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

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

Here are the facts…

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

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

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

Hospital staff and resources can be employed more efficiently.

Importantly – this results in significant financial savings!

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

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



The keyword that defines our design ethos is Active.

The keyword that defines our approach to design is ‘Active’.

If we look up the definition of ‘Active Birth’  we get, “Childbirth during which the mother is encouraged to move around freely and assume any position which feels comfortable”.

Active Birth Pools provide mothers with the space and depth to move freely in the postures natural to labour and birth.

As she moves, she intuitively discovers features that provide support and make her more comfortable.

Design is based upon the dynamics of mothers and midwives as they interact with the pool and each other.

Form is based on function and pared down to the essence of aesthetic utility.

There is a reason for every shape, every curve and every form.

Our water birth pools encourage mothers to move freely and naturally.

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

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

We are pioneers, innovators and trend setters.

Our water birth pools have continuously evolved over the past 35 years.

We’re able to achieve our latest designs because of the highly specialised material we use.

Ficore, a composite resin with unique properties enables us to create incredibly curvaceous pools that mothers and midwives find exceptionally comfortable, practical and easy to use.

In mid-90’s we met with a design specialist to discuss ways our water birth pools could be improved to better serve the needs of mothers and midwives.

This lead to the ground-breaking innovations in birth pool design that have culminated in todays range of award winning water birth pools.

Below a copy of article that appeared in the Chartered Institute of Ergonomics and Human Factors charting the paradigm shift in birth pool design that occurred in the mid-90’s:



A way to make labour shorter, easier and more comfortable

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

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

Janet Balaskas – “Water Birth”

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

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

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

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

You are supported by the buoyancy of the water.

This allows you to relax easily and more deeply.

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

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

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

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

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

This will stimulate strong contractions.

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

You are likely to dilate rapidly during this time.

You may choose to have your baby in water

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

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

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

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

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

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



Educational Centre

Right from the start we have made education an important part of who we are and what we do.

Browse through the categories below or use the search engine to find the information you’re looking for.

Dealing with emergencies

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

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

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

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

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

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


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

Example 1: Emergency evacuation utilising the labour support seat


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


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

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


Example 2) Emergency evacuation utilising the safety seat


The mother is moved into position under the safety seat


The midwives glide her up the side of the pool


Onto the safety seat,

and then onto the rim for transfer onto the trolley


Active Birth Pools are portable hoist compatible

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

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

Clinical Guidelines – Royal Cornwall Hospital

Clinical Guidelines – Royal Worcester Hospital

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

Operational Policy and Clinical Guidelines – Abbey Birth Centre

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

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

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

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

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



Educational Videos

“Freedom of Movement”

The simple, short video has garnered over 11,000,000 views on YouTube.

It shows how mothers instinctively relate to our pools and move naturally to find the most comfortable, supportive and beneficial positions.

Entering the pool  – the Active Birth Pools approach

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

Educational videos for midwives

Active Birth Pools sponsored these educational videos for All4 Maternity to help midwives gain knowledge and understanding about the use of water for labour and birth.

Emersion in water in labour and birth – Part One
Emersion in water in labour and birth – Part Two
For more videos + foreign language productions visit our YouTube Channel

The buoyancy of water helps mothers benefit from upright positions

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

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

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

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

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

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

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


O pináculo do design e desenvolvimento das piscinas de nascimento

As nossas premiadas piscinas de parto com água de qualidade hospitalar têm estado no topo do mercado há mais de 35 anos!

Facultam higiene e segurança incomparáveis a um valor imbatível, melhores resultados e desempenho superior.

São feitas à mão por encomenda na Inglaterra, concebidas para durar décadas com uma garantia vitalícia.

“O pináculo do design e desenvolvimento das piscinas de nascimento.
Uma combinação incomparável de design, materiais e manufatura”
Prémios Building Better Healthcare

Ajudamos no pioneiro uso da água para o trabalho de parto e para o nascimento, criando o design das piscinas que tornaram possível esta revolução nos cuidados de maternidade.

Desde 1987, que fornecemos milhares de banheiras de parto a hospitais do mundo inteiro e que estabelecemos uma reputação de qualidade e serviço.

As mães e parteiras adoram as nossas piscinas de parto na água porque são incrivelmente confortáveis, práticas e fáceis de usar.

Os hospitais adquirem as nossas piscinas porque elas têm um desempenho superior, e proporcionam uma segurança inigualável a um preço imbatível.

Alcançamos o sucesso inovando continuamente, mantendo tudo simples e focando-nos nos nossos princípios fundamentais de segurança, valor e desempenho.

O nosso conhecimento inigualável e a nossa vasta experiência permitem-nos providenciar banheiras de nascimento que minimizem o risco, otimizem resultados e maximizem o valor.

Os juízes afirmaram que, “a combinação de evidências baseadas no design ergonómico centrado na utilizadora, os materiais especializados e a manufatura personalizada resultaram em piscinas de nascimento na água que estavam verdadeiramente numa classe própria”

As Banheiras de Nascimento Active são feitas à mão por artesãos altamente qualificados na Inglaterra e são enviadas para o mundo inteiro.

São fabricadas num material protegido por direitos de propriedade denominado Ficore®, uma resina composta com propriedades extraordinárias.

Este curto e simples vídeo obteve perto de 12.000.000 visualizações no YouTube. Mostra como as mães se identificam instintivamente com as nossas piscinas e se movem naturalmente para encontrarem as posições mais confortáveis e mais benéficas.

Se está à procura duma banheira de parto na água, nós somos excecionalmente qualificados e teremos todo o prazer em ajudar.
Descubra porquê.

Tem interesse em saber mais acerca do parto na água ou como pode montar uma banheira de parto na água?
Visite o nosso Centro Educativo.


“वॉटर बर्थ पूल डिज़ाइन और विकास का शिखर।

हमारा पुरस्कार-विजेता हॉस्पिटल ग्रेड वॉटर बर्थ पूल 35 सालों से भी ज़्यादा समय से मार्केट में टॉप पर है!

ये बेमिसाल स्वच्छता और सुरक्षा, बेजोड़ मूल्य, बेहतर परिणाम और सबसे अच्छा प्रदर्शन प्रदान करते हैं।

इन्हें इंग्लैंड में मांग के आधार पर बनाया जाता है, जो दशकों तक चलते हैं और इनकी जीवन भर की गारंटी है।

वॉटर बर्थ पूल डिज़ाइन और विकास का शिखर।

डिज़ाइन, सामग्रियों और निर्माण का बेजोड़ मेल”

बिल्डिंग बेटर हेल्थकेयर अवॉर्ड्स

हमने प्रसूति देखभाल में इस क्रांति को संभव बनाने वाले पूलों को डिज़ाइन करके प्रसव और जन्म के लिए पानी के इस्तेमाल को आगे बढ़ाने में मदद की।

1987 से हमने दुनिया भर के अस्पतालों में हज़ारों बर्थिंग पूलों की आपूर्ति की है और गुणवत्ता व सेवा के लिए एक प्रतिष्ठा स्थापित की है।

माओं और दाइयों को हमारे बर्थ पूल बहुत पसंद आते हैं क्योंकि ये बेहद आरामदायक, व्यावहारिक और प्रयोग में आसान हैं।

अस्पताल हमारे पूल इसलिए ख़रीदते हैं क्योंकि ये बेहतरीन प्रदर्शन, बेजोड़ सुरक्षा और बेमिसाल महत्व प्रदान करते हैं।

हमने लगातार नए परिवर्तन करके, चीज़ों को सरल बनाये रखकर और हमारे सुरक्षा, मूल्य और प्रदर्शन के मूलभूत सिद्धांतों पर ध्यान केंद्रित करके सफलता हासिल की है।

हमारा बेजोड़ ज्ञान और अनुभव का ख़ज़ाना हमें ऐसे वॉटर बर्थ पूल प्रदान करने में समर्थ करता है, जो जोखिम कम करते हैं, परिणामों को अनुकूल बनाते हैं और महत्व बढ़ाते हैं।

निर्णायकों ने कहा कि, “साक्ष्य-आधारित, प्रयोगकर्ता पर केंद्रित, सुविधाजनक डिज़ाइन, विशेषीकृत सामग्रियों और
शानदार निर्माण के संयोजन के परिणामस्वरूप वॉटर बर्थ पूल की शुरुआत हुई थी
, जो अपने आपमें बेमिसाल थे।”

सक्रिय बर्थ पूलों को ऑर्डर करने पर इंग्लैंड के बेहद कुशल कारीगरों द्वारा बनाया जाता है और दुनिया भर में भेजा जाता है।

ये Ficore® नामक मालिकाना सामग्री से निर्मित किये जाते हैं, जो असाधारण गुणों वाला कम्पोज़िट रेज़िन है।

इस छोटे से साधारण वीडियो को यूट्यूब पर लगभग 12,000,000 बार देखा गया है।
यह दिखाता है कि कैसे मायें हमारे पूल से सहज रूप से जुड़ जाती हैं और सबसे सहज व लाभदायक
स्थितियों का पता लगाने के लिए स्वाभाविक तरीके से जगह बदलती हैं।

यदि आप वॉटर बर्थ पूल की तलाश में हैं तो हम विशेष रूप से आपको सेवा प्रदान करने के योग्य हैं।

इसका कारण जानें।

वॉटर बर्थ या वॉटर बर्थ सुविधा सेटअप करने के बारे में ज़्यादा जानना चाहते हैं?

हमारे शैक्षिक केंद्र पर जाएं।




Vesisynnytysaltaiden muotoilun ja kehityksen huippu

Palkitut sairaalatason vesisynnytysaltaat ovat olleet markkinajohtaja yli 35 vuoden ajan!

Ne tarjoavat verratonta hygieniaa ja turvallisuutta, voittamatonta arvoa, parempia tuloksia sekä ylivoimaista suorituskykyä.

