appear to lack the evidence to ensure confidence in their use, safety in their implementation and importantly, acknowledgement of women’s autonomy to utilise water for labour and birth irrespective of their perceived ‘risk’.
In touching on the difficulties experienced by maternity care providers working within a system largely dominated by a ‘risk adverse’ paradigm, the following paper will highlight the shortfalls of research surrounding water immersion for labour and birth and the difficulties of utilising policies informed almost entirely by this research.
The current paucity of rigorous evidence and the difficulties faced by maternity care providers facilitating the option, highlights that greater emphasis needs to be placed on gaining a substantial evidence-base to inform future water immersion polices with more weight given to both observational data and anecdotal experience.
Future research should focus on both quantitative and qualitative aspects of water use for labour and birth to ensure that policies incorporate the required risk/benefit analysis, the opportunity for shared and informed decision-making and ultimately, the facilitation of woman-centred care.
Should we throw out the bath water?
For many women water immersion (WI) during labour and birth is an attractive and sought after option of care.
Despite the availability of literature surrounding WI for labour and birth many argue that high quality research with which to measure risks and benefits is still lacking.
As the option has become increasingly available, the development of policy to guide and inform care providers in the safe practice of WI for labour and birth has become necessary.
Consequently, policies appear to have been derived from what some describe as a less than substantive evidence-base (Cluett and Burns, 2009).
This has elicited debate as to whether the practice itself and therefore the policies currently informing the practice reflect the required foundational evidence to fulfill the ideal of evidence-based practice.
In touching on the current difficulties experienced by care providers working within in a ‘risk averse’ system the following paper will briefly explore WI for labour and birth, highlight the perceived shortfalls of research pertaining to its practice and discuss some of the difficulties of undertaking research at the level that many believe is required.
The role of qualitative research in informing the practice of labour and birth in water will also be examined with particular reference to the goal of woman-centred care and the need for policy that is reflective of a holistic evidence-base and supportive of women’s experience, satisfaction and choice.
The practice of water immersion for labour and birth
Despite common belief, WI for labour and birth is not a new phenomenon, with history dating back to the Egyptian Pharaohs and the Minoans of Crete (Mackey, 2001). In the 1960’s, Igor Charkovsky, a Russian midwife, began experimenting with the use of water for labour and birth after realising the positive physical and physiological effects of WI (Houston, 2010).
The 1980s saw Michel Odent, a well-known French Obstetrician and arguably the pioneer of modern water birth, establish the first birthing unit allowing women access to baths during labour, many of whom also went on to birth in water
(Houston, 2010). His observations and documented accounts of witnessing women immerse themselves in warm water allowed him to become a major influential figure in the global water birth movement and in the education of practitioners who facilitate the option of WI.
The advantages and benefits of WI during labour and birth have for the most part, not been thoroughly investigated through rigorous research.
Documented benefits include reductions in pharmacological pain relief (Eberhard et al., 2005, Otigbah et al., 2000, Benfield et al., 2001, Cluett and Burns, 2009), reduced blood loss and perineal trauma (Cluett and Burns, 2009) as well as facilitation of dysfunctional labour (Benfield et al., 2010, Cluett et al., 2004).
It has long been held that water immersion facilitates ‘normal’ birth and the latest prospective and descriptive cross sectional research findings provide support for this belief (Burns et al., 2012, Dahlen et al., 2012).
Burns et al. (2012) found that there was a higher frequency of spontaneous birth in nulliparas and greater rates of normal birth in both nulliparous and multiparous women when water was used during labour and/or birth. More specifically, of the 8924 participants almost 90 percent had a spontaneous birth and of these 5192 (58.3%) of women birthed in water.
Further support for benefits of water use come from Dahlen et al. (2012). They found in their Australian descriptive cross sectional study that women birthing in water had lower rates of major perineal trauma and PPH ≥ 500 milliliters when compared with those who used a birth stool on land.
Improved APGAR scores at five minutes were also noted for babies born into water compared to those whose mothers birthed in a semi-recumbent position on land although the authors note that they are unsure as to whether a semi- recumbent position was favoured by practitioners when there were fetal concerns, thereby potentially impacting on the results.
However, what is perhaps most important in terms of these findings is that there were no documented increased adverse outcomes for mothers who utiliszed water during labour and birth nor were there statistically significant increases in unfavourable outcomes for babies born into water.
Anecdotal experience supports these benefits further, with women suggesting greater levels of satisfaction, sense of autonomy and care providers observing less use of pharmacological pain relief and the facilitation of the fourth stage of labour, particularly in the initiation of breastfeeding.
Qualitative researchers have also found that women who birth in water feel protected, safe, relaxed and in control (Benfield et al., 2010, Maude and Foureur, 2007, Benfield, 2002).
For example, one New Zealand interpretive study, conducted by Maude and Foureur (2007), highlighted that WI provided a ‘sanctuary’ or environment whereby women felt protected and sheltered from intervention and interference. Participants also voiced a reduction in the fear of the birthing process and pain.
For many maternity care providers, water use for labour and birth is viewed as a method of providing women an alternative method of pain relief, ease of position changes and relaxation (Gilbert and Tookey, 1999, Meyer et al., 2010, Maude and Foureur, 2007, Woodward and Kelly, 2004, Stark and Miller, 2009).
Although evident throughout the literature, the observation and experience of maternity care providers is often challenged against minimal scientific proof, which to date, is still not entirely definitive.
Conversely, many continue to challenge the use of water for labour and birth claiming that it is neither normal nor natural for land living mammals to birth into water and that there exist too many associated ‘risks’ and adverse outcomes to mother and infant (Kassim et al., 2005, Mammas and Thiagarajan, 2009, Carpenter and Weston, 2011, Pinette et al., 2004).
The most recent published adverse outcomes pertaining to the use of water immersion during labour and birth come from Soileau et al. (2013) and Menakaya et al. (2012). Soileau et al. (2013) documents a neonatal infection and subsequent neonatal demise post a home water birth attributed to a maternal diarrheal infection in the week prior to birth. The infection believed to have been transmitted to the neonate after the mother defecated in the bath during labour.
This provides justification and support for the use of policy and/or guidelines in guiding practitioners in the facilitation of the option. Furthermore, its draws attention to the knowledge and understanding practitioners must attain in order to make decisions that ensure both maternal and neonatal wellbeing and safety when water is used.
Although Menakaya et al. (2012) did not assess maternal or neonatal infections in their retrospective design of 216 Australian women birthing in water, they noted that babies born into water showed a statistically significant difference in APGAR scores less than or equal to seven at one minute and as well as admission to Special Care Nursery (SCN) post birth in the water birth group.
Interestingly, three of the neonates transferred to SCN were admitted for feeding difficulties, issues which cannot be definitely linked to water immersion, one was admitted post a mild shoulder dystocia which presumably required the woman to be evacuated from the bath prior to birth and one for meconium aspiration, suggesting the presence of meconium which is commonly cited contraindication to birthing in water.
The remaining infants were admitted for resuscitation and an apneic event, which are also not unique to infants born in water.
One infant in the control group was admitted to the SCN and was transferred for respiratory distress requiring the longest stay of all infants admitted to the SCN. These findings are dissimilar to those of Mollamahmutoglu et al. (2012) who found no instance of neonatal infection and no significant difference in admission to the Neonatal Intensive Care Unit (NICU) when comparing infants who were born in water with those who were not. These findings are indicative of the inconsistent and contradictory findings pertaining to the use of water for labour and birth across the literature.
As a result, empirical research has failed to provide a definitive risk/benefit analysis relating to WI for labour and birth particularly in terms of maternal and neonatal infection, neonatal SCN/NICU admission, perineal trauma and the incidence of neonatal drowning and water embolism, as examples.
Furthermore, the ongoing reference to ‘potential’, ‘possible’ and ‘theoretical’ risks throughout the literature as well as throughout policy and guideline documents creates difficulty and uncertainty as to what actually constitutes risk and what is deemed as safe when WI is utilised for labour and/or birth (Kvach and Martonffy, 2012, Mackey, 2001, Pinette et al., 2004).
Watering down practice
Maternity care providers aim as far as possible, to deliver care which is women- centered (Carolan and Hodnett, 2007). Woman-centered care (WCC) incorporates the requirement of a woman making informed choices about all aspects of her care through the sharing of information (Leap, 2009).
Maternity care providers hold information that is vital to the woman but given the need to work within protocols and guidelines, may at times provide information to meet institutional and personal expectations and commitments resulting in what Carolan and Hodnett (2007) describe as “rule following and avoidance of responsibility”.
Although not necessarily a deliberate attempt to limit the information and options available to women, difficulties can arise as maternity care providers walk the fine line between meeting obligations as the woman’s advocate and the demands of institutional policies, guidelines and regulations.
Consequently care providers may forsake their role as the woman’s advocate, and instead support an environment that fosters informed compliance (Carolan and Hodnett, 2007).
Unfortunately the ideal of woman-centredness is often relinquished particularly as birth has become viewed a process that requires management and medical influence (Kitzinger, 2006, Davis-Floyd, 2001).
The burden of ‘proof’ and necessity of evidence to support or refute ‘alternative’ options irrespective of women’s requests and subjective knowingness that they work (Klein et al., 2006) has been significant in the debate surrounding water immersion for labour and birth.
Many of the benefits that water provides the labouring and birthing woman are also what may deter care providers from offering it as an option. Women and care providers alike, have suggested that water provides safety, sanctuary and distance from the rest of world allowing women a sense of control and ownership over their labour and birth (Maude and Foureur, 2007). However, this protection from intervention and intrusion
ultimately means that the contemporary methods of monitoring and gauging progress are no longer as accessible or practical. For many practitioners the inability to monitor and assess women as they normally would results in fear, not only of litigation and ‘what if’s’ (Garland, 1919), but also of the practice itself.
Combatting fear and anxiety could be as easy as encouraging care providers to witness women using water during labour and birth, but opinion and bias in disfavour of water immersion demands the current ‘gap’ in research be bridged.
Furthermore, ethical practice calls for practitioners to dissociate personal bias and views from their practice to ensure women’s autonomy and ability to exercise choice are not downplayed or absent in the facilitation of care (ANMC, 2008, ANMC et al., 2008).
This issue is further complicated by the political climate within which maternity care now exists. Despite many care providers supporting the implementation and practice of WI for labour and birth and having the capacity and accreditation to facilitate the practice, they may be restricted by the lack of institutional resources and support (Garland, 2011) and most commonly, policy that is derived from an aversion of risk and research that has yet to determine with any certainty the safety of using water for labour and birth.
WI for labour and birth, despite putting what feels like an ‘alternative’ slant on care, has the potential as a practice and option of care, to assist care providers such as midwives to re-recognize normal physiological birth and subsequently work towards fulfilling the ultimate goal of woman-centred care.
A drought of evidence?
Water birth, in particular, is frequently associated with perceived risks and dangers and for this reason its use continues to be challenged relative to safety implications for mother and infant as has previously been discussed (Pinette et al., 2004, Kvach and Martonffy, 2012).
The conundrum is yet to be resolved particularly given the perceived paucity of definitive evidence. Yet the option is becoming increasingly demanded and therefore available and as a result, policies are in place to guide care providers in its facilitation, which are probably based (at least in part) on this limited evidence.
Although a number of attempts have been made to undertake research at the ‘gold’ standard, randomised controlled trials (RCTs) examining WI for labour and birth have suffered from less than optimal sample sizes, selection bias or poorly controlled confounding factors in groups of low risk women who are usually highly passionate and motivated (Woodward and Kelly, 2004, Schroeter, 2004, Cluett and Burns, 2009).
This is evident in the latest Cochrane review that included only 12 suitable studies, and of these, only three examined the use of water during second stage of labour (Cluett and Burns, 2009). Further to this there is currently no population level data being collected anywhere in the world about outcomes of WI nor even how many women choose to use WI in labour and/or birth in water (Pinette et al., 2004).
Undertaking the recommended research on WI and birth particularly such as the RCT suggested by Davies (2010) is complicated given that randomising for such a study brings about ethical and moral concerns.
Hendrix et al. (2009) found this to be the case in their Dutch questionnaire-based study assessing women’s reasons for not participating in an RCT investigating home birth versus hospital birth. Eighty-four women indicated that they did not participate due to a concern that they would be randomised to the ‘wrong’ group.
Woodward and Kelly (2004) attempted to overcome women’s reluctance to participate in their pilot RCT comparing water birth with land birth by including a ‘preference arm’. Their results indicated there were no significant difference noted between women who were randomised and those who chose the ‘preference arm’ and therefore concluded that women would be happy to be randomised in future and similar trials.
However, criticism of this RCT highlights that their sample size was too small and therefore underpowered to determine safety, particularly given that only 10 women birthed in water. Further to this, Keirse (2005) challenges the validity and generalisability given the ‘preference arm’ and the bias that meant only 20 of the 60 women who had a strong preference for one of the two options, were allocated to their preferred option.
Subsequently, randomisation of women to options of care, which elicit both emotive and somewhat passionate views, such as the use of WI in labour and birth, is not ethically or practically feasible particularly where recruitment of large numbers would be required to determine with any certainty the morbidity and mortality of the intervention.
The proposed undertaking of this type of randomised research is further complicated by inconsistency across institutional policies in addition to funding, necessary infrastructure and available accredited staff (Garland, 2011).
Not only does this make it difficult to allow for the option and implementation of WI for labour and birth but it also inadvertently contributes to the lack of evidence in that accessibility is limited and therefore data on resulting outcomes, scarce. Furthermore, where it is consistently highlighted that high quality evidence is deficient, the question must be asked: who or what is informing the policies already in existence?
Initiating a wave of change
It is consistently highlighted that there is insufficient data to inform the practice of labour and birth in water, but is this really the case? It is clear that there is a paucity of evidence in terms of empirical investigation however volumes of anecdotal experience and observational data are available suggesting that water has significant and undeniable benefits to the women, and arguably to the baby.
Despite its availability, little weight is given to this valuable information, information that could be informing the movement forward and providing direction for future investigation of WI for labour and birth.
There is no denying that greater high level research would be advantageous to providing a definitive set of benefits and risks and therefore, greater insight into the relative safety of WI for labour and birth. However, is a RCT the right option?
The suggestion that rigorous evidence is needed to inform policies and guidelines with confidence and reliability could be attributed to what has been termed the ‘medicalisation’ of pregnancy and birth (Brubaker and Dillaway, 2009, Benoit et al., 2010) particularly where the measure of risk is at the forefront of maternity care facilitation.
However, in a risk-averse climate, adverse events whether recognised through well-constructed studies, auditing or anecdotal accounts, are generally the first to be documented so as to prompt review of practice.
Despite this, a search of the literature surrounding WI for labour and birth highlights very few documented adverse outcomes at any level of evidence and of those that are documented; the outcomes cannot always be definitively attributed to the use of water (Pinette et al., 2004, Cluett and Burns, 2009, Byard and Zuccollo, 2010).
What are readily available are anecdotal and observational accounts that suggest that WI has extensive benefits, not only to the woman but also to birth outcomes. It could therefore be argued that quantitative research alone is insufficient to provide answers to myriad of complexities, questions and queries relating to the practice of WI for labour and birth and therefore, insufficient when informing policies particularly where women choose to exercise self-determination and choice irrespective of their perceived risk.
Freeman and Griew (2007) touch on this in their review of one WI policy and its development. Their findings suggest that policy could further be enhanced by placing weight on the views and experiences of consumers and addressing the importance of informed and shared decision making.
This calls for attitudinal change not only to facilitate care that is woman-centred but also to ensure that women’s autonomy is factored into the development and implementation of policies underpinning practice.
The significance and value of qualitative evidence is slowly being realised, particularly in maternity care where WCC is the ideal. Despite this, empirical evidence is still commonly viewed as more rigorous and therefore more reliable.
This is none too clear in the hierarchies of evidence that fail to give weight to qualitative investigation (Spiby and Munro, 2009). However, as health care moves towards patient-centred models, or woman-centredness (Leap, 2009), as is the case in maternity care, there is the need for increasing weight to be also placed on experience and opinion particularly surrounding policy formation and care facilitation.
In light of this, a multi-faceted evidence-based approach to policy development and implementation of WI for labour and birth is likely to be advantageous.
However, before recommendations can be made, a critical analysis of existing policies and their development should occur in order to highlight whether the so-called scarcity of evidence poses difficulties for those involved in WI policy formation and to what extent policy facilitates and/or restricts water use practice and more importantly, women’s autonomy.