Altaat valmistetaan käsin tilaustyönä Englannissa, joten ne kestävät vuosikymmeniä ja niillä on elinikäinen takuu.

Vesisynnytysaltaiden muotoilun ja kehityksen huippu.
Ennennäkemätön yhdistelmä suunnittelua, materiaaleja ja valmistusta” Building Better Healthcare Awards

Autoimme mullistamaan veden käytön synnytyksessä suunnittelemalla altaita, jotka mahdollistivat tämän äitiyshoidon vallankumouksen.

Vuodesta 1987 lähtien olemme toimittaneet tuhansia synnytysaltaita sairaaloihin ympäri maailmaa ja meillä on vahva laadun ja palvelun maine.

Äidit ja kätilöt rakastavat vesisynnytysaltaitamme, koska ne ovat erittäin mukavia, käytännöllisiä ja helppokäyttöisiä.

Sairaalat ostavat altaitamme, koska ne tarjoavat erinomaista suoriutumista, verratonta turvallisuutta ja voittamatonta arvoa.

Olemme saavuttaneet menestystä jatkuvalla innovaatiolla, pitämällä asiat yksinkertaisina ja keskittymällä turvallisuuden, arvon ja suorituskyvyn periaatteisiin.

Verraton tietämyksemme ja kokemuksemme auttavat meitä toimittamaan vesisynnytysaltaita, jotka minimoivat riskejä, optimoivat tuloksia ja maksimoivat arvoa.

Tuomarit sanoivat: “Todisteiseen perustuvan, käyttäjäkeskeisen, ergonomisen muotoilun, erikoismateriaalien
ja räätälöidyn valmistuksen yhdistelmä on johtanut täysin uuteen synnytysaltaiden luokkaan”

Active Birth Pools -synnytysaltaat ovat erittäin taitavien käsityöläisten tilaustyönä valmistamia Englannissa ja niitä toimitetaan maailmanlaajuisesti.

Altaat valmistetaan patentoidusta Ficore®-komposiittihartsimateriaalista, jolla on poikkeukselliset ominaisuudet.

Tämä lyhyt ja yksinkertainen video on saanut lähes 12 miljoonaa katselukertaa YouTubessa.
Siinä näytetään kuinka äidit vaistomaisesti sopeutuvat altaisiimme
ja liikkuvat luonnollisesti löytääkseen mukavimmat ja hyödyllisimmät asennot.

Jos etsit vesisynnytysallasta, olemme ainutlaatuisen päteviä tehtävään.
Selvitä siihen syy.

Haluatko oppia lisää vesisynnytyksestä tai miten asentaa vesisynnytyslaitos?
Käy koulutuskeskuksessamme.



Den främsta designen och utvecklingen av pooler för vattenförlossning

Våra prisbelönta förlossningspooler av sjukhuskvalitet har varit bäst på marknaden i över 35 år!

De ger oöverträffad hygien och säkerhet, oslagbart värde, bättre resultat och överlägsen prestanda.

De tillverkas för hand på beställning i England, är byggda för att hålla i årtionden och har en livstidsgaranti.

“Den främsta designen och utvecklingen av pooler för vattenförlossning.
En oöverträffad kombination av design, material och tillverkning.”
Utmärkelser för att bygga bättre hälsovård

Vi hjälpte till att vara pionjärer inom vattenförlossning genom att konstruera de pooler som möjliggjorde denna revolution inom förlossningsvården.

Sedan 1987 har vi levererat tusentals förlossningspooler till sjukhus runt om i världen och skapat oss ett gott rykte för kvalitet och service.

Mödrar och barnmorskor älskar våra förlossningspooler eftersom de är otroligt bekväma, praktiska och lätta att använda.

Sjukhusen köper våra pooler för att de ger överlägsen prestanda, oöverträffad säkerhet och oslagbart värde.

Vi har nått framgång genom att ständigt förnya oss, hålla saker och ting enkla och fokusera på våra kärnprinciper om säkerhet, värde och prestanda.

Vår oöverträffade kunskap och erfarenhet gör det möjligt för oss att erbjuda förlossningspooler som minimerar riskerna, optimerar resultaten och maximerar värdet.

Domarna ansåg att “kombinationen av evidensbaserad, användarcentrerad, ergonomisk design, specialiserade material och skräddarsydd tillverkning. hade resulterat i förlossningspooler som verkligen var i en klass för sig.”

Active Birth Pools är handgjorda på beställning av skickliga hantverkare i England och levereras över hela världen.

De tillverkas i ett patenterat material som kallas Ficore®, ett kompositharts med extraordinära egenskaper.

Denna korta, enkla video har fått nästan 12 000 000 visningar på YouTube. Den visar hur mödrar instinktivt förhåller
sig till våra pooler och rör sig naturligt för att hitta de mest bekväma och fördelaktiga positionerna.

Om du letar efter en förlossningspool är vi unikt kvalificerade för att hjälpa dig.
Ta reda på varför.

Vill du veta mer om vattenförlossning eller hur du kan inrätta en anläggning för vattenförlossning?
Besök vårt utbildningscenter.


Toppen af design og udvikling af vandfødselsbassiner

I mere end 35 år har vores prestigefyldte hospitalsbaserede vandfødselsbassiner domineret industrien!

De tilbyder uovertruffen renlighed, sikkerhed og værdi, samt bedre resultater og overlegen ydeevne.

De er håndlavede på bestilling i England, designet til at holde i årtier og kommer med livstidsgaranti.

“Toppen af design og udvikling af vandfødselsbassiner.
En uforlignelig kombination af design, materialer og fremstilling” 

Building Better Healthcare Awards

Ved at skabe de bassiner, der muliggjorde denne revolution inden for barselspleje, bidrog vi til udviklingen af brugen af vand under fødsel og fødsel.

Siden 1987 har vi forsynet hospitaler over hele verden med tusindvis af fødselskar, hvilket har opnået et ry for at være fremragende inden for både produkt og service.

Vores vandfødselsbassiner er en favorit blandt mødre og jordemødre, fordi de er så hyggelige, nyttige og nemme at bruge.

Vores pools er udvalgt af hospitaler, fordi de tilbyder uovertruffen ydeevne, uovertruffen sikkerhed og uovertruffen værdi.

Ved konsekvent at innovere, holde tingene ligetil og koncentrere sig om vores vejledende principper om sikkerhed, værdi og ydeevne, har vi fundet succes.

Vores uovertrufne viden og væld af erfaring gør os til at levere vandfødselsbassiner, der minimerer risikoen, optimerer resultater og maksimerer værdien.

Dommerne sagde, at “Kombinationen af bevisbaseret, brugercentreret, ergonomisk design, specialiserede
materialer og skræddersyet fremstilling havde resulteret i vandfødselsbassiner, der virkelig var i en klasse for sig”

Aktive fødselspools er håndlavet på bestilling af højt kvalificerede håndværkere i England og sendes til hele verden.

De er fremstillet i et proprietært materiale kaldet Ficore®, en kompositharpiks med ekstraordinære egenskaber.

Denne korte, enkle video har fået tæt på 12.000.000 visninger på YouTube.

Det viser, hvordan mødre forholder sig instinktivt til vores pools og bevæger sig naturligt for at finde de mest behagelige og gavnlige stillinger.

Hvis du leder efter en vandfødselsbassin, er vi unikt kvalificeret til at stå til rådighed.
Find ud af hvorfor.

Interesseret i at finde ud af mere om vandfødsel, eller hvordan man opretter en vandfødselsfacilitet?
Besøg vores uddannelsescenter.




L’apice del design e dello sviluppo delle piscine per il parto

Le nostre piscine premiate per il parto in acqua di livello ospedaliero sono le migliori sul mercato da oltre 35 anni!

Garantiscono igiene e sicurezza senza pari, un valore imbattile, risultati migliori e una performance superiore.

Sono fatte a mano su ordinazione in Inghilterra, costruite per durare decenni e garantite per tutta la vita.

“L’apice del design e dello sviluppo delle piscine per il parto.
Una combinazione senza pari di design, materiali e produzione”
Building Better Healthcare Awards

Siamo stati fra i pionieri nell’uso dell’acqua per il travaglio e il parto progettando le piscine che hanno reso possibile questa rivoluzione nell’assistenza alla maternità.

Dal 1987 abbiamo fornito migliaia di piscine per il travaglio agli ospedali di tutto il mondo e ci siamo costruiti una reputazione per la nostra qualità e il nostro servizio.

Madri e ostetriche amano le nostre vasche per il parto in acqua perché sono incredibilmente comode, pratiche e facili da usare.

Gli ospedali comprano le nostre vasche perché garantiscono una performance superiore, una sicurezza senza pari e un valore imbattibile.

Abbiamo ottenuto il successo continuando a innovarci, tenendo le cose semplici e concentrandoci sui nostri principi fondamentali: sicurezza, valore e performance.

La nostra conoscenza senza pari e la grande esperienza ci consentono di fornire vasche per il parto che riducono i rischi, ottimizzano i risultati e massimizzano il valore.

I giudici hanno detto che “La combinazione del design basato sugli studi, incentrato sull’utente ed ergonomico, dei materiali specialistici e della produzione su misura è risultata in piscine da parto di livello superiore”

Le Active Birth Pools sono fatte a mano su ordinazione da artigiani esperti in Inghilterra e vengono spedite in tutto il mondo.

Sono prodotte con un materiale proprietario chiamato Ficore®, una resina composita con proprietà straordinarie.


Questo breve e semplice video ha ottenuto quasi 12.000.000 di visualizzazioni su YouTube.
Mostra come le madri si trovino istintivamente a loro agio nelle nostre piscine e si muovano naturalmente per trovare le posizioni più comode e benefiche.

Se stai cercando una piscina da travaglio, abbiamo delle qualifiche uniche per esserti d’aiuto.
Scopri il perché.

Vorresti scoprire di più sul parto in acqua o su come prepararti per un parto in acqua?
Visita il nostro Centro Educativo.