Pooling for the future
This paper has touched on the many shortfalls of WI research to date as well as foreseeable difficulties of future research surrounding WI for labour and birth. Future research requires greater emphasis on both the quantitative and qualitative aspects of water use for labour and birth to ensure that policies incorporate both the risk/benefit analysis as well as the opportunity for shared and informed decision-making.
This includes greater exploration of the experiences and perceptions of women and importantly, an examination of current WI policies to determine how they are informed and developed and to what extent they facilitate the practice and support women’s autonomy.
Not only is there the potential for this all-encompassing research to assist maternity care providers in working with autonomy as practitioners and ensuring their ability to advocate for women but there is also the potential for the use of water for labour and birth to have positive outcomes in a system that has an ever increasing rate of intervention and deviation from what can be both a normal and natural process.
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Position statement on the use of water for labour and birth
In light of the publication of recent articles that report the growing demand from women around the world who want to have a natural, drug free, non-medicalised birth (Weiss 2014 and Gilbert 2015) we need to look at ways to help them have this experience.
If they are not going be reliant on analgesia for pain relief they need options to help them cope with the pain to allow a physiological labor to unfold.
Immersion in warm water has been unequivocally proven to be of great benefit both physiologically and psychologically.
It is not important if the baby is born in water.
In fact, water birth should be de-emphasised as it is a controversial issue in many parts of the world.
The key point and main benefit that needs to be made and focused on is how 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 fulfillment and accomplishment and babies experience a non-traumatic birth.
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.
Nearly a third of women benefited from the use of a water birth pool in the UK in 2014 (National Maternity Survey 2014).
With up to 60% of mothers open to natural birth now is the time for midwives, obstetricians and hospitals to consider making this safe, low cost option available.
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. (Gupta, Hofmeyr and Shehmar 2012 and Gupta and Nikodem 2000).
Many women also feel empowered in an upright position, and experience a sense of control over their labour (Balaskas 2001).
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. (Gupta JK, Hofmeyr GJ, Smyth R 2007).
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 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).
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 labor to unfold.
Management of High Risk Women using Birthing Pool and Telemetry
There is evidence that water emersion in labour offers women a safe and effective form of pain relief in labour to those women who meet the criteria (NICE, 2007; NICE, 2014; Garland, 2011).
The use of telemetry provides women greater choice and control over their birth experience to facilitate the use of water (Birthing Pool or Bath) in labour and birth where their pregnancy and labour has been categorised as high risk and requires continuous fetal monitoring.
The Standard Operating Procedure (SOP) has been written to facilitate continuous fetal monitoring of high risk women in labour and birth who wish to use the birthing pool / water.
Telemetry is a wireless fetal monitoring device which facilitates continuous toco graph (CTG) monitoring where clinically indicated in the first and second stage of labour on a consultant led delivery suite.
Prior to the woman being offered the use of the birthing pool on the Delivery Suite consideration should be given to the plan of care and requirements of the woman and baby having reviewed the fully ante natal history.
The following lists are not exhaustive and full clinical assessment should be made on admission to delivery suite.
Click here for a copy of these guidelines
Hydrotherapy in Labor and Birth
In recent years, professional organizations that represent maternal-child health care providers have taken various positions on the recommended use of immersion hydrotherapy during labor and birth. The resulting lack of consensus has made consistent and equitable access to this non-pharmacologic method for pain relief in labor challenging.
This model practice template was jointly developed by representatives from the American Association of Birth Centers, American College of Nurse-Midwives, Midwives Alliance of North America, National Association of Certified Professional Midwives, and other experts to offer guidance to health care professionals and institutions that provide or are implementing hydrotherapy services. This document is informed by the most current available information and resources that support best practices and serves as an outline of the various roles and responsibilities involved in providing hydrotherapy during labor and birth. Limited information has been published on the efficacy and safety of specific care practices before, during, or after hydrotherapy. However, this document is informed by the methodologically-sound, peer-reviewed studies that have been published to date. The format of this model practice template allows for adaptation depending on the setting and the maternity care professionals involved to support the development of individual practice guidelines and institutional policies and procedures.
- I.PURPOSEThe purpose of this model practice template is to assist professionals caring for women who labor and/or give birth in water.
- II. DEFINITIONS
- A. Warm water immersion: Immersion in a tub with depth that allows for complete submersion of the abdomen to the breast level.
- B. Water labor: Use of warm water immersion during any stage of labor up to but not including the birth of the neonate.
- C. Waterbirth: Use of warm water immersion during the second stage of labor that results in the birth of a neonate entirely underwater, regardless of the location of delivery of the placenta.
- III. OUTCOME STATEMENT
- A. Provide increased options for the woman regarding labor and birth and enhance the woman’s satisfaction with the birth experience.
- B. In the case of water immersion only, enhance the comfort of the woman and ensure the safety of the woman and fetus throughout the first stage of labor.
- C. In the case of waterbirth, maintain the comfort of the woman and ensure the safety of the woman and fetus throughout labor and birth to achieve a normal, spontaneous, vaginal birth of a healthy newborn under water.
- IV.BENEFITSWarm water immersion during childbirth provides the woman in labor with alternatives to conventional pain relief strategies and birth methods. Respect for the woman’s autonomy and choice is important. Immersion is strongly associated with and may result in the following:
- V.RISKSIn predominantly observational studies, investigators did not find increased rates of maternal, fetal, or neonatal morbidity or mortality associated with labor and birth in water.6, 7, 12, 13 However, it is important to ensure that risks are explained to the woman before immersion, including the following:
- A. Umbilical cord avulsion (tearing). This may occur if too much traction is placed on the cord during waterbirth. Avulsion can typically be managed with little or no negative sequelae if recognized and treated immediately to minimize blood loss. Failure to respond immediately with effective management could result in the need for a neonatal blood transfusion.7, 14–16
- B. Hyperthermia. Elevation of maternal core temperature can result in maternal hyperthermia, which can lead to fetal tachycardia.17 In the absence of infection and with early recognition and intervention, this should resolve upon leaving the tub or cooling the water.16, 17
- C. Perineal laceration. Waterbirth is associated with a decreased rate of third- and fourth-degree perineal lacerations7–9, 18; however, waterbirth may slightly increase the risk of less significant perineal trauma.18
- D. Infection. In studies of water labor and waterbirth, investigators have not demonstrated increased overall rates of maternal or neonatal infection following immersion during any stage of labor regardless of the status of membranes during hydrotherapy.6, 7, 13, 18 However, if the tub is not cleaned properly or harbors unusual organisms such as Pseudomonas or Legionella, the woman and/or neonate could acquire an atypical infection.16, 19–21
- E. Neonatal water aspiration. In case reports, researchers demonstrated that when secondary apnea is present (due to fetal hypoxia), neonates may exhibit a gasping reflex at the time of waterbirth that can result in the inhalation of water and potentially make resuscitation and ventilation more challenging.13, 16, 22 If an indeterminate fetal heart rate pattern is detected, further evaluation is indicated.
- F. Mortality. As with conventional birth, the potential exists for death of the woman or neonate. No maternal deaths have been reported, and only isolated fetal deaths have been attributed to immersion during labor or birth.12, 13, 16–18
- VI.STANDARD REQUIREMENTS TO FACILITATE HYDROTHERAPYDuring the prenatal period, health care providers should discuss the potential use of water during labor and/or birth with all low-risk women as part of an overall discussion and education regarding evidence-based options for pain relief.23 If a woman desires water immersion and/or waterbirth, the health care provider should engage in an ongoing process of informed consent and shared decision making with the woman regarding this option.24 The woman and health care provider should discuss the state of the science, risks and benefits of water immersion and waterbirth, and factors that increase the potential for optimal perinatal outcomes; they should review potential barriers to the use of these options based on the woman’s unique health history (refer to contraindications outlined in section VIII) and preferences. During the informed consent process, the woman and health care provider should discuss issues that include the limited research that is available about waterbirth; the optimal timing and duration of immersion hydrotherapy; and emerging areas of outcomes research, such as seeding the newborn microbiome after waterbirth and any effect of labor or birth in water beyond the standard perinatal outcomes assessed in studies to date.
- VII.ELIGIBILITY CRITERIAWomen who meet the following criteria are eligible to use warm water immersion during labor and/or birth:
- A. Cephalic presentation.
- B. Singleton.
- C. 37 0/7 weeks’ gestation or greater.
- D. Category I fetal heart rate or Category II fetal heart rate after review by the maternity care team and with consideration of stage of labor and associated maternal and fetal factors, including baseline fetal heart rate, regular rhythm, and presence or absence of recurrent fetal heart rate decelerations from the baseline.25, 26 Based upon birth setting and maternal and/or fetal risk factors, fetal heart rate can be evaluated using intermittent auscultation and/or waterproof electronic fetal monitoring during water immersion. Interpretation of fetal heart rate assessment should be consistent with established guidelines, such as those published by the American College of Nurse-Midwives,26 the Association of Women’s Health, Obstetric and Neonatal Nurses,27and the National Institute of Child Health and Human Development.28
- VIII. CURRENT PREGNANCY AND LABOR CONDITIONS IN WHICH WATER IMMERSION OR WATERBIRTH IS NOT RECOMMENDED19
- A. Abnormal vaginal bleeding.
- B. Maternal fever > 38.0°C (100.4°F).
- C. Any condition that requires continuous fetal monitoring that cannot be obtained during immersion.
- D. Active herpes simplex lesion, hepatitis B or C, HIV.
- E. Musculoskeletal issues or reduced mobility that may prevent the woman from leaving the bath quickly if necessary.
- F. Epidural analgesia or anesthesia.
- G. Intrapartum hemorrhage.
- H. Pregnancy complications or conditions that can complicate birth or transition of the neonate to extrauterine life.
- I. Administration of opioid or other sedating medications within one hour of hydrotherapy initiation or longer in case of persistent risk to maternal mobility, airway protection, or ability to follow instructions.
- J. Clinical judgment of the attending provider that the woman’s condition or the fetal status prohibits ongoing immersion.
- IX. PRECAUTIONS
- A. Performance of infection control measures in accordance with separate guidelines (see section XVII).
- B. Universal personal protective equipment should be used according to facility guidelines.
- C. Any break in maternity care professional or patient skin integrity must be covered with an occlusive waterproof dressing.
- D. Emergency equipment must be readily available in the room with the laboring woman.
- E. If the water becomes contaminated with feces or debris, the woman may be asked to leave the tub temporarily until it is removed or the water can be changed and the tub cleaned.
- F. Prolonged heating of standing water may encourage bacterial contamination. Protocols should include a process for regularly scheduled emptying and cleaning of the tub.
- G. After each use, the tub and all reusable equipment must be thoroughly cleaned and allowed to dry before next use per institutional guidelines.
- X. SUGGESTED ADDITIONAL EQUIPMENT FOR INTRAPARTUM WATER IMMERSION
- A. Water thermometer.
- B. Waterproof Doppler and ultrasound gel at tub side for intermittent auscultation or waterproof telemetry on the unit for continuous fetal monitoring if available within the facility.
- C. Small net, strainer, or basin.
- D. Small handheld or waterproof mirror.
- E. Waterproof flashlight.
- XI. STAFF ROLES
- A. Responsibilities of the maternity care provider
- 1) Maintain current knowledge of the advantages, precautions, contraindications, and current literature regarding the use of immersion hydrotherapy.
- 2) During the prenatal period, provide all pregnant women with information about the benefits, risks, and potential harms of hydrotherapy during labor and birth along with other pain relief options. Use an informed consent document to ensure consistency in the presentation of this information. This information should be reviewed again before use of the tub during labor as indicated.
- 3) Offer families the option of hydrotherapy and assess the woman’s desire for this option through an ongoing process of assessment and shared decision making.
- 4) Counsel the woman on the risks and benefits of water immersion for labor and birth and the institutional protocols for use of the tub.
- 5) Perform ongoing assessment of the woman’s condition to determine if labor and/or birth in the water are indicated.
- 6) Ensure adherence to evidence-based guidelines for use of water immersion or waterbirth.
- 7) Provide shared decision making and ongoing assessment of the evolving process and progress of labor; discuss changes in status that may indicate the need to discontinue use of the tub.
- 8) Provide direct supervision of care and birth of the neonate.
- B. Responsibilities of the registered nurse
- 1) Assess the woman’s understanding of the risks and benefits of water immersion for labor and birth and her understanding of institutional protocols for use of the tub; confirm her desire for use of tub for labor and birth.
- 2) Before immersion, ensure the woman meets eligibility criteria outlined in section VII.
- 3) Maintain the safety of the woman in the tub while providing care and support in collaboration with the attending provider. This includes ongoing assessment for changes that may occur that alter the woman’s eligibility for continued use of water immersion. Care includes assessment of maternal and fetal status consistent with standards of care for a woman in labor.25, 29
- 4) Maintain safe tub conditions, including hourly assessment of water temperature. Remove debris and change bath water as needed or as stated in facility protocol.
- 5) Establish and maintain safe route of exit from tub to bed and vice versa, and ensure there are no potential hazards (eg, wet floor, equipment).
- 6) Ensure availability of additional personnel to facilitate safe exit of the woman from tub if indicated.
- C. Responsibilities of non-licensed personnel
- 1) In an out-of-hospital birth setting, non-licensed personnel may help to support a woman using water immersion for labor and or birth. This birth assistant’s role may extend to monitoring the status of the woman and fetus while in the tub under the supervision of the attending provider. The role of the birth assistant should be consistent with her or his established skill and training and institutional or practice guidelines.
- 2) It is recognized that family members and doulas may provide social and emotional support to the woman while she is in the tub. They should be instructed by a member of the health care team on how to call for assistance should they have any concerns or see signs of impending birth. If the woman wants to exit the tub, a health care provider should be informed before she does so.
- A. Responsibilities of the maternity care provider
- XII. MANAGEMENT OF LABOR IN WATER
- A. Before immersion, ensure the woman is a candidate for warm water immersion based on inclusion and exclusion criteria (sections VII and VIII).
- B. The tub should be filled using ordinary tap water without additives (eg, salt, essential oils, sanitizers).
- C. The water temperature should be assessed hourly.
- 1) During the first stage of labor in water, the water temperature should never exceed 37.7°C (100°F) and may be adjusted to cooler temperatures per the woman’s preference.
- D. The woman in labor may enter or leave the water at any point with assistance.
- 1) Record the times that the woman enters and leaves the tub.
- 2) The woman should be instructed to use proper body mechanics when entering and exiting the tub and do so only with staff or a support personn attendance.
- 3) If complications or changes occur in the maternal or fetal condition that require further assessment or treatment outside of the tub, share this information with the family and assist the woman out of the tub.
- E. Positioning for comfort in the tub is dependent on the preferences of the woman and the judgment of the provider in consultation with the woman.
- F. Provide hydration in the form of oral liquids or intravenous (IV) fluids as indicated. All IV or saline lock sites should be covered with an occlusive, water-resistant dressing while the woman is in the tub.
- G. The well-being of the woman and fetus are assessed and managed in accordance with practice protocols for any other woman during labor, including monitoring maternal vital signs, assessing the fetal heart rate,25, 26 and initiating intrauterine resuscitation strategies when indicated (eg, maternal position changes and IV fluid bolus for fetal heart rate changes or Category II fetal heart rate).
- 1) A waterproof Doppler or waterproof electronic fetal monitoring equipment should be used to assess the fetal heart rate.
- 2) Waterproof electronic fetal monitoring equipment may be used to verify or clarify if an indeterminate fetal heart rate pattern is present, and this can guide management.
- 3) Management of indeterminate fetal heart rate patterns depends on multiple factors. Intrapartum resuscitation techniques such as position change, hydration, and correction of hypotension or tachysystole are instituted as necessary.
- H. Vaginal examinations may be performed underwater when necessary.
- I. Intermittent maternal self-administration of nitrous oxide during labor and birth in water is acceptable when available.
- XIII. MANAGEMENT OF THE SECOND STAGE OF LABOR
- A. The woman may choose any position in the tub for pushing during the second stage of labor that feels comfortable and that is deemed safe by the attending provider or registered nurse. The health care professional may request adjustments to the position to facilitate observation of progress and/or to maintain assessment of maternal and fetal well-being.
- B. Water temperature
- 1) During the second stage of labor, the water temperature should never exceed 37.7°C (100°F) and may be adjusted based on the woman’s preference within a narrow range of 36.1°C to 37.7°C (97.0°F to 100°F).
- C. Maternal and fetal well-being should be assessed and documented as they would be for a conventional birth.25
- D. Fetal heart rate and contraction pattern are assessed in accordance with standard of care recommendations, generally every 5 to 15 minutes.25, 28
- E. Supporting birth of the neonate
- 1) The woman should be supported in the use of spontaneous, physiologic pushing.
- 2) The health care provider may use a hands-off or hands-poised position to facilitate birth by controlled, spontaneous, pushing efforts; a hands-on method of birth management may be employed when indicated.
- 3) It may not be necessary to feel for the presence of a nuchal cord if the birth of the body quickly follows the head. Loose nuchal cords and other entanglements can be resolved as the neonate is born underwater before the first breath (see section XVI).
- 4) The time of birth will be noted when the neonate’s entire body is outside of the woman.
- 5) The neonate must be born completely underwater without exposure to air until the face is brought gently and directly to the surface. The neonate’s head must not be resubmerged under water after it has been brought to the surface.
- 6) If a woman raises herself out of the water and exposes the head of the fetus to air, she should be assisted/supported to remain out of the water to avoid the potential risk of the neonate gasping underwater with resubmersion.
- 7) After birth, assist in bringing the neonate directly and gently to the surface (within 5–10 seconds) to minimize tension on the umbilical cord and to reduce the possibility of avulsion. Cord clamps should be readily available.
- 8) Maintain warmth of the neonate through skin-to-skin contact with the woman and submersion of the neonate’s lower extremities, abdomen, and chest. Dry the neonate’s exposed head to reduce heat loss.
- 9) Apgar scores should be obtained at one and 5 minutes after birth per routine.
- 10) In the presence of stable newborn status and transition to extrauterine life, care of the cord can follow best practices to support delayed cord clamping.
- 11) If neonatal resuscitation measures are indicated and this is not possible without cutting the cord, the cord should be clamped and cut, and the neonate removed from the water immediately.
- XIV. MANAGEMENT OF THE THIRD STAGE OF LABOR
- A. The third stage of labor may occur in or out of the tub depending on the status of the woman and neonate, provider skill and comfort, and duration of third stage.
- B. Management of third stage of labor should proceed consistent with standards of care to reduce risk of postpartum hemorrhage. For women at greater risk of postpartum hemorrhage, the third stage should be managed out of the water to support management and accurate quantification of blood loss.
- C. In cases where the health care providers note increasing darkening or discoloration of the water or any indication of increased bleeding, the woman should be immediately removed from the tub for continued evaluation and treatment. While most elements of the management of the third stage of labor, including active management, can be safely implemented in the tub, initiation of some treatments such as bimanual compression and accurate quantification of blood loss should be performed out of the tub.
- D. Quantified or estimated blood loss should be recorded in the medical record. If the third stage is completed out of the water, quantification should occur according to institutional standards.
- E. Postnatal observations of the woman and neonate should be performed in accordance with institutional policies. Most postpartum assessments can be conducted with the dyad in skin-to-skin contact with the woman in the tub.
- F. Evaluation and repair of perineal lacerations are ideally accomplished on a bed for optimal visualization.
- XV. EVALUATION AND CARE OF THE NEONATE
- A. The neonatal resuscitation guidelines of the American Heart Association should be utilized to assess the neonate,29 and Apgar scores should be obtained at one and 5 minutes after birth per routine. If neonatal resuscitation measures are indicated and this is not possible without cutting the cord, the cord should be clamped and cut, and the neonate removed from the water immediately.
- B. Make certain the neonate remains close to the woman (skin-to-skin) and partially submerged to help maintain body temperature. Dry the neonate’s exposed head to reduce heat loss.
- C. If neonatal tachycardia (heart rate >160 bpm), bradycardia (heart rate < 100bpm), hyperthermia (temperature >38°C [100.4°F]), hypothermia (temperature <36°C [97.0°F]), tachypnea (respirations >60 per min), grunting, or retracting is noted, the neonate should be taken out of the tub for further assessment.
- XVI. COMPLICATIONSAs when caring for any woman in labor, the health care professional is responsible for using clinical judgment to respond appropriately when complications arise. If deviations from normal during immersion are observed, the woman should be asked to exit the tub and assisted out of the water for further assessment as necessary to perform standard care assessments and interventions.
- A. Tight nuchal cord. If a tight nuchal cord cannot be reduced, and the somersault maneuver is ineffective, the woman should be assisted to stand above the water so the cord can be clamped and cut to facilitate birth out of the water. Under no circumstances should a nuchal cord be clamped and cut under water. The woman should remain standing to give birth to the rest of the body and to avoid submersion of the neonate’s head after birth.
- B. Shoulder dystocia. If a shoulder dystocia occurs in the tub and cannot be resolved with position change, assist the woman out of the tub to complete the birth. Once the neonate’s head is exposed to air, it should not be re-submerged.
- C. Excessive bleeding
- 1) The presence of excessive bleeding into the water should prompt the immediate evaluation of the source.
- 2) In the case of excessive bleeding, assist the woman out of the tub for further evaluation. Initiate quantification of blood loss to more accurately assess blood loss volume.
- 3) If cord rupture is suspected, the cord should be immediately clamped at the umbilicus and cut. Cord clamps must be readily available. If cord rupture is confirmed, the newborn should be removed from the tub for assessment.
- D. Loss of consciousness. Emergency procedures must be enacted immediately, and the woman should be removed from the tub quickly and safely. Assign one person to ensure the woman’s head remains above the water surface at all times and activate the emergency response team to help lift the unconscious woman out of the tub and to initiate emergency evaluation and treatment.
- XVII. INFECTION CONTROL PRINCIPLESDepending on the setting or type of institution, infection control policies and procedures will vary. These guidelines reflect the scant available data on the use and cleaning of tubs for the purpose of intrapartum immersion hydrotherapy.30 The following principles are offered as guidance for the development of needed policies:
- A. Clean the hydrotherapy tub after each use.
- B. Before cleaning, don non-sterile, single-use gloves.
- C. Drain the hydrotherapy tub, remove all debris from the tub, and dispose of debris in an appropriate receptacle based on the type of waste.
- D. Manually wash all interior surfaces of the hydrotherapy tub using a mild non-abrasive detergent solution and a clean towel or disposable cloth.
- E. Rinse the tub with warm water to remove all detergent residue.
- F. Apply a disinfecting agent to all interior surfaces of the hydrotherapy tub using a spray application and ensure all surfaces are thoroughly wetted with the disinfectant. The minimum time that the germicidal agent must remain in contact with the tub surface to achieve the appropriate level of disinfection is prescribed by the product manufacturer and is indicated on the product label. Only use disinfecting agents that are US Environmental Protection Agency (EPA)-registered as effective against HIV, hepatitis B, and hepatitis C. Consult with the preventive medicine department for approval to use products that are not EPA-registered.
- G. After achieving appropriate disinfection, rinse the hydrotherapy tub with hot water to remove the remaining chemical residue and allow surfaces to air dry.
- H. Clean and disinfect all multiclient use equipment in contact with the bath water (eg, waterproof thermometers, mirrors) as outlined in F.
DISCLAIMER
This document is specific to considerations regarding hydrotherapy during labor and/or birth and is provided as an educational aid to members of the endorsing organizations and interested maternity care providers. This model practice template is not intended to dictate an exclusive course of management or to substitute for individual professional judgment. It presents recognized methods and techniques of clinical practice that maternity care providers may consider incorporating into their practices. The needs of an individual client or the resources and limitations of a particular setting or type of practice may appropriately lead to variations in clinical care. The information in this document is gleaned from published literature available through April 2016. This document will be reviewed against newly available scientific evidence and/or every 5 years after initial publication.
ACKNOWLEDGEMENTS
This document was developed by a multi-organizational task force hosted by the American College of Nurse-Midwives. Members of the task force were self-identified experts in use of hydrotherapy, researchers who have addressed this topic, and formally appointed representatives from the participating organizations. The organizations formally endorsing this document include the American Association of Birth Centers, American College of Nurse-Midwives, Midwives Alliance of North American, and National Association of Certified Professional Midwives. Contributing authors to this document include the following individuals:
Co-Editors
Lisa Kane Low, CNM, PhD, FACNM, FAAN
Associate Professor, University of Michigan School of Nursing
President, American College of Nurse-Midwives
Elizabeth Nutter, CNM, DNP
Major, United States Army
Representative, American College of Nurse-Midwives
Organizational Contributors
Colleen Donovan-Batson, MS, CNM, ARNP
Director, Division of Health Policy and Advocacy
Midwives Alliance of North America
Cynthia B. Flynn, CNM, PhD, FACNM
Representative, American Association of Birth Centers
Lesley Meenach Rathbun, CNM, FNP, MSN
Director, Charleston Birth Place
President, American Association of Birth Centers
Maria Christina Johnson, CNM, MS, FACNM
Director of Professional Practice and Health Policy
American College of Nurse-Midwives National Office Staff
Kaye Kanne, CPM
Representative, National Association of Certified Professional Midwives
Jenna Shaw-Battista, CNM, PhD, FACNM
Representative, American College of Nurse-Midwives
[Corrections added after online publication November 29, 2016: For Colleen Donovan-Batson: Name and credentials were corrected from “Colleen Batson-Donovan, CPM” to “Colleen Donovan-Batson, MS, CNM, ARNP” and “Public” was removed from the title. For Lesley Meenach Rathbun: Rathburn was corrected to Rathbun.]
Individual Expert Contributors
Roma Allen, MSN, RNC-OB
Carrie F. Bonsack, CNM, DNP
Shaunti Meyer, CNM, MA, MS
Catherine Ruhl, CNM, MSN
Research shows that labouring or giving birth in water provides clear benefits for healthy mothers and their babies.
Wednesday, 06 July 2022
Oxford Brookes University
New analysis of research shows that using a birth pool during labour provides “clear benefits” for healthy mums and their newborn, with less intervention and fewer complications during and after the birth than when compared to labouring and giving birth on land. Mothers also report higher levels of satisfaction with their birth experience.
Dr Ethel Burns of Oxford Brookes University Faculty of Health and Life Sciences led a team of researchers, working with Dr Claire Feeley (Oxford Brookes), Dr Priscilla Hall (Emory University, USA) and Dr Jennifer Vanderlaan (University of Nevada, USA). The research looking at 157,546 sets of mothers and babies was published today, in the journal BMJ Open .
What is water immersion during labour?
Water immersion in a birth pool during labour and birth can be divided into two distinct but overlapping categories. Some women may choose to leave a birth pool before giving birth, and others remain in the birth pool to give birth. The researchers wanted to compare healthcare interventions during labour and birth between water birth, labouring in water, and standard care with no water immersion.
The research which was reviewed as part of the study included a broad range of interventions and outcomes. These included things like what drugs were given to ease pain, the health of the baby at birth, loss of blood after the baby was born and the condition of mother and baby.
Low tech care option
Dr Ethel Burns, Senior Midwifery Lecturer at Oxford Brookes University said: ”This research shows that it is just as safe for healthy mothers to give birth in water as on land and that there are considerable benefits for mothers who choose to labour in a birthing pool. Water immersion is an effective method to reduce pain in making it a low-tech way to improve care quality and mothers’ satisfaction with care”.
The authors recommended that future research should include factors that are known to influence interventions and outcomes during and after labour or birth such as how many children a woman has already had, where she gives birth, who looks after her, and the care she receives.
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Recursos Centrados no Usuário
A Banheira de Parto Aquático Active II/360 com Coluna de Água inclui um assento de apoio ao trabalho de parto, facilitando o posicionamento e conforto ótimos para a mãe, e um assento de segurança no nível da borda para monitoramento e evacuações de emergência.
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Active II/360 Water Birth Pool – Ficha Técnica
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Apresentando a Banheira de Parto Aquático Active II: Aprimorando os Cuidados Maternos com Design Avançado
A Banheira de Parto Aquático Active II, projetada pela Active Birth Pools, é uma solução de última geração para instalações de saúde que buscam melhorar seus serviços de cuidados maternos.
Essa avançada banheira de parto aquático incorpora uma mistura de design ergonômico, material inovador e recursos centrados no usuário, tornando-a uma escolha exemplar em ambientes modernos de cuidados maternos.
Desenvolvimento e Expertise
Com base na extensa experiência da Active Birth Pools no campo de soluções de parto aquático, a Banheira de Parto Aquático Active II é o produto de esforços colaborativos com profissionais de saúde.
O design reflete um profundo entendimento das necessidades tanto das mães quanto dos prestadores de cuidados de saúde, enfatizando segurança, conforto e facilidade de uso.
Excelência no Design
A Banheira de Parto Aquático Active II é distinguida por sua forma única e elementos funcionais de design.
A forma de buraco de fechadura, integral ao design, é visualmente atraente e prática, facilitando várias posições e movimentos de parto.
A piscina possui alças de mão embutidas e uma borda em forma de nariz de touro, oferecendo às mães maior estabilidade e apoio durante o trabalho de parto.
Inovação de Material para Durabilidade e Higiene
Construída a partir do material composto proprietário, Ficore®, a Active II oferece durabilidade notável, com uma vida útil significativamente mais longa do que as piscinas tradicionais de parto.
Este material apresenta uma superfície altamente polida e ultra-lisa que é menos propensa a escorregar, crucial para garantir segurança.
As qualidades higiênicas do Ficore® o tornam particularmente adequado para os rigorosos padrões de limpeza exigidos em ambientes de saúde.
Ergonômica e Segura
O design ergonômico da Active II inclui recursos como um assento de apoio ao trabalho de parto para posicionamento ótimo e conforto da mãe, e um assento de segurança no nível da borda para monitoramento e evacuações de emergência.
As dimensões da piscina são estrategicamente determinadas para permitir movimento livre, aprimorando a eficácia da imersão em água durante o trabalho de parto.
Integração de Tecnologia Moderna
Equipada com Iluminação LED Multicolorida e Sistemas de Som Bluetooth, a Banheira de Parto Aquático Active II permite um ambiente de parto personalizável.
Esses recursos tecnológicos auxiliam na criação de uma atmosfera calmante e de apoio propícia ao parto natural.
Sustentabilidade e Viabilidade Econômica
Dada sua longa vida útil e qualidade superior de material, a Banheira de Parto Aquático Active II é uma opção sustentável e economicamente viável para instalações de saúde.
Sua durabilidade se traduz em uma necessidade reduzida de substituições frequentes, alinhando-se com os objetivos econômicos e ambientais das instituições de saúde contemporâneas.
Adoção Global
A Banheira de Parto Aquático Active II ganhou reconhecimento mundial por seu papel no aprimoramento dos cuidados maternos. Sua adoção por inúmeros hospitais e centros de parto sublinha sua eficácia e confiabilidade como uma solução de parto aquático de primeira linha.
Em conclusão, a Banheira de Parto Aquático Active II da Active Birth Pools representa uma fusão de design ergonômico, tecnologia de material avançado e recursos focados no usuário.
É um ativo para instalações de saúde que visam elevar seus serviços de cuidados maternos e oferecer uma experiência de parto mais natural e confortável.
Active II Water Birth Pool – Ficha Técnica
Posicione o cursor sobre o modelo abaixo para mover a imagem ao redor.
Para ver como a Banheira de Parto Aquático Active II ficaria em sua sala de parto, clique no banner abaixo com seu telefone ou tablet.
Apresentando a Banheira de Parto Aquático Venus 360 com Coluna de Água Personalizada: Elevando os Cuidados Maternos a Novos Patamares
A Banheira de Parto Aquático Venus 360, complementada pela Coluna de Água Personalizada, é uma inovação da Active Birth Pools, projetada para instalações de saúde que visam fornecer cuidados maternos superiores.
Essa combinação de uma banheira de parto aquático de última geração e uma coluna de água funcional representa um avanço significativo na tecnologia de parto aquático, atendendo às necessidades dos ambientes de saúde modernos.
Desenvolvimento e Especialização
A Active Birth Pools, com sua rica história em soluções de parto na água, desenvolveu a Banheira de Parto Aquático Venus 360 para atender às demandas em evolução dos cuidados maternos.
A adição da Coluna de Água Personalizada é um testemunho do compromisso da empresa em fornecer soluções abrangentes e especializadas.
Este desenvolvimento é baseado em pesquisa aprofundada e colaboração com profissionais de saúde, garantindo que tanto a piscina quanto a coluna atendam aos mais altos padrões de funcionalidade e segurança.
Inovação no Design
A Banheira de Parto Aquático Venus 360 apresenta um design ergonômico otimizado para espaço e conforto.