Het summum van ontwerp en ontwikkeling van een bevallingsbad

Onze bekroonde bevallingsbaden van ziekenhuiskwaliteit zijn al meer dan 35 jaar de allerbeste op de markt!
Ze zijn hygiënisch en veilig, bieden een onovertroffen waarde, betere resultaten en superieure prestaties.
Ze worden in Engeland op bestelling met de hand gemaakt en zijn gebouwd om niet jaren maar een leven lang mee te gaan.

“Het summum van ontwerp en ontwikkeling van een bevallingsbad.

De perfecte combinatie van ontwerp, materialen en fabricage” 
Building Better Healthcare Awards

Wij hielpen bij de eerste ontwikkelingen van het gebruik van water bij een bevalling en een geboorte. Door speciale bevalbaden te ontwerpen, kwam deze revolutie in de kraamzorg op gang.

Sinds 1987 hebben we al duizenden bevallingsbaden aan ziekenhuizen over de hele wereld geleverd en hebben we op het gebied van kwaliteit en service een geweldige reputatie opgebouwd.

Moeders, verloskundigen en vroedvrouwen zijn dol op onze bevallingsbaden omdat ze ongelooflijk comfortabel, praktisch en gebruiksvriendelijk zijn.

Ziekenhuizen kopen onze bevalbaden omdat ze superieur presteren, ongeëvenaard veilig zijn en een onovertroffen waarde leveren.

We hebben succes geboekt door voortdurend te innoveren, de zaken eenvoudig te houden en ons te concentreren op onze kernprincipes: veiligheid, waarde en prestaties.

Onze ongeëvenaarde kennis en schat aan ervaring stellen ons in staat om bevalbaden te bieden, die de risico’s minimaliseren, de resultaten optimaliseren en de waarde maximaliseren.

Het oordeel van de jury was dat “de combinatie van een op bewijs gebaseerd, gebruikersgericht, ergonomisch ontwerp, gespecialiseerde materialen en de op maat gemaakte fabricage heeft geresulteerd in bevalbaden, die echt een klasse apart zijn”

Active Birth Pools worden op bestelling door zeer bekwame vakmensen in Engeland met de hand gemaakt en wereldwijd verzonden.

Ze worden vervaardigd van een gepatenteerd materiaal Ficore® genaamd, wat een composiethars is met buitengewone eigenschappen.

Deze korte, eenvoudige video is al bijna 12.000.000 keer op YouTube bekeken.

Het laat duidelijk zien hoe instinctief het lichaam van de moeder doet wat het moet doen en natuurlijk beweegt om de meest comfortabele en voordelige posities te kunnen vinden.

Als je op zoek bent naar een gekwalificeerd waterbevallingsbad, zijn onze bevalbaden perfect om je van dienst te zijn.

Ontdek hier waarom.

Wil je graag meer weten over een waterbevalling of het opzetten van een voorziening voor een bevallingsbad?

Bezoek ons Educatief Centrum.



ذروة تصميم حوض الولادة وتطويره

احتلت أحواض الولادة -في المستشفيات الحائزة على جوائز- المرتبة الأولى في السوق لأكثر من 35 عامًا!

فهي توفر نظافة وأمان لا مثيل لهما ، وقيمة لا تضاهى ، ونتائج أفضل وأداء متفوق.

يتم تصنيعها يدويًا حسب الطلب في إنجلترا ، وتم إنشاؤها لتستمر لعقود ومضمونة مدى الحياة.

” ذروة تصميم حوض الولادة وتطويره.
مزيج لا يضاهى من التصميم والخامات والتصنيع ”
يسمح بجوائز رعاية صحية أفضل


لقد ساعدنا في الريادة في استخدام المياه في الولادة من خلال تصميم أحواض المياة التي جعلت هذه الثورة في رعاية الأمهات ممكنة.
لقد قمنا بتزويد المستشفيات حول العالم بالآلاف من أحواض الولادة منذ عام 1987 ، وأرسينا سمعة طيبة من حيث الجودة والخدمة.

تحب الأمهات والدايات أحواض الولادة لدينا لأنها مريحة بشكل لا يصدق وعملية وسهلة الاستخدام.

تشتري المستشفيات أحواض الولادة الخاصة بنا لأنها تقدم أداءً فائقًا وأمانًا لا مثيل له وقيمة لا تضاهى.

لقد حققنا النجاح من خلال الابتكار المستمر ، والحفاظ على الأشياء بسيطة والتركيز على مبادئنا الأساسية للسلامة والقيمة والأداء.

تمكننا معرفتنا وخبراتنا التي لا مثيل لها من توفير أحواض ولادة تقلل المخاطر وتحسن النتائج وتعظم القيمة.

قال الحكام: “أدى الجمع بين التصميم المتقن والمريح المرتكز على المستخدم والمواد الخام المصنعة منها حسب الطلب إلى إنتاج أحواض ولادة حقاً راقية في حد ذاتها”

أحواض الولادة مصنوعة يدويًا بواسطة حرفيين ذوي مهارات عالية في إنجلترا. يمكن طلبها و شحنها إلى جميع أنحاء العالم.

يتم تصنيعها من خامات ذو خصائص غير عادية تسمى Ficore® ، وهو مركب من عناصر مختلفة مدمجة كيميائياً تعالج بالحرارة.

حصد هذا الفيديو القصير والبسيط ما يقرب من 12.000.000 مشاهدة على يوتيوب.

إنه يوضح كيف ترتبط الأمهات بشكل غريزي بأحواضنا ويستخدمونه للحصول على موضع أكثر راحة وفائدة.

إذا كنت تبحث عن حوض ولادة مائي ، فنحن مؤهلون بشكل فريد لتقديم الخدمة.

اعرف لماذا.

هل أنت مهتم بمعرفة المزيد عن الولادة في الأحواض المائية أو كيفية إنشاء مرفق للولادة في الماء؟

قم بزيارة مركزنا التعليمي.

Der Höhepunkt der Entwicklung und des Designs von Wassergeburtsbecken

Unsere preisgekrönten Wasserentbindungsbecken in Krankenhausqualität sind seit über 35 Jahren Marktführer!

Sie bieten unvergleichliche Hygiene und Sicherheit, ein unschlagbares Preis-Leistungs-Verhältnis, bessere Ergebnisse und überlegene Leistung.

Sie werden auf Bestellung in England von Hand gefertigt, sind für Jahrzehnte konzipiert und haben eine lebenslange Garantie.

“Der Höhepunkt der Entwicklung und des Designs von Wassergeburtsbecken.

Eine unvergleichliche Kombination von Design, Materialien und Herstellung” 
Building Better Healthcare Awards


Wir waren Wegbereiter für den Einsatz von Wasser bei Wehen und Geburten, indem wir Becken entwarfen, die diese Revolution in der Geburtshilfe erst möglich machten.

Seit 1987 haben wir Tausende von Entbindungsbecken an Krankenhäuser in aller Welt geliefert und uns einen guten Ruf für Qualität und Service erworben.

Mütter und Hebammen lieben unsere Wassergeburtsbäder, weil sie unglaublich bequem, praktisch und einfach zu bedienen sind.

Krankenhäuser kaufen unsere Becken, da sie überragende Leistung, unvergleichliche Sicherheit und einen unschlagbaren Wert bieten.

Wir sind erfolgreich, da wir stets innovativ bleiben, die Dinge einfach halten und uns auf unsere Kernprinzipien Sicherheit, Wert und Leistung besinnen.

Unser unübertroffenes Wissen und unser Erfahrungsschatz ermöglichen es uns, Wassergeburtsbecken anzubieten, die das Risiko minimieren, die Ergebnisse optimieren und den Wert maximieren.

Die Preisrichter sagten: “Die Kombination aus evidenzbasiertem, nutzerzentriertem, ergonomischem Design, speziellen Materialien und maßgeschneiderter Fertigung hat zu einem Wassergeburtsbecken geführt, das wirklich eine Klasse für sich darstellt.

Geburtsbecken werden auf Bestellung von hochqualifizierten Handwerkern in England handgefertigt und in die ganze Welt verschickt.

Sie werden aus dem firmeneigenen Material Ficore® hergestellt, einem Kompositharz mit außergewöhnlichen Eigenschaften.

Dieses kurze, einfache Video wurde auf YouTube bereits fast 12.000.000 Mal aufgerufen.

Es zeigt, wie Mütter instinktiv mit unseren Becken umgehen und sich natürlich bewegen, um die bequemsten und vorteilhaftesten Positionen zu finden.


Wenn Sie auf der Suche nach einem Wassergeburtsbecken sind, sind wir besonders qualifiziert, Ihnen zu helfen.
Finden Sie heraus, warum.

Möchten Sie mehr über Wassergeburten erfahren oder wissen, wie Sie eine Wassergeburtsstation einrichten können?
Besuchen Sie unser Bildungszentrum.


Le summum de la conception et du développement de la baignoire de naissance

Nos piscines d’accouchement de qualité hospitalière, primées, sont en tête du marché depuis plus de 35 ans !

Elles offrent une hygiène et une sécurité inégalées, un rapport qualité-prix imbattable, de meilleurs résultats et des performances supérieures.

Elles sont fabriquées à la main sur commande en Angleterre, construites pour durer des décennies et garanties à vie.

“Le summum de la conception et du développement de la baignoire de naissance. Une combinaison incomparable de design, de matériaux et de fabrication” Building Better Healthcare Awards

Nous avons été les premiers à utiliser l’eau pour le travail et l’accouchement en concevant les piscines qui ont permis cette révolution dans les soins de maternité.

Depuis 1987, nous avons fourni des milliers de piscines de naissance à des hôpitaux partout dans le monde et avons acquis une réputation de qualité et de service.

Les mères et les sages-femmes adorent nos baignoires d’accouchement, car elles sont incroyablement confortables, pratiques et faciles à utiliser.

Les hôpitaux achètent nos piscines parce qu’elles offrent des performances supérieures, une sécurité inégalée et une valeur imbattable.