Sua forma de buraco de fechadura não é apenas esteticamente agradável, mas também funcionalmente suportiva para várias posições de parto.
A piscina inclui alças de mão embutidas e uma borda em forma de nariz de touro, oferecendo estabilidade e apoio para as mães durante o trabalho de parto.
A Coluna de Água Personalizada aprimora a funcionalidade da piscina ao fornecer uma solução prática para instalações hidráulicas e acessórios necessários.
Qualidade do Material e Higiene
Construída a partir de Ficore®, um material composto exclusivo, a Venus 360 oferece durabilidade e higiene excepcionais, superando a vida útil de piscinas tradicionais de parto.
A superfície altamente polida e ultra-lisa da piscina é menos escorregadia, garantindo segurança. A Coluna de Água, feita do mesmo material de alta qualidade, integra-se perfeitamente com a piscina, mantendo os rigorosos padrões de higiene essenciais em ambientes de saúde.
Benefícios Ergonômicos
O design ergonômico da Venus 360, juntamente com a Coluna de Água, fornece um assento de apoio ao trabalho de parto para posicionamento e conforto ideais.
Apesar de suas dimensões médias, a piscina permite movimento livre, aprimorando a eficácia da imersão em água durante o trabalho de parto.
A Coluna de Água serve como uma estrutura de apoio estável para as mães e um descanso conveniente para as parteiras.
Integração Tecnológica
A Venus 360 está equipada com Iluminação LED Multicolorida e Sistemas de Som Bluetooth, possibilitando um ambiente de parto personalizado e tranquilizador.
Esses recursos criam uma atmosfera de apoio propícia ao parto natural, aprimorando a experiência geral do parto.
Sustentabilidade e Viabilidade Econômica
A durabilidade da Banheira de Parto Aquático Venus 360 e da Coluna de Água Personalizada as torna escolhas sustentáveis e econômicas para instalações de saúde.
Seu desempenho de longo prazo reduz a necessidade de substituições frequentes, alinhando-se com os objetivos econômicos e ambientais da saúde moderna.
Adoção Global e Impacto
A Banheira de Parto Aquático Venus 360 com a Coluna de Água Personalizada tem sido adotada por instalações de saúde em todo o mundo, reconhecida por sua abordagem inovadora aos cuidados maternos.
Seu reconhecimento global sublinha sua eficácia e confiabilidade como uma solução completa de parto na água.
Em conclusão, a Banheira de Parto Aquático Venus 360 com a Coluna de Água Personalizada da Active Birth Pools representa uma combinação harmoniosa de design ergonômico, tecnologia de material avançado e recursos pensativos.
É uma escolha estratégica para instalações de saúde que buscam oferecer uma experiência aprimorada de cuidados maternos, proporcionando conforto, segurança e eficiência em um pacote compacto e abrangente.
Venus 360 Water Birth Pool – Ficha Técnica
Posicione o cursor sobre o modelo abaixo para mover a imagem ao redor.
Para ver como a Banheira de Parto Aquático Venus 360 ficaria em sua sala de parto, clique no banner abaixo com seu telefone ou tablet.
Apresentando a Banheira de Parto Aquático Venus II: Uma Solução Avançada em Cuidados Maternos
A Banheira de Parto Aquático Venus II, desenvolvida pela Active Birth Pools, representa um avanço significativo no campo dos cuidados maternos.
Esta piscina de tamanho médio é projetada para proporcionar uma experiência de parto ótima, combinando design ergonômico com qualidade superior de material, tornando-a uma escolha ideal para instalações de saúde que buscam aprimorar seus serviços de cuidados maternos.
Antecedentes e Desenvolvimento
Active Birth Pools tem sido líder em soluções de parto na água desde a década de 1980.
O desenvolvimento da Banheira de Parto Aquático Venus II é resultado de uma extensa colaboração com profissionais de saúde, incluindo parteiras, obstetras e especialistas em ergonomia.
Essa colaboração resultou em um design de piscina que prioriza as necessidades tanto da mãe quanto do prestador de cuidados de saúde.
Design e Funcionalidade
A Banheira de Parto Aquático Venus II é caracterizada por sua forma de buraco de fechadura, que serve a propósitos práticos além de seu apelo visual.
O design inclui alças de mão embutidas e uma borda em forma de nariz de touro, proporcionando apoio e estabilidade para várias posições de parto.
Essas características são particularmente benéficas para apoiar posições de agachamento e ajudar as mães a segurar com segurança durante o trabalho de parto.
Qualidade do Material e Higiene
Construída a partir de Ficore®, um material composto exclusivo da Active Birth Pools, a Venus II é distinguida por sua longevidade, com uma expectativa de vida superior a 25 anos.
Este material oferece uma superfície altamente polida e ultra-lisa que é menos escorregadia do que os materiais tradicionais de piscina, aumentando assim a segurança.
Além disso, as propriedades de higiene superiores do material o tornam uma escolha adequada para os exigentes padrões de higiene de ambientes de saúde.
Segurança e Ergonomia
O design ergonômico da Venus II inclui um assento de apoio ao trabalho de parto, que auxilia na posição de parto ideal e oferece uma área de descanso para a mãe.
As dimensões e profundidade da piscina foram cuidadosamente consideradas para facilitar o movimento livre e maximizar os benefícios da imersão em água durante o trabalho de parto.
Integração Tecnológica
A Venus II está equipada com comodidades modernas, como Iluminação LED Multicolorida e Sistemas de Som Bluetooth.
Esses recursos permitem a personalização do ambiente de parto, contribuindo para uma atmosfera calmante e de apoio para o parto natural.
Sustentabilidade e Custo-Benefício
A natureza durável da Banheira de Parto Aquático Venus II a torna uma opção sustentável e econômica para instalações de saúde.
Sua longa vida útil e a necessidade reduzida de substituição estão alinhadas com os objetivos econômicos e ambientais das instituições de saúde modernas.
Adoção Global e Reconhecimento
A Banheira de Parto Aquático Venus II é reconhecida globalmente por sua contribuição para a melhoria dos cuidados maternos.
Sua adoção por hospitais e centros de parto em todo o mundo é um testemunho de sua eficácia e confiabilidade como solução de parto na água.
Em resumo, a Banheira de Parto Aquático Venus II da Active Birth Pools oferece uma combinação de design avançado, qualidade superior de material e recursos práticos.
Ela se destaca como um ativo valioso para instalações de saúde que visam fornecer cuidados maternos aprimorados e uma experiência de parto mais natural.
Venus II Water Birth Pool – Ficha Técnica
Posicione o cursor sobre o modelo abaixo para mover a imagem ao redor.
Para ver como a Banheira de Parto Aquático Venus II ficaria em sua sala de parto, clique no banner abaixo com seu telefone ou tablet.
Nyckelordet som definierar vår designfilosofi är Aktiv
Nyckelordet som definierar vårt tillvägagångssätt för design är “Aktiv”.
Om vi slår upp definitionen av “Aktiv förlossning” får vi, “Förlossning under vilken mamman uppmuntras att röra sig fritt och anta vilken position som känns bekväm”.
Aktiva förlossningsbassänger ger mödrar utrymme och djup att röra sig fritt i de ställningar som är naturliga för arbete och födsel.
När hon rör sig, upptäcker hon intuitivt funktioner som ger stöd och gör henne bekvämare.
Designen bygger på dynamiken mellan mödrar och barnmorskor när de interagerar med bassängen och varandra.
Formen baseras på funktion och är nedskalad till essensen av estetisk nytta.
Det finns en anledning till varje form, varje kurva och varje gestaltning.
Våra vattenfödelsebassänger uppmuntrar mödrar att röra sig fritt och naturligt.
De interagerar instinktivt med bassängen och hittar komfort och stöd var de än är.
Frihet att röra sig kombinerat med det avslappnande effekten av varmt vatten och frisättning av oxytocin ökar avsevärt möjligheten till fysiologiskt arbete och förlossning.
Vi är pionjärer, innovatörer och trendskapare.
Våra vattenfödelsebassänger har kontinuerligt utvecklats under de senaste 35 åren.
Vi kan uppnå våra senaste designer på grund av det högspecialiserade material vi använder.
Ficore, en kompositresin med unika egenskaper, gör det möjligt för oss att skapa otroligt kurviga bassänger som mödrar och barnmorskor finner exceptionellt bekväma, praktiska och lätta att använda.
I mitten av 90-talet träffade vi en designspecialist för att diskutera hur våra vattenfödelsebassänger kunde förbättras för att bättre tillgodose behoven hos mödrar och barnmorskor.
Detta ledde till banbrytande innovationer inom designen av förlossningsbassänger som har kulminerat i dagens utbud av prisbelönta vattenfödelsebassänger.
Nedan en kopia av en artikel som publicerades i Chartered Institute of Ergonomics and Human Factors som kartlägger det paradigmskifte inom design av förlossningsbassänger som skedde i mitten av 90-talet:
Aktiva Förlossningsbassänger: Hållbarhetsrapport
Sedan grundandet 1987 har Aktiva Förlossningsbassänger varit i framkant när det gäller att designa och leverera vattenförlossningsbassänger.
Vårt engagemang för ergonomiska, säkra och högkvalitativa förlossningsbassänger har gjort oss till ett föredraget val för vårdinrättningar globalt.
Hållbara Material och Produktion
Aktiva Förlossningsbassänger betonar hållbarhet genom vår användning av Ficore®-komposit, ett material känt för sin livslängd, hållbarhet och motståndskraft mot kemikalier och bakterier.
Med en livslängd på över 25 år överträffar det hållbarheten hos material som vanligtvis används i tillverkningen av förlossningsbassänger.
Bassängerna är handgjorda i England av skickliga hantverkare, vilket säkerställer minskat koldioxidavtryck och stöd för lokal sysselsättning.
Barnmorskor på Royal Berkshire Hospital firar 25-årsjubileet för sin vattenförlossningsanläggning.
Denna tidiga modell som levererades 1992 fungerar fortfarande utmärkt.
Produkthållbarhet
Designen av Aktiva Förlossningsbassänger fokuserar på hållbarhet och livslängd, i syfte att minska avfall och resursanvändning över tid.
Den höga isoleringsfaktorn hos Ficore® och den dubbla väggkonstruktionen säkerställer bättre värmebehållning, vilket minskar energiförbrukningen för att bibehålla vattentemperaturen.
Ergonomisk och Användarcentrerad Design
I samarbete med barnmorskor, obstetriker och ergonomiexperter har vi utvecklat designer som tillgodoser komforten för mödrar och vårdpersonal.
Detta tillvägagångssätt är i linje med principer för människocentrerad design och bidrar till välbefinnande och säkerhet för användarna, vilket förbättrar den totala förlossningsupplevelsen.
Barnmorskor på `Bronte Birth Centre firar öppningen av sin vattenförlossningsanläggning i sin nya Venus Pool
Ekonomiska Fördelar
Aktiva Förlossningsbassänger är kostnadseffektiva för vårdinrättningar på grund av deras hållbarhet och låga underhållsbehov.
De bidrar även till minskade sjukhusvistelser och ingrepp, vilket leder till ekonomiska besparingar för hälsovårdssystemen.
Socialt Ansvar
Säkerhet och kundnöjdhet är av största vikt i designen av dessa bassänger, med fokus på behoven hos mödrar, spädbarn och vårdarbetare.
Den positiva återkopplingen från en global kundkrets understryker vårt engagemang för kvalitet och säkerhet.
Slutsats
Aktiva Förlossningsbassänger visar ett djupt engagemang för hållbarhet med sina hållbara material, ergonomiska designer och effektiva produktionsmetoder.
Vårt tillvägagångssätt gynnar miljön och främjar ekonomisk och social hållbarhet inom sjukvården.
Bassängerna är garanterade för livet, överträffar andra på marknaden när det gäller säkerhet, hygien och användarnöjdhet.
De är byggda för att hålla i årtionden, sparar upp till 20 000 pund under bassängens livslängd tack vare deras utökade livslängd och minskade underhålls- och energikostnader.
Aktiva Förlossningsbassänger erbjuder inte bara finansiella besparingar utan minskar också miljöpåverkan genom mindre avfall och effektiv användning av resurser.
De har blivit ett populärt val på förlossningsavdelningar, ofta påverkande mödrars val av anläggning.
Barnmorskor hyllar bassängerna för deras komfort och säkerhet, och sjukhus rapporterar att mödrar som använder dessa bassänger upplever enklare och mer okomplicerade förlossningar, vilket leder till minskade sjukhusvistelser och ytterligare ekonomiska och miljömässiga besparingar.
Sammanfattningsvis står Aktiva Förlossningsbassänger ut som det mest hållbara alternativet på marknaden, och bidrar avsevärt till normaliseringen och stärkandet av förlossningsprocessen.
Omfamna tidvatten: Det övertygande argumentet för vattenfödslingspooler på sjukhus
Active Birth Pools: Etos och Värderingar Uttalande
Active Birth Pools, grundat 1987, har spelat en banbrytande roll i användningen av vatten för arbete och förlossning.
Deras värderingar och tillvägagångssätt kan förstås helt och hållet genom att undersöka olika aspekter av deras verksamhet och produkter.
Innovation och Banbrytande Ande:
Active Birth Pools hjälpte till att bana väg för användningen av vatten i arbete och förlossning, i nära samarbete med barnmorskor, mödrar, obstetriker och experter inom infektionskontroll och manuell hantering.
Detta samarbetsbaserade tillvägagångssätt ledde till utvecklingen av världens första speciellt utformade sjukhusklassade vattenförlossningsbassäng, vilket visar deras åtagande för innovation och förbättring inom mödravård.
Säkerhet, Värde och Prestanda:
Företaget betonar dessa kärnprinciper i sina produkter.
De fokuserar på att producera förlossningsbassänger som är säkra, erbjuder stort värde och presterar exceptionellt.
Detta fokus är tydligt i deras användning av specialiserade material som Ficore®, ett proprietärt material känt för sin hållbarhet, praktikalitet och säkerhetsfunktioner.
Ficore®-bassänger, till exempel, behåller värme effektivt och är resistenta mot bakterier och hårda desinfektionsmedel, vilket säkerställer höga hygienstandarder.
Ergonomisk Design:
Active Birth Pools tillämpar evidensbaserade, användarcentrerade ergonomiska designprinciper.
Deras bassänger är utformade för att möta komfortbehoven hos både mödrar och barnmorskor, med design som stödjer olika positioner som sittande, knästående och hukande.
Bassängernas breda kanter gör att barnmorskor kan vila bekvämt, likt att sitta vid ett skrivbord, vilket visar deras hänsyn till både användarnas komfort och praktikalitet.
Kundåterkoppling och Godkännanden:
Företaget värdesätter kundåterkoppling och har fått många positiva vitsord från sjukvårdspersonal och mödrar.
Dessa vitsord betonar ofta komfort, användarvänlighet, säkerhet och praktikalitet i bassängerna, vilket återspeglar företagets engagemang för kvalitet och användarnöjdhet.
Byggkvalitet och Garanti:
Active Birth Pools är handgjorda på beställning i England av mycket skickliga hantverkare som är stolta över sitt arbete och engagerade i excellens.
Active Birth Pools erbjuder en livstidsgaranti på sina vattenförlossningsbassänger, vilket återspeglar deras engagemang för kvalitet och hållbarhet.
Denna livstidsgaranti är ett bevis på det förtroende företaget har till sin design, material och tillverkningsprocesser.
Hållbarhet och Långsiktighet:
Active Birth Pools lägger vikt vid hållbarhet.
Deras bassänger har en förväntad livslängd på över 25 år, vilket gör dem till ett hållbart val jämfört med andra förlossningsbassänger med kortare livslängd.
Denna långsiktighet ger inte bara valuta för pengarna utan ligger även i linje med principer för miljömässig hållbarhet.
Global Räckvidd och Erfarenhet:
Med en historia som sträcker sig över flera årtionden har Active Birth Pools levererat tusentals vattenförlossningsbassänger över hela världen.
Deras omfattande erfarenhet och kunskap inom området har gjort dem till ett ledande val för sjukhus och barnmorskor globalt.
Denna globala räckvidd understryker deras engagemang för att förbättra mödravård på en global skala.
Sammanfattningsvis är Active Birth Pools värderingar centrerade kring innovation, säkerhet, ergonomisk design, kundnöjdhet, hållbarhet och ett globalt perspektiv på att förbättra mödravård.
Dessa värderingar har väglett deras verksamhet och produktutveckling, vilket positionerar dem som ledare på marknaden för vattenförlossningsbassänger.