Nous avons réussi en innovant continuellement, en gardant les choses simples et en nous concentrant sur nos principes fondamentaux de sécurité, de valeur et de performance.

Nos connaissances inégalées et la richesse de notre expérience nous permettent de réaliser des piscines de naissance dans l’eau qui minimisent les risques, optimisent les résultats et maximisent la valeur.

“Les membres du jury ont déclaré que la combinaison d’une conception ergonomique fondée sur des données probantes et centrée sur l’utilisateur, de matériaux spécialisés et d’une fabrication sur mesure a permis de créer des piscines d’accouchement dans l’eau qui sont vraiment uniques en leur genre .”

Les baignoires d’accouchement Active sont fabriquées à la main sur commande par des artisans hautement qualifiés en Angleterre et expédiées dans le monde entier.

Elles sont fabriquées dans un matériau exclusif appelé Ficore®, une résine composite aux propriétés extraordinaires.


Cette vidéo courte et simple a été vue près de 12 millions de fois sur YouTube.

Elle montre comment les mères établissent un lien instinctif avec nos baignoires et se déplacent naturellement pour trouver les positions les plus confortables et bénéfiques.

Si vous recherchez d’une piscine d’accouchement, nous sommes particulièrement qualifiés pour vous aider.
Découvrez pourquoi.

Vous souhaitez en savoir plus sur l’accouchement dans l’eau ou sur la manière de créer une installation d’accouchement dans l’eau?
Visitez notre centre éducatif.

Reasons to consider a water birth

Bridge to Health –  Sian Smith

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

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

Here are some of the reasons why:

Water is relaxing!

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

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

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

Water is a natural pain reliever

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

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

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

It reduces stress and anxiety

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

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

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

It reduces the risk of perineal tearing

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

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

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

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

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

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


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

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

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

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

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

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

It is safe!

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

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

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

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

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

The benefits of labouring in water for overweight and obese mothers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Birth under water – Michel Odent

Michel Odent’s groundbreaking report “Birth Under Water” that was published in the Lancet in December 1983 is widely regarded as the seminal moment in time when the use of water for labour and birth entered our consciousness.

I’d personally like to thank Michel for being the inspiration that led me to begin to create and develop water birth pools in 1987 and for facilitating the birth of my son Theo at home in 1988.

Keith Brainin – Founder & Director Active Birth Pools

Birth under water – Michel Odent

Originally published in the Lancet: 1983

Centre Hospitalier Général de Pithiviers, PIthiviers 45300, France

The 100th birth under water in our hospital in June provided my team with an opportunity to summarise our experience of the use of water in an obstetric unit.

Since a report on birth under water in 1805,1 the subject has been rarely broached in the medical literature.

In Pithiviers, a hospital which is, in other respects, a conventional state hospital,2 a small pool has been installed close to the homely birthing room.

This pool is large enough (2m in diameter) and deep enough (about 0.7m) to make it easy for a woman in it to change her posture.

Many parturients feel and irresistible attraction to water. We don’t advise women to try the pool; we simply offer the pool as a possibility.

The water is ordinary mains tap water, at a temperature of 37 °C. The water is not sterilized, and contains no chemicals or additives on any sort.

We tend to reserve the pool for women who are experiencing especially painful contractions (lumbar pains, in particular), and where the dilation of the cervix is not progressing beyond about 5cm. In these circumstances, there is commonly a strong demand for drugs.

In most cases, the cervix becomes fully dilated within 1 or 2 hours of immersion in the pool, especially if the lights are dimmed.

It is possible to check the fetal heartbeat regularly with a small ultrasound stethoscope or with a traditional obstetrical stethoscope. Most women choose to leave the water in the second stage.

We believe that the warm pool facilitates the first stage of labour because of the reduction of the secretion of nor-adrenaline and other catecholamines; the reduction of sensory stimulation when the ears are under water; the reduction of the effects of gravity; the alteration of nervous conduction; the direct muscular stretching action; and peripheral vascular action.

Other factors, however, are difficult to rationalise. We have found, for example, that the mere sight of water and the sound of it filling the pool are sometimes sufficient stimuli to release inhibitions so that a birth may occur before the pool is full.

We have observed that water seems to help many parturients reach a certain state of consciousness where they become indifferent to what is going on around them.

Although nearly all the women who enter the pool leave it before birth, the process of delivery can sometimes be so extraordinarily fast under water, that some parturients do not leave the pool at the second stage.

Birth under water is therefore not exceptional in our unit, although it may not be intentional. During the second stage, immersion in warm water seems to help women to lose inhibitions. Most women cry out freely during the last contractions.

When the birth happens under water, the newborn infant is brought gently to the surface and placed in the mother’s arms. This is always done within seconds but without rushing (I am present at the pool for every underwater delivery).

Our experience confirms that the newborn’s first breathing is triggered by contact with the air and the sudden difference in temperature.

There is no risk of inhalation of water. It is useful to remember that in the human species carotid chemoreceptors are thought to be insensitive at birth, and very likely play no part at the time of the first cry. 3,4,5 Only 2 newborn infants out of 100 needed suction of the upper respiratory tract and a short period of manual ventilatory support.

At the time of first contact, most mothers are in a vertical position, kneeling in the water.  They hold the baby in their arms in such a way that skin-to-skin and eye-to-eye contact are as perfect as possible.

An early demonstration of the rooting reflex is almost the rule, and a first sucking 20 min after the birth is common.

Water seems to facilitate the development of the mother-infant relationship. We cut the umbilical cord and help the mother leave the pool just before expulsion of the placenta.

We consider that there might be a risk of water embolism if the mother were to stay in the pool after this time. In 100 underwater deliveries there were 2 manual removals of placenta (our general rate is less than 1%).

All the presentations were cephalic. In breech presentations, our strategy is to use the first stage as a test before deciding on either a vaginal delivery or a caesarian section: in these cases we prefer not to interfere with drugs or with a bath.

Among the 100 women who gave birth underwater, there were 43 primipara, 37 secundiparas, 14 para 3, 2 para 4, one para 5, one para 6, and one para 7.

The youngest was 19 and the oldest was 43. The average age was 28. The lowest birth weight was 2.15kg and the highest was 4.40 kg, we did not perform any episiotomies.

All the tears (of which there were 29) were first degree. We had no infectious complications, even where the membranes were already broken.

There were no perinatal deaths. One infant was transferred to a paediatric unit one day after the birth with groaning and respiratory failure, symptoms which were diagnosed as subarachnoid haemorrhage after delivery in the posterior position at 37 weeks.

Only one infant was jaundiced and required phototherapy (15mg/dl bilirubin on the second day). One of the infants born under water died suddenly some weeks later, although it was previously considered to be perfectly healthy.

We have found no risk attached either to labour or to birth under water, and in any hospital where a pool is in daily use, a birth under water is bound to happen now and then.

Compared with the supported squatting position in the birthing room, we have found that the end of the second stage of labour can be more difficult under water, particularly for primipara, but immersion during the second half of the first stage of labour is helpful, particularly for parturients having painful and insufficient contractions.

It should be possible for any conventional hospital to have a pool situated close to the birthing room and operating theatre.

The use of warm water during labour requires further research, but we hope that other experience would confirm that immersion in warm water is an efficient, easy, and economical way to reduce the use of drugs and the rate of intervention in parturition.



1. Embry M. Observation sur un accouchement terminé dans le bain. Ann Soc Méd Prat Montpellier 1805; 5: 13.

2. Gillett J. Chilbirth in Pithiviers, France. Lancet 1979; ii: 894-96.

3. Girard F, Lacaisse A, Dejours P. Lestimulus O 2 ventilatoire à la période néonatale chez l’homme. J Physiol (Paris) 1960; 52: 108-09.

4.  Purves MJ. The effects of hypoxia in the newborn lamb before and after denervation of the carotid chemoreceptors. J Physiol 1966; 185: 60-77.

5.  Purves MJ. Chemoreceptors and their reflexes with special reference to the fetus and newborn. J Devl Physiol 1981;  3: 21-57.


Sheila Kitzinger – Birth in Water: Just a Fad?

Originally published December 11, 2014

World-renowned social anthropologist and birth activist Sheila Kitzinger (1929-2015) was a strong advocate for birth in water, known as waterbirth.

A voice for the ability for every woman to choose, Sheila believed that waterbirth should be an option in mainstream maternity care.

May0042569. Daily Telegraph. Childbirth Guru Sheila Kitzinger for DT Weekend. Picture shows Sheila Kitzinger MBE, she is an author and social anthropologist specialising in pregnancy, childbirth and the parenting of babies and young children. Picture taken in her bedroom, she does most of her writing in her four poster bed. Location Standlake, Oxfordshire. Picture date 27/09/2012

In this piece for Birth Institute, Sheila outlined some of the myths surrounding the birth method, and provides evidence that, in fact, waterbirth is a safe, effective and empowering birthing option.

Learn how to support women through labor and delivery in water. Become a midwife!

Waterbirth is often discussed as if it were a novelty – and a dangerous one at that. It has been assumed to be something that “dropouts” and “weirdoes” choose, or that it is just a recent, passing phenomenon.

In truth, birthing in water is a safe and widespread practice among hospitals in the UK and Western Europe – including Switzerland, Italy, Spain, Portugal, Malta, Denmark, Norway and Finland.

Furthermore, most practices aren’t as new as we think (the Ostend Aquanatal Centre in Belgium has been going strong since the late 80s), and waterbirth practices are here to stay.

Birth in water is safe and effective

Swiss study reveals that when using a pool women require less analgesia, have a lower incidence of perineal trauma, and reduced blood loss at delivery.

NICE (National Institute for Health and Care Excellence) concludes that waterbirth ‘provides the safest form of pain relief’.

There is evidence that being in water improves uterine contractility and speeds dilatation.  So, awoman giving birth in water is less exposed to interventions, including artificial augmentation of uterine activity, and is more likely to feel happy about her birth experience afterwards.

Yet that may not only be due to the water.  Labouring women who give birth in water have more one-to-one care from a midwife they have come to know.

This, combined with a relaxed environment in which the pool is used, contributes to the positive results. More first time mothers have spontaneous births in a freestanding midwifery center or at home than those in hospital.

In the UK, the NHS (National Health Service) states that women should be able to use a pool if they wish, and recommends one be available for every thousand women.

This option has become part of mainstream maternity care, and approximately 75% of all hospitals in the UK have installed birthing tubs.

Many community midwives are eager to raise the homebirth rate, and portable pools, designed to be used by just one woman (to avoid cross-infection), are selling well.

Complicated waterbirthing pools are not necessary.

Chairs, stools and other contraptions restrict movement, and when a woman is immobilized she is more likely to need obstetric intervention.

Francoise Freedman of Birthlight in Cambridge suggests using a pool at home to explore yoga movements during pregnancy.

These include hip-openers, kneeling stretches, and those to prevent and ease back pain, and others for ribcage expansion and pelvic floor toning.

The warm water acting as a cushion also makes a comfortable space to practice perineal massage.

Waterbirth is here to stay

Midwives keen on home birth and waterbirth were once seen as dissidents and mavericks.

This has changed now – so much that in the UK, it is common to encourage women to choose to labour, and perhaps give birth, in water and in their own home.  Pregnant women and midwives are being empowered now.

Every midwife-run and staffed birth center for low risk women offers pools, and midwives are beginning to develop the skills to use them. There is a feast of research from which midwives can learn more.

Ethel Burns, Waterbirth Practitioner, Research Midwife and Midwifery Teacher, and I have drawn up recommendations for practice in a paper available from Oxford Brookes University (read it here).

Sheila Kitzinger (1929-2015) was a social anthropologist of birth and an advocate of home births.  She believed that women have the right to decide the place of birth and kind of care they prefer, and to make an informed choice, based on research and their own values.

Women suffering post-traumatic stress after birth would ring her for help, seeking the confidence to deal with it.  For years she worked with mothers and babies in prison and asylum centers.  She lectured all over the world and her books are published in 23 languages.

Exploring movements in Water

Sheila was a keen proponent of water birth.

Her wonderful article gives us examples of the type and range of movements natural to labour and birth that mothers explore in water.


The pool in the photos is an original Oval Portable Water Birth Pool circa 1987  – to my knowledge the first specially designed portable water birth pool ever produced.

Please click here for a copy of Exploring movements in water:

The case for the wide-spread development of water birth facilities

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 economic impact

Studies have shown that women who are supported during labour need to have fewer painkillers, experience fewer interventions and give birth to stronger  babies.

A focus on normalising birth results in better quality, safer care for mothers and their babies with an improved experience.

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

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

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

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

Psychologically speaking, and in particular for first time mothers, the less intervention and a more hands on approach with one-to-one support means that mothers will leave hospital feeling held and therefore far better prepared for motherhood.

This again has a domino effect, not just on the welfare of the infant, but also circumventing the need for costly government and interventionist approaches in particular for younger mothers post-partum.

The experience of hospitals that have birth pools demonstrates the savings  achieved through reduced use of medical methods of pain relief and shorter hospital stays.


Birth of the water baby – Michel Odent

In 1977, a state hospital near Paris began quietly changing the way women gave birth.

Obstetrician Dr Michel Odent believed that childbirth had become too medicalised and he wanted a more natural approach.

So he introduced a pool to ease the pain of labour and eventually some babies were even born in the pool.

Witness speaks to Dr Odent about the innovation that has become a revolution using the power of water.

Watch the video – Birth of the water baby



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

Since 1987 we’ve supplied thousands of birthing tubs to hospitals around the world and established a reputation for quality and service.

Mothers and midwives love our water birth pools because they are incredibly comfortable, practical and easy to use.

Hospitals buy our pools because they deliver superior performance, unparalleled safety and unbeatable value.

We’ve achieved success by continuously innovating, keeping things simple and focusing on our core principles of safety, value and performance.

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

The judges said that, “The combination of evidence based, user-centred, ergonomic design, specialised materials and bespoke manufacturing had resulted in water birth pools that were truly in a class of their own”

Active Birth Pools are handmade to order by highly skilled craftsmen in England and shipped world-wide.

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Water Birth Pools: The economic reality and impact

I wrote this article a few years ago.

It seems particularly relevant now.

Recent news has highlighted the restrictive financial environment that maternity units will be expected to operate in.

Yet, at the same time midwives are charged with the important task of improving the quality of care and services.

David Cameron has said, “The whole aim of these NHS reforms is to make sure we get the value for the money we put in.”[1]

In the same article, Stephen Dorrell, former Health Secretary commented that, “In real terms, the NHS budget was being broadly maintained, but we’re having to find ways of doing more with the same amount of money.”[2]

The only way of improving maternity services is by optimising facilities, saving money wherever practical and normalising childbirth to a far greater extent.

Studies have shown that women who are supported during labour need to have fewer painkillers, experience fewer interventions and give birth to stronger babies.

After their babies are born, supported women feel better about themselves, their labour and their babies.

A focus on normalising birth results in better quality, safer care for mothers and their babies with an improved experience.

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

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

These changes benefit not only women and their families but also maternity staff.  Midwives are able to spend less time on non-clinical tasks and more on caring for women and their babies.

Psychologically speaking, and in particular for first time mothers, the less intervention and a more hands on approach with one-to-one support means that mothers will leave hospital feeling held and therefore far better prepared for motherhood.

This again has a domino effect, not just on the welfare of the infant, but also circumventing the need for costly government and LA interventionist approaches in particular for younger mothers post-partum.

What increases the likelihood of normal births?

It is also known that some factors help to facilitate straightforward birth without evidence of additional risks, including one-to-one support, immersion in water for low-risk women, planning for a home birth, care from known midwives, more extensive training of junior doctors, employment of consultant midwives focusing on normality, and support on the labour ward from consultant obstetricians[3].

How can midwives make a case for purchasing birth pools?

The need for more water birth facilities is evident.  The problem is that financial controllers are under pressure to save money.

They will not be easily convinced of the necessity unless you clearly stress that purchasing pools should not be viewed as a cost but rather to make the case that they are a valuable investment and will enable your unit to optimise resources, improve the quality of care and yield a return of significant financial savings.

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

The bed is no longer the primary focus of the room: having birth pools in hospitals and delivery suites facilitates pain relief encourages relaxation and therefore confidence and promotes mobility along with soft furnishings such as beanbags.

Importantly, this results in significant financial savings! 

Our cost study has revealed that savings of up to £700.00 per birth can be achieved.

For example, St Richards Hospital in Chichester has three of our birth pools as well as our soft furnishings.

They recently reported their first successful VBAC in the pool for a woman who had previously had twins by c-section.

Depending on complications, a c-section costs between £1,370 and £1,879 in contrast to a normal delivery that is usually between £735 and £1,097.[4]

The experience of hospitals that have birth pools demonstrates that the cost of installing a pool is soon recouped by the savings achieved through reduced use of medical methods of pain relief and shorter hospital stays.

Wherever possible, women should have the opportunity to labour in water, as this is often far more comfortable.

The NHS has advised hospitals to ensure facilities are in place for this: three pools for 1,000 births a year is seen as adequate provision[5].

[1] BBC: 19/01/11
[2] BBC 19/01/11 taken from BBC Radio 4 Today programme
[3] Hodnett ED, Gates S, Hofmeyr GJ, Sakala C.  Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub2
[4] NHS Institute, 2009
[5] NHS Guidelines on Childbirth 26 September 2007

The use of water for labour and birth

Health Times: Karen Keast

Water is a life force in more ways than one – it covers more than 70 per cent of our earth and we drink it to survive.

When it comes to using water for childbirth, water birth is still a contentious issue that divides healthcare professionals and organisations alike.

The fact that it’s contentious at all surprises some of Australia’s leading midwives, writes Karen Keast.

There are legends of Egyptian pharaohs being born in water and of South Pacific women giving birth in shallow seas.

The first written report of a water birth in the western world occurred in France in 1803, when a mother experiencing a long and difficult labour was helped to give birth in a tub of warm water.

In the 1970s, Igor Tjarkovsky, a boat builder, investigated the therapeutic benefits of water and installed a glass tank in his home for women to use for childbirth.

French obstetrician Michel Odent went on to pave the future of water birth.

After a mother, using water to ease the pain of her labour, accidentally gave birth in the water, he went on to install a plastic paddling pool in a hospital so more women could enjoy the benefits of water birth while reducing their need for painkillers.

Only a small proportion of women in Australia choose to give birth in water each year although the exact number of water births is not known.

Griffith University Professor Jenny Gamble, a practising midwife of 30 years, says water births have come a long way in Australia but there is still a long way to go.

Professor Gamble recalls when a new maternity wing opened up at a Brisbane hospital, the then director general who was touring the facility instructed the plugs from the tubs to be removed.

“In his own way, he was saying water births might be a bad thing,” she says.

“Those days are gone. Water has become more accessible to women. There’s quite a lot of evidence to say that water is safe for women.

“More and more hospitals are putting in big tubs and there’s a range of deep tubs. It’s coming but it’s all too slow.”

Advocates of water birth say its benefits include the relaxing effect of warm water and feelings of weightlessness, buoyancy and ease of movement which help to alleviate pain naturally.

Western Sydney University Professor Hannah Dahlen, a privately practising midwife and spokesperson for the Australian College of Midwives, says evidence shows water immersion may also help improve blood flow in the uterus, lower blood pressure, provide less painful contractions and result in shorter labours and fewer interventions.

Professor Dahlen last year published a study in the Journal of Midwifery examining the outcomes of 6144 Australian women who had normal vaginal births in a birth centre over a 12-year period.