Den främsta designen och utvecklingen av pooler för vattenförlossning
Omfamna tidvatten: Det övertygande argumentet för vattenfödslingspooler på sjukhus
Presentamos la Piscina de Parto en Agua Active II/360 con Columna de Agua Personalizada: la Cima de la Innovación en Atención Materna
Active Birth Pools ofrece la Piscina de Parto en Agua Active II/360 con Columna de Agua Personalizada, una solución sofisticada diseñada para instalaciones de atención médica que buscan proporcionar una atención materna ejemplar.
Esta combinación avanzada integra una piscina de parto en agua de última generación con una columna de agua funcional y elegante, epitomizando lo último en innovación de diseño y tecnología de materiales para el sector de atención materna.
Desarrollo Avanzado para las Necesidades de la Atención Médica Moderna
La Piscina de Parto en Agua Active II/360, un producto de Active Birth Pools, está diseñada para satisfacer las demandas en constante evolución de la atención materna contemporánea.
Complementada con la Columna de Agua Personalizada, este sistema es el resultado de una extensa investigación y colaboración con profesionales de la salud.
El enfoque ha sido crear una solución que ofrezca funcionalidad superior, seguridad y comodidad, al tiempo que aborda las necesidades prácticas tanto de los proveedores de atención médica como de las madres.
Diseño Ergonómico para una Experiencia Mejorada
La Piscina de Parto en Agua Active II/360 está diseñada con énfasis en la excelencia ergonómica y la eficiencia espacial.
La forma de cerradura de la piscina no solo es visualmente atractiva, sino que también brinda beneficios funcionales, admitiendo una variedad de posiciones y movimientos de parto.
La piscina incluye asas empotradas y un borde en forma de bull-nose para brindar un mayor soporte y seguridad.
La Columna de Agua Personalizada se integra perfectamente, ofreciendo una solución elegante para la plomería y los accesorios necesarios, mejorando así la utilidad y la estética de la piscina.
Calidad Superior del Material
Construida a partir de Ficore®, un material compuesto patentado exclusivo de Active Birth Pools, la Active II/360 ofrece una durabilidad, higiene y seguridad excepcionales.
La superficie altamente pulida y ultra suave del material es menos resbaladiza, lo que es crucial para garantizar la seguridad.
La Columna de Agua, fabricada con el mismo material de alta calidad, complementa el diseño de la piscina y mantiene los altos estándares de higiene requeridos en entornos de atención médica.
Características Centradas en el Usuario
La Piscina de Parto en Agua Active II/360 con la Columna de Agua incluye un asiento de apoyo para el trabajo de parto, facilitando una posición óptima y comodidad para la madre, y un asiento de seguridad a nivel del borde para la monitorización y evacuaciones de emergencia.
El diseño de la piscina permite el movimiento libre, lo cual es esencial para el uso efectivo de la inmersión en agua durante el trabajo de parto.
La Columna de Agua agrega funcionalidad como una estructura de soporte estable y una plataforma de utilidad práctica.
Integración de Mejoras Tecnológicas
La piscina está equipada con iluminación LED multicolor y sistemas de sonido Bluetooth, lo que permite la creación de un entorno personalizado y relajante.
Estas características son fundamentales para establecer una atmósfera de apoyo que favorezca el parto natural.
Sostenibilidad y Beneficios Económicos
El diseño duradero de la Piscina de Parto en Agua Active II/360 con Columna de Agua Personalizada la convierte en una opción sostenible y económicamente sólida para las instalaciones de atención médica.
Su rendimiento a largo plazo y la reducción de la necesidad de reemplazos frecuentes hacen de ella una inversión eficiente, alineada con los objetivos económicos y ambientales de las instituciones de atención médica modernas.
Adopción y Reconocimiento Global
La Piscina de Parto en Agua Active II/360 con Columna de Agua Personalizada ha sido reconocida a nivel mundial por su enfoque innovador en la atención materna.
Su adopción por parte de instalaciones de atención médica en todo el mundo es un testimonio de su eficacia, confiabilidad y compromiso con el avance de las prácticas de parto en agua.
En conclusión, la Piscina de Parto en Agua Active II/360 con Columna de Agua Personalizada de Active Birth Pools representa una fusión armoniosa de diseño avanzado, tecnología de material superior y una cuidadosa integración de características centradas en el usuario.
Es una elección estratégica e innovadora para las instalaciones de atención médica que buscan ofrecer una experiencia de atención materna superior, brindando comodidad, seguridad y eficiencia en un paquete integral y elegante.
Active II/360 Water Birth Pool – Hoja de Datos
Coloque su cursor sobre el modelo a continuación para mover la imagen.
Para ver cómo se vería la Piscina de Parto en Agua Active II/360 en su sala de partos, haga clic en el banner a continuación con su teléfono o tableta.
Presentando la Piscina de Parto en Agua Active II: Mejorando la Atención Materna con Diseño Avanzado
La Piscina de Parto en Agua Active II, diseñada por Active Birth Pools, es una solución de última generación para instalaciones de atención médica que buscan mejorar sus servicios de atención materna.
Esta avanzada piscina de parto en agua incorpora una combinación de diseño ergonómico, material innovador y características centradas en el usuario, lo que la convierte en una elección ejemplar en entornos modernos de atención materna.
Desarrollo y Experiencia
Arraigada en la amplia experiencia de Active Birth Pools en el campo de las soluciones de parto en agua, la Piscina de Parto en Agua Active II es el producto de esfuerzos colaborativos con profesionales de la salud.
El diseño refleja una comprensión profunda de las necesidades tanto de las madres como de los proveedores de atención médica, enfatizando la seguridad, la comodidad y la facilidad de uso.
Excelencia en el Diseño
La Piscina de Parto en Agua Active II se distingue por su forma única y elementos funcionales de diseño.
La forma de cerradura, integral en el diseño, es atractiva a la vista y práctica, facilitando diversas posiciones y movimientos de parto.
La piscina cuenta con asas empotradas y un borde en forma de bull-nose, ofreciendo a las madres una mayor estabilidad y soporte durante el trabajo de parto.
Innovación en el Material para Durabilidad e Higiene
Construida a partir del material compuesto patentado Ficore®, la Active II ofrece una durabilidad notable, con una vida útil significativamente más larga que las piscinas de parto tradicionales.
Este material presenta una superficie altamente pulida y ultra suave que es menos propensa al resbalón, crucial para garantizar la seguridad.
Las cualidades higiénicas de Ficore® lo hacen especialmente adecuado para los rigurosos estándares de limpieza requeridos en entornos de atención médica.
Ergonomía y Seguridad
El diseño ergonómico de la Active II incluye características como un asiento de apoyo para el trabajo de parto para una posición óptima y comodidad de la madre, y un asiento de seguridad a nivel del borde para la monitorización y evacuaciones de emergencia.
Las dimensiones de la piscina están estratégicamente determinadas para permitir el movimiento libre, mejorando la efectividad de la inmersión en agua durante el trabajo de parto.
Integración de Tecnología Moderna
Equipada con iluminación LED multicolor y sistemas de sonido Bluetooth, la Piscina de Parto en Agua Active II permite un entorno de parto personalizable.
Estas características tecnológicas contribuyen a crear un ambiente tranquilo y de apoyo propicio para el parto natural.
Sostenibilidad y Viabilidad Económica
Dada su larga vida útil y su calidad superior de material, la Active II Water Birth Pool es una opción sostenible y económicamente viable para instalaciones de atención médica.
Su durabilidad se traduce en una reducción de la necesidad de reemplazos frecuentes, alineándose con los objetivos económicos y ambientales de las instituciones de atención médica contemporáneas.
Adopción Global
La Piscina de Parto en Agua Active II ha ganado reconocimiento en todo el mundo por su papel en la mejora de la atención materna.
Su adopción por numerosos hospitales y centros de parto subraya su eficacia y confiabilidad como una solución de primer nivel para el parto en agua.
En conclusión, la Piscina de Parto en Agua Active II de Active Birth Pools representa una fusión de diseño ergonómico, tecnología de material avanzado, y características centradas en el usuario.
Es un activo para las instalaciones de atención médica que buscan elevar sus servicios de atención materna y ofrecer una experiencia de parto más natural y cómoda.
Active II Water Birth Pool – Hoja de Datos
Coloque su cursor sobre el modelo a continuación para mover la imagen.
Para ver cómo se vería la Piscina de Parto en Agua Active II en su sala de partos, haga clic en el banner a continuación con su teléfono o tableta.
Presentando la Piscina de Parto en Agua Venus 360 con Columna de Agua Personalizada: Elevando la Atención Materna a Nuevas Alturas
La Piscina de Parto en Agua Venus 360, complementada por la Columna de Agua Personalizada, es una oferta innovadora de Active Birth Pools, diseñada para instalaciones de atención médica que buscan proporcionar una atención materna superior.
Esta combinación de una piscina de parto en agua de última generación y una columna de agua funcional representa un avance significativo en la tecnología de parto en agua, atendiendo a las necesidades de los entornos de atención médica modernos.
Desarrollo y Especialización
Active Birth Pools, con su rica historia en soluciones de parto en agua, ha desarrollado la Piscina de Parto en Agua Venus 360 para abordar las demandas cambiantes de la atención materna.
La adición de la Columna de Agua Personalizada es un testimonio del compromiso de la empresa de proporcionar soluciones completas y especializadas.
Este desarrollo se basa en una investigación exhaustiva y colaboración con profesionales de la salud, asegurando que tanto la piscina como la columna cumplan con los más altos estándares de funcionalidad y seguridad.
Innovación en el Diseño
La Piscina de Parto en Agua Venus 360 presenta un diseño ergonómico optimizado para el espacio y la comodidad.
Su forma de cerradura no solo es estéticamente atractiva, sino que también ofrece soporte funcional para diversas posiciones de parto.
La piscina incluye asas empotradas y un borde en forma de bull-nose, que ofrecen estabilidad y soporte para las madres durante el trabajo de parto.
La Columna de Agua Personalizada mejora la funcionalidad de la piscina al proporcionar una solución práctica para las instalaciones de fontanería y accesorios necesarios.
Calidad del Material e Higiene
Construida a partir de Ficore®, un material compuesto único, la Venus 360 ofrece una durabilidad e higiene excepcionales, superando la vida útil de las piscinas de parto tradicionales.
La superficie altamente pulida y ultra suave de la piscina es menos resbaladiza, asegurando la seguridad. La Columna de Agua, fabricada con el mismo material de alta calidad, se integra perfectamente con la piscina, manteniendo los estrictos estándares de higiene esenciales en entornos de atención médica.
Beneficios Ergonómicos
El diseño ergonómico de la Venus 360, junto con la Columna de Agua, proporciona un asiento de apoyo para el trabajo de parto para una posición óptima y comodidad durante el parto.
A pesar de sus dimensiones medianas, la piscina permite el movimiento libre, mejorando la efectividad de la inmersión en agua durante el trabajo de parto.
La Columna de Agua sirve como una estructura de soporte estable para las madres y un lugar conveniente de descanso para las matronas.
Integración Tecnológica
La Venus 360 está equipada con iluminación LED multicolor y sistemas de sonido Bluetooth, lo que permite un entorno de parto personalizable y relajante.
Estas características crean un ambiente de apoyo propicio para el parto natural, mejorando la experiencia general del parto.
Sostenibilidad y Viabilidad Económica
La durabilidad de la Piscina de Parto en Agua Venus 360 y la Columna de Agua Personalizada las convierte en opciones sostenibles y rentables para las instalaciones de atención médica.
Su rendimiento a largo plazo reduce la necesidad de reemplazos frecuentes, alineándose con los objetivos económicos y ambientales de la atención médica moderna.
Adopción Global e Impacto
La Piscina de Parto en Agua Venus 360 con Columna de Agua Personalizada ha sido adoptada por instalaciones de atención médica de todo el mundo, siendo reconocida por su enfoque innovador en la atención materna.
Su reconocimiento global subraya su eficacia y confiabilidad como una solución completa de parto en agua.
En conclusión, la Piscina de Parto en Agua Venus 360 con la Columna de Agua Personalizada de Active Birth Pools representa una combinación armoniosa de diseño ergonómico, tecnología de material avanzado y características reflexivas.
Es una elección estratégica para las instalaciones de atención médica que buscan proporcionar una experiencia de atención materna mejorada, ofreciendo comodidad, seguridad y eficiencia en un paquete compacto y completo.
Venus 360 Water Birth Pool – Hoja de Datos
Coloque su cursor sobre el modelo a continuación para mover la imagen
Para ver cómo se vería la Piscina de Parto en Agua Venus 360 en su sala de partos, haga clic en el banner a continuación con su teléfono o tableta.
Presentando la Piscina de Parto en Agua Venus II: una Solución Avanzada en la Atención Materna
La Piscina de Parto en Agua Venus II, desarrollada por Active Birth Pools, representa un avance significativo en el campo de la atención materna.
Esta piscina de tamaño mediano está diseñada para proporcionar una experiencia de parto óptima, combinando un diseño ergonómico con una calidad de material superior, lo que la convierte en la elección ideal para las instalaciones de atención médica que buscan mejorar sus servicios de atención materna.
Antecedentes y Desarrollo
Active Birth Pools ha sido líder en soluciones de parto en agua desde la década de 1980.
El desarrollo de la Piscina de Parto en Agua Venus II es el resultado de una extensa colaboración con profesionales de la salud, incluyendo matronas, obstetras y expertos en ergonomía.
Esta colaboración ha culminado en un diseño de piscina que prioriza las necesidades tanto de la madre como del proveedor de atención médica.
Diseño y Funcionalidad
La Piscina de Parto en Agua Venus II se caracteriza por su forma de cerradura, que sirve propósitos prácticos además de su atractivo visual.
El diseño incorpora asas empotradas y un borde en forma de bull-nose, proporcionando soporte y estabilidad para diversas posiciones de parto.
Estas características son particularmente beneficiosas para respaldar posiciones de cuclillas y ayudar a las madres a sujetarse de manera segura durante el trabajo de parto.
Calidad del Material e Higiene
Construida a partir de Ficore®, un material compuesto exclusivo de Active Birth Pools, la Venus II se distingue por su longevidad, con una expectativa de vida que supera los 25 años.
Este material ofrece una superficie altamente pulida y ultra suave que es menos resbaladiza que los materiales tradicionales de las piscinas, mejorando así la seguridad.
Además, las propiedades de higiene superiores del material lo convierten en una opción adecuada para los exigentes estándares de higiene de entornos de atención médica.
Seguridad y Ergonomía
El diseño ergonómico de la Venus II incluye un asiento de apoyo para el trabajo de parto, que ayuda en la posición óptima para el parto y ofrece un área de descanso para la madre.
Las dimensiones y la profundidad de la piscina se han considerado cuidadosamente para facilitar el movimiento libre y maximizar los beneficios de la inmersión en agua durante el trabajo de parto.
Integración Tecnológica
La Venus II está equipada con comodidades modernas como iluminación LED multicolor y sistemas de sonido Bluetooth.
Estas características permiten la personalización del entorno de parto, contribuyendo a crear un ambiente calmado y de apoyo para el parto natural.
Sostenibilidad y Rentabilidad
La naturaleza duradera de la Piscina de Parto en Agua Venus II la convierte en una opción sostenible y rentable para las instalaciones de atención médica.
Su larga vida útil y la reducida necesidad de reemplazo se alinean con los objetivos económicos y ambientales de las instituciones de atención médica modernas.
Adopción y Reconocimiento Global
La Piscina de Parto en Agua Venus II es reconocida a nivel mundial por su contribución a la mejora de la atención materna.
Su adopción por parte de hospitales y centros de parto de todo el mundo es un testimonio de su eficacia y confiabilidad como solución de parto en agua.
En resumen, la Piscina de Parto en Agua Venus II de Active Birth Pools ofrece una combinación de diseño avanzado, calidad de material superior y características prácticas.
Es un activo valioso para las instalaciones de atención médica que buscan proporcionar una atención materna mejorada y una experiencia de parto más natural.
Venus II Water Birth Pool – Hoja de Datos
Coloque su cursor sobre el modelo a continuación para mover la imagen
Para ver cómo se vería la Piscina de Parto en Agua Venus II en su sala de partos, haga clic en el banner a continuación con su teléfono o tableta
Presentación de la Piscina de Parto en Agua Princess II/360 con Columna de Agua Personalizada: una Solución Compacta y Completa para la Atención Materna
Active Birth Pools presenta la Piscina de Parto en Agua Princess II/360 con Columna de Agua Personalizada, una solución compacta pero completa para las modernas instalaciones de atención médica centradas en la optimización de la atención materna.