Her research compared women giving birth in water with those who gave birth in six other positions out of the water – kneeling or all fours, squatting, side lying, using a birth stool, standing and, the most common birth position in the country – semi-seated.

Professor Dahlen found those who gave birth on a birth stool had almost a one-and-a-half time’s higher rate of major perineal trauma and more than twice the rate of haemorrhage after delivery compared with water birth.

There was no difference in major perineal trauma and haemorrhage after delivery between women who gave birth in water and those who had a semi-seated position.

While those babies born in a semi-seated position had a four-and-a-half time’s higher incidence of five minute APGAR scores less than seven.

APGAR scores, which rate the newborn’s breathing effort, heart rate, muscle tone, reflexes and skin colour, of less than seven at five minutes after birth indicate medical intervention was needed to resuscitate the baby.

“Some studies have shown better outcomes but basically I found no difference to other birth positions,” she says.

“There was no evidence of harm. We want to do more research in Australia.

“We have no evidence to date that it’s harmful but we need more and more evidence to show it’s safe.”

Professor Dahlen says a water birth also provides women with a sense of protected space.

“They talk about how they felt there was a barrier; they felt it was a cocoon where they could feel safe,” she says.

Professor Dahlen says one common concern about water births is that the baby could drown but she says babies are born with a diving reflex, or bradycardic response, that causes them to hold their breath under water.

Professor Dahlen says despite mounting evidence proving the benefits of water birth, they still remain contentious in Australia.

“I have never understood it. I find it fascinating that water is so scary.”

Professor Gamble agrees.

“We’re talking about water, just water – not epidurals, not heavy duty drugs,” she says.

“Thank goodness hospitals are moving towards increasing their remodelling of their maternity suites to include tubs but quite frankly it’s a lot of fuss for something as simple as warm water.”

Professor Gamble says water births are common practice at planned home births, and are used during labour or active birth.

“Some women want to get in and get out for birth, some want to labour in the water and some hop in just for the birth – anything goes.”

Perhaps, most importantly, Professor Dahlen says water births are not about the baby.

“That’s what people get wrong,” she says.

“It’s about the mother and if you have a really happy and relaxed and stress free mother you actually have a baby that’s advantaged – they are born and very placid.

“They don’t often cry – they come up and blink.

“They are breathing fine. They come up all lovely and warm and then go to their mother’s chest.

“I really love water births.”


The history of Water Birth

There have been accounts of women labouring and giving birth in water mostly amongst peoples living near a source of shallow warm water such as the South Pacific islanders.

In most traditional societies the rituals and practices of childbirth have, until recent times, been a matter of secrecy and handed down through generations of women.

There are oral traditions of similar practices among the Maori, the Indians of Central America, and the Ancient Greeks and Egyptians.

In 1805, the first account the use of water in Europe was documented.

A French woman, who had laboured for two days before being encouraged to get into a warm bath by her enlightened doctor then progressed to give birth to a healthy baby within an hour.

Sadly, for millions of women at the time there was no recognition of the importance of this event.

Aside from this, there are no accounts of a tradition of childbirth in water in Europe or other northerly regions.

The reason for this may be a simple matter of climate and plumbing.

Only with the widespread availability of artificially heated water and portable and installed birthing pools in comparatively recent times, has giving birth in water become a real option for women anywhere in the world.

Waterbirth was pioneered in the 1960’s by the Russian researcher Igor Tjarkovsky.

Using a large aquarium he installed a glass tank in his own home in Moscow in which many mothers gave birth .

Stunning photographs of these extraordinary births were published in the west and inspired the first water births.

For today’s generation of mothers, the key figure in the use of water for labour and birth is the French obstetrician Michel Odent.

In 1977 Odent installed a pool in the hospital at Pithiviers , not with the idea of promoting birth in water, but primarily as an additional option for pain relief and rest during long or difficult labours.

He has said ‘the reason for the birthing pool is not to have the baby born in water but to facilitate the birth process and to reduce the need for drugs and other interventions.’

Odent published his findings in the Lancet and his recommendations in this article provided the basis for the first midwifery guidelines for waterbirths.

Odent, M.  Birth under water.  The Lancet. December 24/31, 1983. pp 1476-1477

Inspired by news of what was happening in Moscow and France, the earliest waterbirths in the West took place at home in pools that were often improvised by the couples themselves and attended by independent midwives.

The parents created birthing pools using any large waterproof container they could find – including refuse skips, cattle troughs, inflatable paddling pools or garden ponds lined with a plastic sheet.

This happened simultaneously in several parts of the world and began to cause ripples in the world of obstetrics.

When reports and images of the first waterbirths were published, the world looked on in amazement.

The women who chose this way of birthing and their attendants were variously regarded as crazy, deluded, foolhardy or inspired.

The medical establishment rallied to condemn or at least call the practice into question, citing theoretical risks of infection and fears of the baby drowning.

Such fears have been largely appeased by the work of Dr Paul Johnson, neonatal physiologist at the John Radcliffe Hospital, Oxford.

His research on the mechanisms that trigger breathing in the newborn provided scientific confirmation of the safety of birth underwater at body temperature for babies who are not at risk.

He described how the baby is protected against the possibility of breathing while underwater in the few seconds between emerging from the birth canal and being lifted out of the water.

This response is known as the ‘dive reflex’.

Johnson, P.  Birth under water – to breathe or not to breathe. British Journal of Obstetrics and Gynaecology, vol 103, no 3, March 1996. pp 202-208

In 1999 Ruth E. Gilbert and Pat A. Tookey of the Institute of Child Health, London, published a hugely important study in the BMJ that effectively provided the ‘green light’ for labour and delivery in water.

It was a study of the outcomes for all babies born in water in the UK in a two-year period between 1994 and 1996.

A total of 4,032 waterbirths were included in the study (about 0.6 per cent of all deliveries).

All 1500 consultant paediatricians in the British Isles were asked if they knew of cases of perinatal death or admission to special care within 48 hours of labour or delivery in water.

The study showed that there was no increased risk to health for babies born in water as compared with babies born to other low-risk women on land.

Since then a burgeoning of interest in the use of water in labour in the UK has led to the development of a unique concentration of knowledge and expertise within the mainstream maternity system.

Positive encouragement to the use of water in labour and childbirth has come from the Royal College of Midwives, which recommends that midwives should develop the knowledge and skills to assist women at a waterbirth .

Water labour and birth is an option which is limited to ‘low risk’ women having an uncomplicated birth following a healthy pregnancy.

In the UK the issues of safe practice have been addressed by the health authorities, Royal College of Midwives, midwifery supervisors and one or two obstetricians.

A significant body of research studies and several important surveys have been undertaken.

Development has been more carefully and diligently monitored than many of the obstetric procedures that are widely used.

Against this backdrop, more of the managers of maternity services in the UK are increasingly being persuaded that the option of using water in labour and for birth should be available to all women.

The extent of the use of birth pools in the UK increased.

Pools are now used in hospitals as well as independent birth centres, some of which specialize in waterbirths, and in the community at home births with both independent and NHS midwives.

The Edgware Birth Centre in North London is an example of a new type of forward-thinking NHS birth unit.

Typically 70 per cent of women who give birth at the centre use water during labour and 50 per cent give birth in water.

Since it’s inception outcomes show far fewer interventions than for low-risk births at a conventional hospital birth unit.

This is a model of care which would transform our maternity services if widely adopted.

In October 2000 the UK’s Royal College of Midwives estimated that 50 per cent of maternity units provided facilities for labour or birth in water.

The usage of pool varied between 15 and 60 per cent, which may be an indicator of the significance of the role of the midwife in supporting and encouraging women to consider the use of water.

Since then the number of UK hospitals and birth centres with installed pools has risen to closer to 60 per cent.

However, that does not necessarily mean that the pools are being fully or enthusiastically utilized or that the pool is always available.

It’s not uncommon for women to be discouraged from using them or to be told that trained midwives are not available.

Sometimes stringent protocols around the use of a pool can limit it’s usefulness and frustrate both mothers and midwives.

Women who want to use a pool are often also told that this may not be possible if the pool is already in use.

It’s time for such problems to be addressed and for all women to have the possibility of using a birth pool wherever they choose to give birth.

Water birth is one of the greatest innovations in childbirth of our times and can no longer be regarded as a passing fad.

The use of epidurals today has reached epidemic proportions and contributes significantly to the high caesarean and intervention rate and is also very costly, requiring a high level of expert attendance.

The simple expedient of a pool of warm water is by now a proven way to confine the use of epidurals to those women who really need them and improve safety and quality of the birth experience.



Nothing helps mothers cope with pain in labour more effectively

Water birth pools play a vital role in helping mothers experience physiological labour and natural birth.

Nothing helps mothers cope with pain more effectively.

If mothers are not going be reliant on analgesia for pain relief they need other options.

Mothers who enter a pool of warm water in established labour find that they are better able to cope with the pain.

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

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 & optimise resources.

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 to consider making this safe, effective, low cost option more widely available.

On land mothers contend with the force of gravity which limits movement as labour progresses and they tire.

Many women do not have the fitness to maintain upright postures for lengths of time. (Gupta JK, Hofmeyr GJ, Smyth R 2007).

Mothers who are overweight or obese are often unable to cope with the physical demands.

The transition from the land to water helps revive & energise mothers giving them 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).

This allows her to move in ways not possible on land.

To explore and benefit from the postures natural to labour & birth .

The calming, relaxing effect of the warm water promotes the flow of oxytocin.

This powerful hormone plays a huge role in childbirth.

It causes the uterus to contract and triggers the ‘fetal ejection reflex’.

Immersion in water has a beneficial physiological effect on hormone secretion, including oxytocin surges which can advance dilation and stimulate contractions (Odent 2014).

Setting up a water birth facility

Hospitals in the United Kingdom have been evolving clinical guidelines for the use of water for labour and birth for over 3o years.

The protocols for operational policy that they’ve developed are widely regarded as the benchmark standard internationally.

Below a collection of guidelines and publications to help you create a water birth facility.