Esta innovadora combinación reúne una piscina de parto en agua eficiente en espacio y una columna de agua funcional, encarnando tecnología avanzada de diseño y materiales para satisfacer las diversas necesidades de los entornos de atención materna.
Desarrollo Estratégico para la Eficiencia del Espacio
La Piscina de Parto en Agua Princess II/360, desarrollada por Active Birth Pools, aborda los desafíos únicos del espacio limitado en algunos entornos de atención médica.
En conjunto con la Columna de Agua Personalizada, este desarrollo refleja el compromiso de Active Birth Pools de ofrecer soluciones de alta calidad y eficientes en espacio sin comprometer la funcionalidad ni la seguridad.
El proceso de desarrollo involucró una estrecha colaboración con profesionales de la salud, asegurando que tanto la piscina como la columna se alineen con las necesidades prácticas de la atención materna.
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Diseño Ergonómico y Funcional
La Piscina de Parto en Agua Princess II/360 está diseñada con un enfoque en la ergonomía y la eficiencia del espacio.
La forma de cerradura de la piscina maximiza la utilidad del espacio al tiempo que proporciona soporte funcional para diversas posiciones de parto.
La piscina incluye asas empotradas y un borde en forma de bull-nose para mayor estabilidad y soporte durante el trabajo de parto.
La Columna de Agua Personalizada complementa la funcionalidad de la piscina al ofrecer una solución simplificada para la fontanería y los accesorios necesarios, mejorando la utilidad general de la configuración.
Material Superior para Durabilidad e Higiene
Elaborada a partir del material compuesto exclusivo Ficore®, la Piscina de Parto en Agua Princess II/360 presume de una durabilidad e higiene excepcionales.
La superficie altamente pulida y ultra suave del material está diseñada para ser menos resbaladiza, mejorando la seguridad.
La Columna de Agua, fabricada con el mismo material de alta calidad, mantiene los estándares de higiene críticos en entornos de atención médica e se integra perfectamente con la piscina.
Beneficios Centrados en el Usuario
La Princess II/360 con su Columna de Agua proporciona un asiento de apoyo para el trabajo de parto que permite una posición óptima para el parto y comodidad para la madre.
El diseño compacto de la piscina todavía permite el movimiento libre, vital para la efectividad de la inmersión en agua durante el trabajo de parto.
La Columna de Agua sirve como una estructura de soporte estable y una plataforma de utilidad conveniente, agregando funcionalidad a la piscina.
Tecnología Integrada para una Experiencia de Parto Mejorada
Equipada con iluminación LED multicolor y sistemas de sonido Bluetooth, la Piscina de Parto en Agua Princess II/360 permite un entorno de parto personalizable y calmante.
Estas características contribuyen a crear un ambiente de apoyo y propicio para el parto natural.
Sostenibilidad y Eficiencia Económica
La Piscina de Parto en Agua Princess II/360 con Columna de Agua Personalizada es una elección sostenible y económicamente viable para las instalaciones de atención médica.
Su diseño duradero asegura un uso a largo plazo, reduciendo la necesidad de reemplazos frecuentes y alineándose con los objetivos económicos y ambientales de las instituciones de atención médica modernas.
Reconocimiento Global por la Excelencia Compacta
La Piscina de Parto en Agua Princess II/360 con Columna de Agua Personalizada ha ganado reconocimiento global por proporcionar una solución compacta pero completa en la atención materna.
Su adopción por parte de instalaciones de atención médica en todo el mundo es un testimonio de su eficacia, confiabilidad y enfoque innovador en la atención materna eficiente en espacio reducido.
En resumen, la Piscina de Parto en Agua Princess II/360 con Columna de Agua Personalizada de Active Birth Pools ofrece una combinación única de diseño compacto, tecnología avanzada de materiales y una integración reflexiva de características.
Representa una elección estratégica para las instalaciones de atención médica que buscan brindar una atención materna mejorada en espacios limitados, garantizando comodidad, seguridad y eficiencia en un paquete completo.
Princess II/360 Water Birth Pool – Hoja de Datos
Coloque su cursor sobre el modelo a continuación para mover la imagen
Para ver cómo se vería la Piscina de Parto en Agua Princess II/360 en su sala de partos, haga clic en el banner a continuación con su teléfono o tableta
Presentando la Piscina de Parto en Agua Princess II: una Revolución Compacta en la Atención Materna
La Piscina de Parto en Agua Princess II, desarrollada por Active Birth Pools, es una solución compacta pero altamente funcional diseñada específicamente para instalaciones de atención médica que se enfocan en mejorar la atención materna.
Esta piscina combina un diseño ergonómico, tecnología de materiales avanzados y características bien pensadas, adaptándose especialmente a entornos donde el espacio es limitado, sin comprometer la calidad de la experiencia de parto.
Desarrollo e Innovación
Como parte del compromiso duradero de Active Birth Pools de mejorar las soluciones de parto en agua, la Piscina de Parto en Agua Princess II es el resultado de una extensa investigación y colaboración con profesionales de la salud.
Representa una comprensión de las limitaciones espaciales en algunos entornos de atención médica, al tiempo que aborda las necesidades de las madres y los proveedores de atención médica.
Características de Diseño
La Piscina de Parto en Agua Princess II, a pesar de ser compacta, no sacrifica funcionalidad ni comodidad.
Su diseño eficiente incluye una forma distintiva de cerradura, proporcionando beneficios prácticos para varias posiciones de parto.
La piscina está equipada con asas empotradas y un borde en forma de bull-nose, que ofrecen un soporte crucial y estabilidad para las madres durante el trabajo de parto.
Excelencia en los Materiales
Elaborada con Ficore®, un material compuesto exclusivo de Active Birth Pools, la Princess II presume de una durabilidad y higiene superiores.
Su vida útil supera con creces a las piscinas de parto tradicionales, y la superficie altamente pulida y ultra suave del material está diseñada para ser menos resbaladiza, mejorando la seguridad.
Esta elección de material es particularmente ventajosa para mantener los altos estándares de higiene requeridos en entornos de atención médica.
Ergonómica y Segura
Las consideraciones ergonómicas en la Princess II incluyen un asiento de apoyo para el trabajo de parto, proporcionando una posición óptima para el parto y comodidad para la madre.
A pesar de su tamaño compacto, las dimensiones de la piscina están cuidadosamente planificadas para permitir el movimiento libre y maximizar los efectos terapéuticos de la inmersión en agua durante el trabajo de parto.
Integración Tecnológica
La Princess II está equipada con iluminación LED multicolor y sistemas de sonido Bluetooth, lo que permite un entorno de parto personalizable y calmante.
Estas características contribuyen a un ambiente de apoyo, promoviendo el parto natural.
Sostenibilidad y Rentabilidad
La naturaleza duradera de la Piscina de Parto en Agua Princess II la convierte en una elección sostenible para las instalaciones de atención médica.
Su capacidad de uso a largo plazo y la reducción en la frecuencia de reemplazo la convierten en una inversión económicamente sólida, especialmente en entornos donde el espacio y los recursos son limitados.
Reconocimiento Global
La Piscina de Parto en Agua Princess II ha sido reconocida a nivel mundial por su enfoque innovador en la atención materna eficiente en espacios reducidos.
Su adopción en varios hospitales y centros de parto es un testimonio de su confiabilidad y eficacia como una solución compacta para el parto en agua.
En resumen, la Piscina de Parto en Agua Princess II de Active Birth Pools es una fusión ejemplar de diseño compacto, tecnología de materiales avanzados y características centradas en el usuario.
Es una elección estratégica para las instalaciones de atención médica que buscan ofrecer una atención materna mejorada en espacios limitados, proporcionando una experiencia de parto cómoda y segura.
Princess II Water Birth Pool – Hoja de Datos
Coloque su cursor sobre el modelo a continuación para mover la imagen
Para ver cómo se vería la Piscina de Parto en Agua Princess II en su sala de partos, haga clic en el banner a continuación con su teléfono o tableta
Perché la stanza in cui dai alla luce dovrebbe essere come la stanza in cui sei rimasta incinta
Ricordo la prima volta che ho sentito parlare di questo concetto in un discorso che Michel Odent ha tenuto all’Active Birth Centre di Londra alla fine degli anni ’80. Mi sembrò istintivamente sensato.
Ecco perché……
Il concetto di creare un ambiente di nascita che rispecchi il comfort e l’intimità della stanza in cui probabilmente è avvenuto il concepimento è molto valido.
Vari studi e opinioni di esperti enfatizzano il profondo impatto dell’ambiente di nascita sia sugli aspetti fisiologici che psicologici del parto.
L’impatto dell’ambiente sulla nascita fisiologica
Le ricerche indicano che l’ambiente in cui una donna partorisce influisce significativamente sull’inizio e sul progresso del travaglio.
Un’atmosfera calma, privata e sicura è favorevole al normale funzionamento neuro-ormonale, sostenendo la fisiologia del travaglio e del parto.
Idealmente, questo ambiente dovrebbe replicare l’ambiente familiare e intimo simile a quello in cui potrebbe essere avvenuto il concepimento, poiché la familiarità è collegata a meno interventi medici e a una maggiore soddisfazione materna.
Sicurezza e comfort psicologico
Gli aspetti psicologici di un ambiente di nascita non possono essere sopravvalutati.
Creare un ambiente di nascita simile a casa, simile all’ambiente personale e intimo del concepimento, riduce significativamente la necessità di analgesia intrapartum e aumenta la probabilità di un parto vaginale spontaneo e la soddisfazione materna.
Questo è fondamentale, poiché lo stato psicologico della madre può influenzare profondamente il processo di travaglio.
Il ruolo di ambienti di nascita alternativi
Ambienti di nascita alternativi, come stanze simili a camere da letto o ambienti piacevoli, hanno dimostrato di aumentare la probabilità di un parto vaginale spontaneo, l’allattamento al seno tra le sei e le otto settimane e una visione positiva delle donne sulla cura.
Questi ambienti spesso includono stimolazioni multisensoriali come la vista, il tatto, il suono e gli aromi, che possono essere fondamentali durante il travaglio e il parto.
Creare un ambiente di supporto
Elementi come mobili comodi, capacità di controllare l’illuminazione e il rumore, e la privacy sono integrali per creare un ambiente di nascita di supporto.
Questi fattori, che ricordano un ambiente più personale e intimo, sono fondamentali per garantire un’esperienza di parto positiva.
L’inclusione di oggetti e ambienti familiari può svolgere un ruolo cruciale nell’imitare l’ambiente del concepimento, rendendo così il processo di nascita più naturale e meno stressante.
Conclusione
In sostanza, la stanza in cui dai alla luce dovrebbe idealmente riflettere la stanza in cui sei rimasta incinta a causa del suo profondo impatto sugli aspetti fisiologici e psicologici del parto.
Creare un ambiente familiare, confortevole e intimo, simile a quello in cui è avvenuto il concepimento, può migliorare notevolmente l’esperienza di nascita, portando a risultati positivi sia per la madre che per il bambino.
Il video “Libertà di Movimento” raggiunge 12.000.000 di visualizzazioni su YouTube!
L’apice del design e dello sviluppo delle piscine per il parto
Warum der Raum, in dem Sie gebären, wie der Raum sein sollte, in dem Sie empfangen haben
Ich erinnere mich, zum ersten Mal von diesem Konzept in einem Vortrag gehört zu haben, den Michel Odent im Active Birth Centre in London Ende der 80er Jahre gehalten hat. Es ergab für mich instinktiv Sinn.
Hier ist der Grund……
Das Konzept, eine Geburtsumgebung zu schaffen, die den Komfort und die Intimität des Raumes widerspiegelt, in dem wahrscheinlich die Empfängnis stattfand, hat große Bedeutung.
Verschiedene Studien und Expertenmeinungen betonen die tiefgreifende Wirkung der Geburtsumgebung auf die physiologischen und psychologischen Aspekte der Geburt.
Die Auswirkungen der Umgebung auf die physiologische Geburt
Forschungen zeigen, dass die Umgebung, in der eine Frau gebärt, den Beginn und den Fortschritt der Wehen erheblich beeinflusst.
Eine ruhige, private und sichere Atmosphäre fördert die normale neurohormonale Funktion und unterstützt die Physiologie von Wehen und Geburt.
Diese Umgebung sollte idealerweise das vertraute, intime Ambiente nachahmen, ähnlich dem, in dem die Empfängnis stattgefunden haben könnte, da Vertrautheit mit weniger medizinischen Eingriffen und größerer mütterlicher Zufriedenheit verbunden ist.
Psychologische Sicherheit und Komfort
Die psychologischen Aspekte einer Geburtsumgebung können nicht überbewertet werden.
Das Schaffen einer heimähnlichen Geburtsumgebung, ähnlich dem persönlichen und intimen Umfeld der Empfängnis, reduziert deutlich den Bedarf an intrapartaler Analgesie und erhöht die Wahrscheinlichkeit einer spontanen vaginalen Geburt und mütterlicher Zufriedenheit.
Dies ist entscheidend, da der psychologische Zustand der Mutter den Geburtsprozess tiefgreifend beeinflussen kann.
Die Rolle alternativer Geburtsumgebungen
Alternative Geburtsumgebungen, wie z.B. schlafzimmerähnliche Räume oder Ambient-Zimmer, haben sich als förderlich für die Wahrscheinlichkeit einer spontanen vaginalen Geburt, des Stillens in den ersten sechs bis acht Wochen und einer positiven Sicht der Frauen auf die Betreuung erwiesen.
Diese Umgebungen beinhalten oft multisensorische Stimulationen wie Sehen, Fühlen, Hören und Düfte, die während der Wehen und Geburt von entscheidender Bedeutung sein können.
Schaffung einer unterstützenden Umgebung
Elemente wie bequeme Möbel, die Möglichkeit, Beleuchtung und Geräusche zu kontrollieren, und Privatsphäre sind integraler Bestandteil einer unterstützenden Geburtsumgebung.
Diese Faktoren, die an eine persönlichere und intimere Umgebung erinnern, sind entscheidend, um eine positive Geburtserfahrung zu gewährleisten.
Die Einbeziehung vertrauter Gegenstände und Umgebungen kann eine zentrale Rolle bei der Nachahmung der Empfängnisumgebung spielen und somit den Geburtsprozess natürlicher und weniger stressig machen.
Fazit
Im Wesentlichen sollte der Raum, in dem Sie gebären, idealerweise den Raum widerspiegeln, in dem Sie empfangen haben, aufgrund seiner tiefgreifenden Auswirkungen auf die physiologischen und psychologischen Aspekte der Geburt.
Das Schaffen einer vertrauten, komfortablen und intimen Umgebung, ähnlich dem Ort der Empfängnis, kann das Geburtserlebnis erheblich verbessern und zu positiven Ergebnissen für Mutter und Kind führen.
Freiheit der Bewegung” erreicht 12.000.000 Aufrufe auf YouTube!
Waarom Actieve Geboorte Pools de nummer 1 keuze zijn wereldwijd
Prospective cohort study of water immersion in an Irish maternity setting
Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting
Paula L Barry, Lean E McMahon, Ruth AM Banks, Ann M Fergus, Deirdre J Murphy
Abtract:
Objective To examine the birth outcomes for women and babies following water immersion for labour only, or for labour and birth.
Design Prospective cohort study.
Setting Maternity hospital, Ireland, 2016–2019.
Participants A cohort of 190 low-risk women who used water immersion; 100 gave birth in water and 90 laboured only in water. A control group of 190 low-risk women who received standard care.
Methods Logistic regression analyses examined associations between water immersion and birth outcomes adjusting for confounders. A validated Childbirth Experience Questionnaire was completed.
Main outcome measures Perineal tears, obstetric anal sphincter injuries (OASI), postpartum haemorrhage (PPH), neonatal unit admissions (NNU), breastfeeding and birth experiences.
Results Compared with standard care, women who chose water immersion had no significant difference in perineal tears (71.4% vs 71.4%, adj OR 0.83; 95% CI 0.49 to 1.39) or in OASI (3.3% vs 3.8%, adj OR 0.91; 0.26–2.97). Women who chose water immersion were more likely to have a PPH ≥500 mL (10.5% vs 3.7%, adj OR 2.60; 95% CI 1.03 to 6.57), and to exclusively breastfeed at discharge (71.1% vs 45.8%, adj OR 2.59; 95% CI 1.66 to 4.05). There was no significant difference in NNU admissions (3.7% vs 3.2%, adj OR 1.06; 95% CI 0.33 to 3.42). Women who gave birth in water were no more likely than women who used water for labour only to require perineal suturing (64% vs 80.5%, adj OR 0.63; 95% CI 0.30 to 1.33), to experience OASI (3.0% vs 3.7%, adj OR 1.41; 95% CI 0.23 to 8.79) or PPH (8.0% vs 13.3%, adj OR 0.73; 95% CI 0.26 to 2.09). Women using water immersion reported more positive memories than women receiving standard care (p<0.01).