Clinical Guidelines – Royal Cornwall Hospital

Clinical Guidelines – Royal Worcester Hospital

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

Operational Policy and Clinical Guidelines – Abbey Birth Centre

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

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

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

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

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

Waterbirth Guidelines – Midwifery Led Unit, Wirral Hospital

Choosing a Water Birth – East and North Hertfordshire

Birthing pool use of labour and delivery – Wansbeck General Hospital

Water birth and use of water in labour guideline – Buckinghamshire Healthcare

Water for labour and birth guideline – Northern health and Social Care Trust

Immersion in water during labour and birth – NHS Forth Valley

Intrapartum care midwifery led unit – Wirral Women & Children’s Hospital

Guidelines for water birth within the hospital and at home – Dartford & Gravesham NHS

Disinfection and Sterilisation policy (infection control) – Basingstoke and North Hampshire NHS FT

Michel Odent – the birthing pool test

This article first appeared in Midwifery Today, Issue 115, Autumn 2015.

There are many reasons to avoid last-minute cesarean sections that are decided at a phase of real emergency.

They are usually preceded by signs of fetal distress and they are often performed in poor technical conditions.

Furthermore, they are associated with negative long-term outcomes.

For example, according to an American study, women with a full-term second stage cesarean have a spectacular increased rate of subsequent premature births (13.5%) compared to a first-stage cesarean (2.3%) and to the overall national rate (7–8%) (Levine et al. 2014).

There are also serious reasons to avoid prolonged pharmacological assistance during labor, since the probable long-term effects of its different components (particularly drips of synthetic oxytocin) have never been evaluated through valuable scientific studies.

When a woman enters the pool in hard labor, there is an immediate pain relief, and therefore an immediate reduction in the levels of stress hormones.

Since stress hormones and oxytocin are antagonistic, the main short-term response is usually a peak of oxytocin and therefore a spectacular progress in the dilation.

We must add reasons to avoid, when it is possible, prelabor cesareans.

Apart from impaired lung maturation, it appears that the state of stress deprivation associated with “birth without labor” has a great variety of effects on the child, such as a lack of maturation of its olfactory sense (Varendi, Porter and Winberg 2002), which is a guide towards the nipple as early as the hour following birth (Odent 1977; Odent 1978).

Low levels of specific informational substances in the blood of stress-deprived neonates suggest effects on metabolic pathways and development of certain brain structures (Hermansson, Hoppu and Isolauri 2014; Simon-Areces et al. 2012).

It appears also that the milk microbiome and the gut flora of infants are disturbed in a specific way after birth by prelabor cesareans (Azad et al. 2013; Dogra et al. 2015), which is the mode of medicalized birth that disturbs breastfeeding more than all others (Prior et al. 2012; Zanardo et al. 2012).

Unexpectedly, it has been revealed recently that the risk of placenta previa in subsequent pregnancies is statistically significant only if the cesarean has been performed before the labor starts (Downes et al. 2015).

Finally, we are reaching a phase in the history of midwifery and obstetrical practices when an in-labor non-emergency cesarean appears in many cases as the best alternative to drugless childbirth.

In such a context, we understand the need for a new generation of tests in order to decide early enough during labor that the vaginal route is acceptable, without waiting for the phase of real emergency (Odent 2004).

The Basis for the Birthing Pool Test

The birthing pool test is the typical example of a tool adapted to futuristic strategies. It is based on a simple fact.

When a woman in hard labor enters the birthing pool and gets immersed in water at the temperature of the body, a spectacular progress in the dilation is supposed to occur within an hour or two.

If the already well-advanced dilation remains stable in spite of water immersion, privacy (no camera!) and dim light, one can conclude that there is a major obstacle. There is no reason for procrastinations. It is wiser to perform right away an in-labor non-emergency cesarean.

In the early 1980s, I had already mentioned in a mainstream medical journal (Odent 1983) the reason why we originally introduced the concept of birthing pools in the context of a French state hospital.

I had also described the most typical scenario: “We tend to reserve the pool for women who are experiencing especially painful contractions (lumbar pain, in particular), and where the dilatation of the cervix is not progressing beyond about 5 cm. In these circumstances, there is commonly a strong demand for drugs.

In most cases, the cervix becomes fully dilated within 1 or 2 hours of immersion…” At that time, I could only refer to most cases.

Afterwards, I analyzed the outcomes in the rare cases when the dilation had not progressed after an hour or two in the bath. I realized that finally a cesarean had always been necessary, more often than not after long and difficult first and second stages.

This is how I started to tacitly take into account what I had not yet called the birthing pool test.

More recently it happened that I mentioned the birthing pool test during information sessions for doulas.

This is how I learned from a series of reports about births in London hospitals.

It is obvious that many long and difficult labors with the usual range of drugs preceding an emergency cesarean would be avoided if the birthing pool test had been interpreted.

One of these anecdotes is particularly significant.

A woman in hard labor arrived in a maternity unit with her doula while the dilation of the cervix was already well advanced.

Soon after, she entered the birthing pool.

More than an hour later, the dilation had not progressed.

The doula, who was aware of the birthing pool test, was adamant that this woman could not safely give birth by the vaginal route.

A senior doctor was eventually called and diagnosed a brow presentation.

A brow presentation is difficult to diagnose in early labor and is incompatible with the vaginal route. In this case, the doula knew that a cesarean would be necessary, although she could not explain why.

The birthing pool test implies that an internal exam has been performed just before immersion so that, if necessary, a comparison will become possible after an hour or two.

This is an important practical detail, because midwives who are familiar with undisturbed and unguided births in silence, semi-darkness and privacy usually can follow the progress of labor with other criteria than a repeated evaluation of the dilation of the cervix.

Today, we can offer a physiological scenario explaining why immersion in warm water (set to the temperature of the body) makes the contractions more effective during a limited period of time.

When a woman enters the pool in hard labor, there is an immediate pain relief, and therefore an immediate reduction in the levels of stress hormones.

Since stress hormones and oxytocin are antagonistic, the main short-term response is usually a peak of oxytocin and therefore a spectacular progress in the dilation.

After that, there is a long-term complex response, which is a redistribution of blood volume.

This is the standard response to any sort of water immersion.

There is more blood in the chest (Norsk and Epstein 1988).

When the chest blood volume is increased, certain specialized cells in the atria release a peptide commonly called ANP (atrial natriuretic peptide) that interferes with the activity of the posterior pituitary gland (Gutkowska, Antunes-Rodrigues and McCann 1997).

We can all observe the effects of a reduced activity of our posterior pituitary gland after being in a bath for a while: we pass more urine.

This means that the release of vasopressin—a water retention hormone—is reduced.

In fact, the chain of events is not yet completely clarified (Mukaddam-Daher et al. 2002).

We have recently learned that oxytocin—the love hormone—has receptors in the heart (!) and that it is a regulator of ANP (Gutkowska et al. 1997).

In practice, we need to remember that the immediate peak of oxytocin following immersion in warm water will induce a feedback mechanism and eventually the uterine contractions will become less effective after an hour or two.


  • Azad, MB, et al. 2013. “Gut Microbiota of Healthy Canadian Infants: Profiles by Mode of Delivery and Infant Diet at 4 Months.” CMAJ 185 (5): 385–94.
  • Dogra, S, et al. 2015. “Dynamics of Infant Gut Microbiota Are Influenced by Delivery Mode and Gestational Duration and Are Associated with Subsequent Adiposity.” MBio 6 (1): e02419–14.
  • Downes, KL, et al. 2015. “Previous Prelabor or Intrapartum Cesarean Delivery and Risk of Placenta Previa.” Am J Obstet Gynecol 212 (5): 669 e1–6.
  • Gutkowska, J, J Antunes-Rodrigues and S McCann. 1997. “Atrial Natriuretic Peptide in Brain and Pituitary Gland.” Physiol Rev 77 (2): 465–515.
  • Gutkowska, J, et al. 1997. “Oxytocin Releases Atrial Natriuretic Peptide by Combining with Oxytocin Receptors in the Heart.” Proc Natl Acad Sci USA 94 (21): 11,704–09.
  • Hermansson, H, U Hoppu and E Isolauri. 2014. “Elective Caesarean Section Is Associated with Low Adiponectin Levels in Cord Blood.” Neonatology 105 (3): 172–74.
  • Levine, LD, et al. 2014. “Does Stage of Labor at Time of Cesarean Affect Risk of Subsequent Preterm Birth?” Am J Obstet Gynecol 212 (3): 360 e1–7.
  • Mukaddam-Daher, S, et al. 2002. “Regulation of Cardiac Oxytocin System and Natriuretic Peptide during Rat Gestation and Postpartum.” J Endocrinol 175 (1): 211–16.
  • Norsk, P, and M Epstein. 1985. “Effects of Water Immersion on Arginine Vasopressin Release in Humans.” J Appl Physiol 64 (1): 1–10.
  • Odent, Michel. 1977. “The Early Expression of the Rooting Reflex.” In Proceedings of the 5th International Congress of Psychosomatic Obstetrics and Gynaecology, Rome 1977. 1117–19. London: Academic Press.
  • ———. 1978. “L’expression précoce du réflexe de fouissement.” In Les cahiers du nouveau-né, vol. 1–2, edited by E Herbinet. 169–85. Paris: Stock.
  • ———. 1983. “Birth Under Water.” Lancet 2 (8365–66): 1476–77.
  • ———. 2004. The Caesarean. London: Free Association Books.
  • Prior, E, et al. 2012. “Breastfeeding after Cesarean Delivery: A Systematic Review and Meta-analysis of World Literature.” Am J Clin Nutr 95 (5): 1113–35.
  • Simon-Areces, J, et al. 2012. “UCP2 Induced by Natural Birth Regulates Neuronal Differentiation of the Hippocampus and Related Adult Behavior.” PLoS ONE 7 (8): e42911.
  • Varendi, H, RH Porter and J Winberg. 2002. “The Effect of Labor on Olfactory Exposure Learning within the First Postnatal Hour.” Behav Neurosci 116 (2): 206–11.
  • Zanardo, V, et al. 2012. “Impaired Lactation Performance Following Elective Delivery at Term: Role of Maternal Levels of Cortisol and Prolactin.” J Matern Fetal Neonatal Med 25 (9): 1595–98.