Conclusions Women choosing water immersion for labour or birth were no more likely to experience adverse birth outcomes than women receiving standard care and rated their birth experiences more highly.
Waterbirth: a national retrospective cohort study… 2021
Waterbirth: a national retrospective cohort study of factors associated with its use among women in England
H. Aughey,J. Jardine,N. Moitt,K. Fearon,J. Hawdon,D. Pasupathy,I. Urganci,NMPA Project Team &T. Harris
BMC Pregnancy and Childbirth volume 21, Article number: 256 (2021)
Abstract
Background
Waterbirth is widely available in English maternity settings for women who are not at increased risk of complications during labour. Immersion in water during labour is associated with a number of maternal benefits. However for birth in water the situation is less clear, with conclusive evidence on safety lacking and little known about the characteristics of women who give birth in water.
This retrospective cohort study uses electronic data routinely collected in the course of maternity care in England in 2015–16 to describe the proportion of births recorded as having occurred in water, the characteristics of women who experienced waterbirth and the odds of key maternal and neonatal complications associated with giving birth in water.
Methods
Data were obtained from three population level electronic datasets linked together for the purposes of a national audit of maternity care. The study cohort included women who had no risk factors requiring them to give birth in an obstetric unit according to national guidelines. Multivariate logistic regression models were used to examine maternal (postpartum haemorrhage of 1500mls or more, obstetric anal sphincter injury (OASI)) and neonatal (Apgar score less than 7, neonatal unit admission) outcomes associated with waterbirth.
Results
46,088 low and intermediate risk singleton term spontaneous vaginal births in 35 NHS Trusts in England were included in the analysis cohort. Of these 6264 (13.6%) were recorded as having occurred in water. Waterbirth was more likely in older women up to the age of 40 (adjusted odds ratio (adjOR) for age group 35–39 1.27, 95% confidence interval (1.15,1.41)) and less common in women under 25 (adjOR 18–24 0.76 (0.70, 0.82)), those of higher parity (parity ≥3 adjOR 0.56 (0.47,0.66)) or who were obese (BMI 30–34.9 adjOR 0.77 (0.70,0.85)). Waterbirth was also less likely in black (adjOR 0.42 (0.36, 0.51)) and Asian (adjOR 0.26 (0.23,0.30)) women and in those from areas of increased socioeconomic deprivation (most affluent versus least affluent areas adjOR 0.47 (0.43, 0.52)).
There was no association between delivery in water and low Apgar score (adjOR 0.95 (0.66,1.36)) or incidence of OASI (adjOR 1.00 (0.86,1.16)). There was an association between waterbirth and reduced incidence of postpartum haemorrhage (adjOR 0.68 (0.51,0.90)) and neonatal unit admission (adjOR 0.65 (0.53,0.78)).
Conclusions
In this large observational cohort study, there was no association between waterbirth and specific adverse outcomes for either the mother or the baby. There was evidence that white women from higher socioeconomic backgrounds were more likely to be recorded as giving birth in water. Maternity services should focus on ensuring equitable access to waterbirth.
Asumiendo la Marea: El Caso Atractivo de las Piscinas de Parto en Agua en los Hospitales
En el siempre cambiante panorama de la atención materna, los hospitales buscan continuamente formas innovadoras de mejorar la experiencia de parto para las futuras madres.
Una innovación que está ganando impulso es la integración de piscinas de parto en el agua dentro de las instalaciones hospitalarias.
Lejos de ser una simple tendencia, las piscinas de parto en el agua ofrecen una miríada de beneficios que no solo priorizan el bienestar tanto de la madre como del niño, sino que también contribuyen a una experiencia de parto más holística y empoderadora.
En este artículo, nos adentramos en las razones convincentes por las cuales los hospitales deberían considerar abrazar la marea e incorporar piscinas de parto en el agua en sus servicios de atención materna.
Alivio Natural del Dolor:
El agua ha sido reconocida durante mucho tiempo como un potente analgésico natural.
Sumergirse en agua tibia puede aliviar la intensidad de las contracciones y proporcionar una sensación de ingravidez, reduciendo el impacto de la gravedad en el cuerpo.
Los hospitales que ofrecen piscinas de parto en el agua brindan a las madres una opción alternativa de manejo del dolor que complementa los métodos tradicionales, ofreciendo un enfoque más personalizado para el confort durante el trabajo de parto.
Numerosos estudios han demostrado la eficacia de la inmersión en agua para aliviar el dolor del parto.
Una revisión publicada en el “Journal of Perinatal Education” (Harper et al., 2016) concluyó que la inmersión en agua tibia durante el trabajo de parto reduce significativamente la percepción del dolor, proporcionando a las futuras madres una opción de alivio del dolor no farmacológica y basada en evidencia.
La investigación publicada en el “Journal of Obstetric, Gynecologic & Neonatal Nursing” (Thoeni et al., 2019) sugiere que la inmersión en agua durante el trabajo de parto reduce las hormonas del estrés, promoviendo un estado más relajado tanto para la madre como para el bebé.
Niveles más bajos de hormonas del estrés se han asociado con una mejora en el bienestar materno y resultados de parto favorables, respaldando el argumento a favor de las piscinas de parto en agua como enfoque holístico para la atención materna.
Reducción del Estrés y la Ansiedad:
El proceso de parto puede ser una fuente de ansiedad para muchas futuras madres.
Las piscinas de parto en agua crean un entorno tranquilo y relajante, fomentando la relajación y reduciendo los niveles de estrés.
La flotabilidad del agua promueve una sensación de ingravidez, permitiendo que las madres se muevan con más libertad y adopten posiciones cómodas, contribuyendo a una experiencia de parto más positiva y empoderadora.
La investigación publicada en el “Journal of Obstetric, Gynecologic & Neonatal Nursing” (Thoeni et al., 2019) sugiere que la inmersión en agua durante el trabajo de parto reduce las hormonas del estrés, promoviendo un estado más relajado tanto para la madre como para el bebé.
Niveles más bajos de hormonas del estrés se han asociado con una mejora en el bienestar materno y resultados de parto favorables, respaldando el argumento a favor de las piscinas de parto en agua como enfoque holístico para la atención materna.
Facilitación del Movimiento y la Posición:
Las piscinas de parto en agua proporcionan un entorno propicio para el movimiento y la posición durante el trabajo de parto.
La flotabilidad permite una mayor movilidad, permitiendo que las madres cambien de posición fácilmente y encuentren la postura más cómoda para el parto.
Esta flexibilidad puede mejorar el progreso del trabajo de parto y facilitar un proceso de parto más suave.
Un estudio publicado en el “American Journal of Obstetrics & Gynecology” (Zanetti-Daellenbach et al., 2007) encontró que la inmersión en agua mejora la movilidad materna durante el trabajo de parto.
La flotabilidad del agua permite un movimiento y posicionamiento más fáciles, acortando potencialmente la duración del trabajo de parto y reduciendo la necesidad de intervenciones.
Esta evidencia subraya la importancia de las piscinas de parto en agua al proporcionar un entorno propicio para las posiciones óptimas de parto.
Mejora de la Circulación Sanguínea:
El agua tibia en una piscina de parto promueve una mejora en la circulación sanguínea, lo cual puede ser particularmente beneficioso durante el trabajo de parto.
Una circulación mejorada ayuda a reducir la hinchazón y promover el flujo de oxígeno, contribuyendo al bienestar tanto de la madre como del bebé.
Los hospitales que incorporan piscinas de parto en agua priorizan los aspectos fisiológicos del parto, promoviendo un entorno de parto más saludable.
El impacto positivo de la inmersión en agua tibia en la circulación sanguínea ha sido bien documentado.
Un ensayo controlado aleatorio publicado en el “Journal of Midwifery & Women’s Health” (Burns et al., 2012) reveló que la inmersión en agua tibia aumenta el flujo sanguíneo periférico y la oxigenación, proporcionando beneficios fisiológicos que contribuyen al bienestar general tanto de la madre como del bebé.
Mejora del Vínculo:
El entorno íntimo y privado de una piscina de parto en agua fomenta la participación de la pareja y promueve una conexión más profunda entre los padres y el recién nacido.
La experiencia compartida del trabajo de parto y el parto en una piscina de parto en agua puede fortalecer el vínculo emocional entre los compañeros, promoviendo una sensación de unidad y responsabilidad compartida al dar la bienvenida al miembro más nuevo de la familia.
Un exhaustivo metaanálisis publicado en “Birth: Issues in Perinatal Care” (Nikodem et al., 2016) examinó los resultados psicológicos de la inmersión en agua durante el trabajo de parto.
El análisis encontró una correlación positiva entre las experiencias de parto en agua y un aumento en la satisfacción materna y en el vínc
La inclusión de piscinas de parto en agua en los servicios de atención materna hospitalaria representa un paso progresivo hacia la implementación de un enfoque más integral y centrado en el paciente para el parto.
Más allá de los beneficios físicos, como el alivio natural del dolor y la mejora de la circulación, las piscinas de parto en agua contribuyen a una experiencia más enriquecedora emocionalmente para ambos padres.
A medida que los hospitales se esfuerzan por priorizar el bienestar y las preferencias de las futuras madres, la integración de piscinas de parto en agua se presenta como una elección convincente, resonando con la conexión ancestral entre la humanidad y el abrazo tranquilizador del agua durante el milagro del parto.
Incorporar piscinas de parto en agua en los servicios de atención materna hospitalaria no es simplemente un paso progresivo; es un salto respaldado científicamente hacia la provisión de experiencias de parto basadas en evidencia y centradas en el paciente.
La multitud de estudios que respaldan los beneficios de la inmersión en agua durante el trabajo de parto refuerza la idea de que los hospitales deberían considerar las piscinas de parto en agua no como un lujo, sino como un elemento crucial para fomentar un entorno de parto seguro, cómodo y basado en evidencia.
La avalancha de evidencia respalda de manera abrumadora la integración de piscinas de parto en agua como una fuerza transformadora en la atención materna moderna.
La cúspide del diseño y el desarrollo de las piscinas de nacimiento en el agua.
Nada ayuda a las madres a sobrellevar el dolor en el parto de manera más efectiva
El video “Libertad de Movimiento” alcanza 12,000,00 vistas en YouTube!
Perché le piscine per il parto attivo sono la scelta numero 1 a livello mondiale
Negli anni ’80, abbiamo intrapreso un viaggio insieme a ostetrici, madri, ginecologi, specialisti del controllo delle infezioni ed esperti in movimentazione manuale.
Insieme, abbiamo creato la prima piscina per il parto in acqua di grado ospedaliero al mondo, prestando la massima attenzione a ogni dettaglio.
Da allora, abbiamo continuato a perfezionare i nostri progetti, migliorare i nostri materiali e elevare le nostre capacità di produzione ed ingegneria.
Quest’evoluzione ha dato vita a piscine per il parto in acqua che non solo prioritizzano la sicurezza, ma si allineano perfettamente con i desideri sia delle madri che delle ostetriche.
I giudici dei Building Better Healthcare Awards lo hanno descritto in modo succinto, affermando che l’armoniosa fusione di progettazione basata su prove, centrata sull’utente, ergonomicità, materiali specializzati e produzione su misura ha portato a piscine per il parto in acqua che si distinguono in una categoria a parte.
La nostra dedizione incrollabile consiste nell’offrire piscine per il parto intelligentemente progettate che offrono una sicurezza ineguagliabile, un valore straordinario e prestazioni eccezionali, il tutto restando incredibilmente pratiche, convenienti e sostenibili dal punto di vista ambientale.
Al centro di tutto ciò c’è una vera passione per il design e la qualità, alimentata da un impegno incondizionato per migliorare l’esperienza del travaglio e del parto sia per le ostetriche che per le madri e i neonati.
Siamo orgogliosi di aver fornito innumerevoli piscine per il parto in acqua agli ospedali di tutto il mondo.
Le nostre collaborazioni con gli utenti finali, gli specialisti e i produttori ci hanno spinto a sviluppare e migliorare continuamente le nostre capacità.
Ogni Active Birth Pool viene realizzata artigianalmente su misura in Inghilterra da abili artigiani che sono immensamente orgogliosi del loro lavoro e che si attengono agli standard più elevati di eccellenza.
Il nostro processo di progettazione tiene conto della delicata interazione tra madri, ostetriche e la piscina per il parto.
Abbiamo abbracciato principi di progettazione basati su prove, centrati sull’utente ed ergonomici per creare piscine per il parto in acqua che sono non solo estremamente confortevoli, ma anche incredibilmente pratiche e user-friendly.
Le forme intricate e accattivanti delle nostre piscine sono progettate per catturare sia i sensi che le emozioni.
Ogni curva, ogni contorno ha uno scopo, dove la forma si fonde elegantemente con l’utilità estetica.
Attraverso il processo di fabbricazione senza soluzione di continuità in Ficore®, abbiamo rivoluzionato il concetto di piscina per il parto.
Questa innovazione ha dato vita a piscine che combinano senza soluzione di continuità eleganza, praticità e facilità d’uso.
Le eccezionali qualità di Ficore® ci consentono di produrre piscine per il parto in acqua che eccellono in termini di prestazioni, valore e sicurezza oltre misura.
La nostra profonda comprensione del processo di nascita e il nostro impegno verso le esigenze delle ostetriche ci hanno spinto a progettare piscine per il parto che proteggono attivamente le ostetriche e le madri dai potenziali rischi associati al parto in acqua..
Siamo pienamente consapevoli del potenziale delle piscine per il parto di ospitare batteri dannosi.
In risposta, abbiamo introdotto una serie di funzioni innovative che non solo mitigano il rischio, ma amplificano anche la sicurezza al massimo grado.
La vostra tranquillità e sicurezza sono al centro di tutto ciò che facciamo.
Il video “Libertà di Movimento” raggiunge 12.000.000 di visualizzazioni su YouTube!
L’apice del design e dello sviluppo delle piscine per il parto
Nada ayuda a las madres a sobrellevar el dolor en el parto de manera más efectiva
Las piscinas de parto en agua desempeñan un papel vital en ayudar a las madres a experimentar un trabajo de parto fisiológico y un parto natural.
Nada ayuda a las madres a sobrellevar el dolor de manera más efectiva. Si las madres no van a depender de la analgesia para el alivio del dolor, necesitan otras opciones.
Las madres que ingresan a una piscina de agua tibia durante el trabajo de parto establecido encuentran que son mejores para sobrellevar el dolor.
La inmersión en agua tibia ha sido inequívocamente demostrada como de gran beneficio tanto fisiológica como psicológicamente.
Las mujeres tienen un mayor sentido de realización y logro, y los bebés experimentan un parto no traumático.
Además de los beneficios obvios para las madres y los bebés, las parteras experimentan una mayor satisfacción laboral y los hospitales ahorran dinero y optimizan recursos.
Casi un tercio de las mujeres se beneficiaron del uso de una piscina de parto en agua en el Reino Unido en 2014 (Encuesta Nacional de Maternidad 2014).
Con hasta un 60% de las madres dispuestas a un parto natural, ahora es el momento de considerar la disponibilidad más amplia de esta opción segura, efectiva y de bajo costo.
En tierra, las madres luchan contra la fuerza de gravedad, lo que limita el movimiento a medida que avanza el trabajo de parto y se cansan.
Muchas mujeres no tienen la capacidad física para mantener posturas erguidas durante largos períodos de tiempo (Gupta JK, Hofmeyr GJ, Smyth R 2007).
Las madres que tienen sobrepeso u obesidad a menudo no pueden hacer frente a las demandas físicas.
La transición de la tierra al agua ayuda a revivir y energizar a las madres, dándoles una nueva oportunidad en la vida y un sentido de propósito.
La flotación del agua apoya a la madre, reduciendo su peso relativo aproximadamente en un 33% (Principio de Arquímedes).
Esto le permite moverse de formas que no son posibles en tierra.
Para explorar y beneficiarse de las posturas naturales para el trabajo de parto y el parto. El efecto calmante y relajante del agua tibia promueve el flujo de oxitocina.
Esta poderosa hormona desempeña un papel fundamental en el parto.Hace que el útero se contraiga y desencadena el ‘reflejo de eyección fetal’.
La inmersión en agua tiene un efecto fisiológico beneficioso en la secreción de hormonas, incluyendo aumentos de oxitocina que pueden avanzar la dilatación y estimular las contracciones (Odent 2014).
La cúspide del diseño y el desarrollo de las piscinas de nacimiento en el agua.
El video “Libertad de Movimiento” alcanza 12,000,00 vistas en YouTube!
Water birth – a valuable and safe method to promote natural childbirth and physiological labour
Water birth pools serve a pivotal role in enhancing the experience of physiological labour and natural childbirth for mothers.
In fact, they are particularly effective in helping mothers manage pain without relying on analgesia for relief (National Institute for Health and Care Excellence, 2014).
Research has shown that women who enter a warm water pool during established labour are better equipped to cope with the pain associated with childbirth.
Immersion in warm water has been unequivocally proven to offer significant physiological and psychological benefits during labor (Cluett et al., 2004).
The benefits extend beyond pain management; women who choose water birth often report a heightened sense of fulfillment and accomplishment, while babies experience a gentler, less traumatic birth process (Royal College of Obstetricians and Gynaecologists, 2014).
In addition to these advantages for mothers and babies, midwives also experience increased job satisfaction, and healthcare facilities can save resources and costs by providing water birth options (National Institute for Health and Care Excellence, 2014).
Statistics from the National Maternity Survey in 2014 indicate that nearly a third of women in the UK benefited from using a water birth pool (Care Quality Commission, 2014).
With up to 60% of mothers showing interest in natural birth, it is opportune to consider expanding the availability of this safe, cost-effective approach (American College of Obstetricians and Gynecologists, 2017).
On dry land, mothers face the challenge of gravity, which limits their movement as labor progresses and fatigue sets in.
Many women may lack the physical fitness required to maintain upright postures for extended periods (Gupta et al., 2007).
Additionally, mothers who are overweight or obese may struggle to cope with the physical demands of labor (Vahratian et al., 2005).
The transition from land to water can rejuvenate and energize mothers, providing them with a newfound sense of purpose.
The buoyancy of water reduces a mother’s relative weight by approximately 33%, allowing her to move in ways that would be impossible on land and explore natural labor and birthing postures (American College of Nurse-Midwives, 2014).
Furthermore, the warm water’s calming and relaxing effects promote the release of oxytocin, a critical hormone in childbirth.
Oxytocin induces uterine contractions and triggers the “fetal ejection reflex,” further aiding the birthing process.
Immersion in water has been shown to have a positive physiological impact on hormone secretion, including oxytocin surges that can facilitate cervical dilation and stimulate contractions (Odent, 2014).
In conclusion, water birth pools offer a multifaceted approach to childbirth that benefits both mothers and babies, enhances midwives’ job satisfaction, and provides cost-effective options for healthcare facilities.
The evidence supports the integration of water birth as a valuable and safe method to promote natural childbirth and physiological labor experiences.
Hvorfor Active Birth Pools er det førstevalg i verden
Tilbage i midten af 80’erne begav vi os ud på en rejse sammen med jordemødre, mødre, fødselslæger, specialister i infektionskontrol og eksperter inden for manuel håndtering.
Sammen skabte vi verdens allerførste fødekar af hospitalskvalitet med omhyggelig opmærksomhed på hver eneste detalje.
Siden da har vi fortsat med at forfine vores design, forbedre vores materialer og hæve vores produktions- og ingeniørmæssige evner.
Denne udvikling har ført til fødekar i vand, der ikke kun prioriterer sikkerhed, men også passer perfekt til både mødres og jordemødres ønsker.
Dommerne ved Building Better Healthcare Awards udtrykte det kort og præcist ved at sige, at den harmoniske blanding af evidensbaseret, brugercentreret, ergonomisk design, specialmaterialer og skræddersyet produktion har resulteret i fødekar i vand, der står i en klasse for sig selv.
Vores ubøjelige dedikation ligger i at tilbyde intelligent designede fødekar, der leverer enestående sikkerhed, bemærkelsesværdig værdi og fremragende ydeevne, samtidig med at de forbliver utroligt praktiske, omkostningseffektive og miljømæssigt bæredygtige.
Vores kerne består af en ægte passion for design og kvalitet, drevet af en urokkelig forpligtelse til at forbedre oplevelsen af fødsel og fødsel for både jordemødre, mødre og babyer.
Vi er stolte af at have leveret utallige fødekar i vand til hospitaler over hele verden.
Vores samarbejde med slutbrugere, specialister og producenter har drevet os til løbende at udvikle og forbedre vores evner.
Hvert Active Birth Pool er omhyggeligt håndlavet efter bestilling i England af højt kvalificerede håndværkere, der er meget stolte af deres arbejde og holder sig selv til de højeste standarder for kvalitet.
Vores designproces tager hensyn til den delikate samspil mellem mødre, jordemødre og fødekarret.
Vi har omfavnet evidensbaserede, brugercentrerede, ergonomiske designprincipper for at skabe fødekar i vand, der ikke kun er utroligt komfortable, men også lette at bruge og brugervenlige.
De komplekse og indbydende former på vores kar er designet til at fange både sanser og følelser.
Hver bue, hver kontur tjener et formål, hvor form elegant smelter sammen med æstetisk nytte.
Gennem den problemfri, ensartede fabriceringsproces i Ficore® har vi revolutioneret konceptet med fødekar.
Denne innovation har født kar, der problemfrit kombinerer elegance, praktisk anvendelighed og brugervenlighed.
Ficore®’s exceptionelle egenskaber giver os mulighed for at producere fødekar i vand, der excellerer i ydeevne, værdi og sikkerhed uden mål.
Vores dybe forståelse af fødselsprocessen og vores forpligtelse over for jordemødres behov har drevet os til at designe fødekar, der aktivt beskytter jordemødre og mødre mod de potentielle risici, der er forbundet med fødsel i vand.
Vi er skarpt opmærksomme på potentialet for, at fødekar kan huse skadelige bakterier.
Som svar har vi introduceret en række innovative funktioner, der ikke kun mindsker risikoen, men også øger sikkerheden til det højeste niveau.
Din tryghed og sikkerhed er hjertet i alt, hvad vi gør.”
The use of water for labour and birth – Colchester University Hospital
Feeling relaxed, secure and in control and being able to move about freely can make
it more likely for you to have a quicker and more natural birth.
For some women using a birthing pool can offer all of these benefits.
Today more and more women are considering using water for pain relief in labour.
A midwife can support you in using a birthing pool at home or in our midwife-led units
at Colchester General Hospital and Clacton and Harwich hospitals in the community.
Using a birthing pool is likely to increase the chances of a normal vaginal delivery
and therefore we would like to offer this option to as many women as possible.
We have compiled this leaflet to give you and your partner relevant information about
labouring and giving birth in water.
Please talk to your midwife during the antenatal period who will be able to answer any questions you may have.
Please click here to read the full document
Labouring women who used a birthing pool in obsteric units in Italy: prospective observational study
Background: For women at low risk of childbirth complications, water immersion during labour is a care option in many high income countries.
Our aims were (a) to describe maternal characteristics, intrapartum events, interventions, maternal and neonatal outcomes for all women who used a birthing pool during labour who either had a waterbirth or left the pool and had a landbirth, and for the subgroup of women who had a waterbirth in 19 obstetric units, and (b) to compare maternal characteristics, intrapartum events, interventions, and maternal and neonatal outcomes for women who used a birthing pool with a control group of women who did not use a birthing pool for whom we prospectively collected data in a single centre.
Methods: Prospective observational study in 19 Italian obstetric units 2002-2005.
Participants were: (a) 2,505 women in labour using a birthing pool in 19 obstetric units; and (b) 114 women in labour using a birthing pool and 459 women who did not use a birthing pool in one obstetric unit.
Descriptive statistics were calculated for the sample as a whole and, separately, for those women who gave birth in water. Categorical data were compared using Chi square statistics and continuous data by T-tests.
Results: Overall, 95.6% of women using a birthing pool had a spontaneous vertex delivery, 63.9% of which occurred in water. Half of nulliparas and three quarters of multiparas delivered in water.
Adverse maternal and neonatal outcomes were rare.
There were two cases of umbilical cord snap with waterbirth.
Compared with controls, significantly more women who used a birthing pool adopted an upright birth position, had hands off delivery technique, and a physiological third stage.
Significantly fewer nulliparas had an episiotomy, and more had a second degree perineal tear, with no evidence of a difference for extensive perineal tears.
Conclusions: Birthing pool use was associated with spontaneous vaginal birth.
The increase in second degree tears was balanced by fewer episiotomies.
Undue umbilical cord traction should be avoided during waterbirth.
Click here for PDF of the study
Factors influencing water immersion during labour: qualitative case studies of six maternity units in the United Kingdom
Background: Water immersion during labour can provide benefits including reduced need for regional analgesia and a shorter labour.
However, in the United Kingdom a minority of women use a pool for labour or birth, with pool use particularly uncommon in obstetric-led settings.
Maternity unit culture has been identified as an important influence on pool use, but this and other possible factors have not been explored in-depth.
Therefore, the aim of this study was to identify factors influencing pool use through qualitative case studies of three obstetric units and three midwifery units in the UK.
Methods: Case study units with a range of waterbirth rates and representing geographically diverse locations were selected. Data collection methods comprised semi-structured interviews, collation of service documentation and public-facing information, and observations of the unit environment.
There were 111 interview participants, purposively sampled to include midwives, postnatal women, obstetricians, neonatologists, midwifery support workers and doulas.
A framework approach was used to analyse all case study data.
Results: Obstetric unit culture was a key factor restricting pool use.
We found substantial differences between obstetric and midwifery units in terms of equipment and resources, staff attitudes and confidence, senior staff support and women’s awareness of water immersion.
Generic factors influencing use of pools across all units included limited access to waterbirth training, sociodemographic differences in desire for pool use and issues using waterproof fetal monitoring equipment.
Conclusions: Case study findings provide new insights into the influence of maternity unit culture on waterbirth rates.
Access to pool use could be improved through midwives based in obstetric units having more experience of waterbirth, providing obstetricians and neonatologists with information on the practicalities of pool use and improving accessibility of antenatal information.
In terms of resources, recommendations include increasing pool provision, ensuring birth room allocation
Click here for PDF of the study
Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth
Background: There is limited research examining midwives’ education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic.
Methods: This mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia.
Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire.
Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth.
Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts.
Results: The majority (85%; 29 of 34) of midwives surveyed returned a questionnaire.
Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven.
Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth.
Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance.
Phase two included two focus groups of seven and five midwives.
Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space.
Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth.
Conclusions: This research contributes to the growing knowledge base examining midwives’ education, knowledge and practice around immersion in water for labour or birth.
It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are integral to sustaining waterbirth as an option for low risk women.
Click here for PDF of the study
The perceptions and experiences of women who achieved and did not achieve a water birth
Background: There is a gap in knowledge and understanding relating to the experiences of women exposed to the opportunity of waterbirth.
Our aim was to explore the perceptions and experiences of women who achieved or did not achieve their planned waterbirth.
Methods: An exploratory design using critical incident techniques was conducted between December 2015 and July 2016, in the birth centre of the tertiary public maternity hospital in Western Australia. Women were telephoned 6 weeks post birth.
Demographic data included: age; education; parity; and previous birth mode.
Women were also asked the following: what made you choose to plan a waterbirth?; what do you think contributed to you having (or not having) a waterbirth?; and which three words would you use to describe your birth experience?
Frequency distributions and univariate comparisons were employed for quantitative data.
Thematic analysis was undertaken to extract common themes from the interviews.
Results: A total of 31% (93 of 296) of women achieved a waterbirth and 69% (203 of 296) did not. Multiparous women were more likely to achieve a waterbirth (57% vs 32%; p < 0.001).
Women who achieved a waterbirth were less likely to have planned a waterbirth for pain relief (38% vs 52%; p = 0.24).
The primary reasons women gave for planning a waterbirth were: pain relief; they liked the idea; it was associated with a natural birth; it provided a relaxing environment; and it was recommended.
Two fifths (40%) of women who achieved a waterbirth suggested support was the primary reason they achieved their waterbirth, with the midwife named as the primary support person by 34 of 37 women.
Most (66%) women who did not achieve a waterbirth perceived this was because they experienced an obstetric complication.
The words women used to describe their birth were coded as: affirming; distressing; enduring; natural; quick; empowering; and long.
Conclusions: Immersion in water for birth facilitates a shift of focus from high risk obstetric-led care to low risk midwifery-led care.
It also facilitates evidence based, respectful midwifery care which in turn optimises the potential for women to view their birthing experience through a positive lens.
Click here for a PDF of the study
A systematic meta-thematic synthesis to examine the views and experiences of women following water immersion during labour and waterbirth
Aims: To gather, quality assess, synthesize and interpret the views, feeling, and experiences of women who used water immersion during labour and/or birth.
Design: A systematic meta-thematic synthesis and GRADE-CERQual.
Data sources: We searched MEDLINE, CINHAL, PsychINFO, AMED, EMBASE (MIDIRS only), LILACS, AJOL. Additional searches were carried out using Ethos (thesis database), cross-referencing against Google Scholar and citation chasing. Searches were carried out in August 2019, updated February 2020.
Methods: Studies that met the selection criteria were appraised for quality. Data were extracted from the studies using meta-thematic analytical techniques; coding, descriptive findings, and analytical findings. The descriptive findings were subjected to confidence assessments using GRADE-CERQual.
Results: Seven studies met the inclusion criteria. Nine key statements of findings were generated – one had high confidence, three moderate, three low and one very low confidence in the findings. The analytical findings generated three main themes: Liberation and Self-Emancipation, Synergy, transcendence and demarcation and Transformative birth and beyond. Overall, women experienced warm water immersion during labour and/or birth positively. Both the water and pool itself, facilitated women’s physical and psychological needs during labour and/or birth, including offering effective analgesia. Our findings indicated that birthing pools are versatile tools that provide for a space that women can adapt and influence to best suit their individual needs.
Conclusion: Women who used warm water immersion for labour and/or birth describe liberating and transformative experiences of welcoming their babies into the world. They were empowered, liberated, and satisfied. We recommend maternity professionals and services offer water immersion as a standard method of pain relief during labour/birth.
Impact: Understanding women’s experiences of labour and birth will inform future clinical practice. Midwives are optimally positioned to enhance women’s access to water immersion. These findings have implications for education, guideline, and policy development as well as clinical practice.
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Water birth: a national retrospective cohort study of factors associated with its use among women in England
Water birth is widely available in English maternity settings for women who are not at increased risk of complications during labour. Immersion in water during labour is associated with a number of maternal benefits.
However for birth in water the situation is less clear, with conclusive evidence on safety lacking and little known about the characteristics of women who give birth in water.
This retrospective cohort study uses electronic data routinely collected in the course of maternity care in England in 2015–16 to describe the proportion of births recorded as having occurred in water, the characteristics of women who experienced water birth and the odds of key maternal and neonatal complications associated with giving birth in water.
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Waterbirth in low-risk pregnancy: An exploration of women’s experiences
Abstract
Aims: To explore retrospective descriptions about benefits, negative experiences and preparatory information related to waterbirths.
Design: A qualitative study.
Methods: Women who gave birth in water with healthy pregnancies and low-risk births were consecutively recruited between December 2015–October 2018 from two birthing units in Sweden.
All who gave birth in water during the recruitment period were included (N = 155) and 111 responded to the survey.
Women were emailed a web-based survey six weeks postpartum. Open-ended questions were analysed with qualitative content analysis.
Results: Two themes were identified related to benefits: (a) physical benefits: the water eases labour progression while offering buoyancy and pain relief; and (b) psychological benefits: improved relaxation and control in a demedicalized and safe setting.
Two themes were identified related to negative experiences: (a) equipment related issues due to the construction of the tub and issues related to being immersed in water; and (b) fears and worries related to waterbirth.
In regard to preparatory information, respondents reported a lack of general and specific information related to waterbirths, even after they contacted birthing units to ask questions.
Supplemental web-based information was sought, but the trustworthiness of these sources was questioned and a need for trustworthy web-based information was articulated.
Conclusion: Women who give birth in water experience physical and psychological benefits, but need better equipment and sufficient information.
There is room for improvement with regard to prenatal and intrapartum care of women who give birth in water.
Click here for PDF of the study