A landmark in the history of water birth – Michel Odent

August 21, 1999 should be remembered as a landmark in the history of water birth.

On that day the British Medical Journal published an unprecedented study about “the perinatal mortality and morbidity among babies delivered [sic] in water” (1).

This study is authoritative for several reasons:

  • The conclusions are based on large numbers: the authors traced the 4,032 babies born
    under water in England and Wales between April 1994 and March 1996.
  • The authors belong to a prestigious department of epidemiology and public health
    (Institute of Child Health, London, United Kingdom).
  • The report has been published in a respected peer review medical journal.


In order to convince anyone of the seriousness of this study, all midwives should be aware of the sophisticated methods used by the London epidemiologists.

Several inquiries were combined in order to eliminate the effects of under-reporting.

From April 1994 to April 1996, all 1,500 consultant pediatricians in the British Isles were surveyed each month by the “British Paediatric Surveillance Unit” and asked to report whether or not they knew of any births that met the case definition of “perinatal death or admission for special care within 48 hours of birth following labour or delivery in water.”

The findings were compared with reports to the confidential inquiry into stillbirths and death in infancy (a mandatory notification scheme).

At the same time a postal questionnaire was sent to all National Health Service (NHS) maternity units in England and Wales in 1995 and again in 1996 to determine the total number of deliveries in water during the study period.


The main results can be easily summarized and remembered.

There were five perinatal deaths among 4,032 births in water; that is a rate of 1.2 per 1,000. In the context of the United Kingdom this rate is similar for low risk deliveries that do not take place in water.

Furthermore, none of these five deaths were attributable to delivery in water: one stillbirth was diagnosed before immersion; another stillbirth occurred after a concealed pregnancy and unattended homebirth with no previous prenatal care; one baby died aged three days with neonatal herpes infection; one died aged thirty minutes with an intracranial hemorrahage after precipitate delivery; and another one, who died aged eight hours, was found to have hypoplastic lungs at postmortem examination.

There were thirty-four babies admitted for special care; that is a rate of 8.4 per 1,000.

Rates of admission for special care of babies born to low risk primiparous women are significantly higher than for babies born in water.

Birth in water may have caused water aspiration in two babies.


Compared with well known anecdotes, such as one case of neonatal polycythemia reported in The Lancet in 1997(2), this survey of more than 4,000 babies born (rather than delivered!) in water has been paradoxically ignored by the media, the medical circles and the natural childbirth movement as well.

However, it undoubtedly represents a landmark in the history of the use of water during labour.

From now on midwives should not be the prisoners of strict protocols.

Updated flexible guidelines should accept that “in any hospital where a pool is in daily use a birth under water is bound to happen now and then”(3).

Midwives are far less anxious and invasive wherever a birth under water is considered acceptable if the woman does not have the time or is reluctant to get out of the water during a powerful “fetus ejection reflex.”

The first effect of this study should be to change the focus.

An opportunity is given to recall that the main reason for the birthing pools is to facilitate the birth process and to reduce the need for drugs and other intervention.

In order to control the current epidemic of epidurals the point is to divulge a small number of simple updated recommendations in order to make the most effective use of birthing pools.

Updated recommendations

The main recommendations are based on the fact that immersion in water at the temperature of the body tends to facilitate the birth process during a limited length of time (in the region of an hour or two).

This simple fact is confirmed by clinical observation and by the results of a Swedish randomised controlled study suggesting that women who enter the bath at five centimetres or after (“late bath group”) have a short labour and a reduced need for oxytocin administration and epidural analgesia (4).

Physiologists can offer interpretations.

The common response to immersion is a redistribution of blood volume (more blood in the chest) that stimulates the release by specialized heart cells of the atrial natriuretic peptide (ANP).

The inhibitory effect of ANP on the activity of the posterior pituitary gland is slow, in the region of one to two hours (5).

When a woman is in labour this inhibitory effect is preceded by an analgesic effect that is associated with lower levels of stress hormones and increased release of oxytocin.

Furthermore it is partly via a release of oxytocin that the redistribution of blood volume stimulates the specialized heart cells.

The first practical recommendation is to give great importance to the time when the laboring woman enters the pool.

Experienced midwives have many tricks at their disposal to help women be patient enough so that they can ideally wait until five centimetres dilation.

A shower, that more often as not implies complete privacy, is an example of what the midwife can suggest while waiting.

The BMJ survey clearly indicates that many women stay too long in the bath (the average time was in the region of three hours for women who gave birth in water!).

One reason is that many of them enter the bath long before five centimetres.

The second recommendation is to avoid planning a birth under water.

When a woman has planned a birth under water she may be the prisoner of her project; she is tempted to stay in the bath while the contractions are getting weaker, with the risk of long second and third stages.

There are no such risks when a birth under water follows a short series of irresistible contractions.

The recommendations regarding the temperature should not be overlooked.

It is easy to check that the water temperature is never above 37° C (the temperature of the maternal body).

Two cases of neonatal deaths have been reported after immersion during labor in prolonged hot baths (39.7° C in one case) (6).

The proposed interpretation was that the fetuses had reached high temperatures (the temperature of a fetus is 1° higher than the maternal temperature) and could not meet their increased needs in oxygen.

The fetus has a problem of heat elimination.

At the dawn of a new phase in the history of childbirth one can anticipate that, if a small number of simple recommendations are taken into account, the use of water during labor will seriously compete with epidural anesthesia.

Then helping women to be patient enough and enter the pool at the right time will appear as a new aspect of the art of midwifery.

Michel Odent, MD founded the Primal Health Research Centre in London and developed the maternity unit in Pithiviers, France, where birthing pools are used. He is the author of ten books published in twenty languages. Two of them—Birth Reborn and The Nature of Birth and Breastfeeding—were published originally in the United States. His most recent book is The Caesarean.



Using Water During Labor and Birth 

Originally published by Jessica Vogtman: November 27, 2016
Humans have an integral relationship with the element of water.
It runs through our veins, we are born of it, and it is necessary for our survival.
We are drawn to it for escape, adventure, release, and cleansing.
As a woman is preparing to give birth, water is a means of release from the weight of her growing belly, and the means to ease her aching muscles.

Water is a great coping tool in labor, whether through a shower or tub. (For the sake of this paper we will only be mentioning the use of a tub.)

The use of water in labor can aide in pain management by increasing relaxation, decreasing strain on muscles, and creating freedom of movement.

The mother’s ability to relax her muscles during labor can affect the length of labor and the intensity of contractions.

The more a mother fights and tenses her muscles the worse contractions may feel.
Especially in active labor, the mother may need as many coping strategies as possible.
The birthing tub offers a great respite, and a simple way to relax.

Version 2

The birthing tub is often called, “The midwife’s epidural”, for its effectiveness (Drichta, Owen p. 257).

The warmth of the water helps to ease the pain felt from contractions, relaxing muscles of the pelvic floor and back, and creates a mental space that creates privacy (Drichta p. 258).

It is recommended to maintain water temperature at 96-98 degrees.

Using higher temperatures could cause increased blood pressure, dehydration and lethargy (Drichta p. 258).
The bath is also deeply engrained as a place of mental release in daily routines.

Our bathtubs are typically places of retreat to relax, and the mental association during labor holds true.

Labor is a physically demanding process.

From hours of walking, lunging, squatting, intense contractions, and the possibility of little sleep can make for a grueling marathon on the mother’s muscles.

The warmth of the tub eases both the pain of the contractions and the work of her remaining muscles (Drichta p. 257).

Being in a large tub that covers her belly, the mother is buoyant and freed from the gravity of dry land.

Her pelvic muscles are relaxed and her cervix will continue to dilate, often with more ease as she relaxes.

A mother that is able to relax and mentally release her tension, will have an easier time laboring than a mother that is fighting each contraction.

Being weightless allows the mom to assume positions that could be too taxing on land, such as deep squats using the side of the pool, that will help baby to descend and turn.

She’s able to easily move from one position to the next in response to her labor, while remaining warm and relaxed.

The ease of movement allows the mother to find her own rhythm and coping responses that she would not have had if she was limited to a bed.


Her ability to move through labor gives the mother more control and autonomy during the birth.

She’s able to push in the position that suits her, catch her own baby, and bring baby to chest without outside help or others manipulating her body. She has full confidence and control.

Relaxation, decreased strain on muscles and freedom of movement are gained for the birthing mother with the use of water during labor. The three work together as a pain management strategy, addressing both mental and physical tension that could hinder a birth.

The birthing tub is used at its greatest advantage during late stage active labor through transition.

It is recommended that for every hour spent in the tub, the mother spends at least thirty minutes out of the tub.

This is to ensure that contractions do not slow down, as can sometimes happen.

Often contractions may just feel less intense, but are still actively working.
According to Water BirthInternational, “Getting back in the water after thirty minutes will reactivate the chemical and hormonal process, including a sudden and often marked increase in oxytocin.” (Harper p. 2)
As with other labors, hydration is of the utmost importance. Keep a drink with a straw nearby so the mother can drink at will.

The birth can be completed in the water as well, depending on location (some hospitals only allow laboring in the tub) and as long as the labor is not having any complications (ex:meconium, shoulder dystocia).

Works Cited

Drichta, Jane E., CPM and Owen, Jodilyn, CPM. The Essential Homebirth Guide for Families Planning or Considering Birthing at Home. 2003. Simon and Schuster.

Harper, Barbara. “Guidelines for Safe Waterbirth.”Waterbirth International. p. 2

Jessica Vogtman has lived in Maryland since 2003, and has been a Carroll County resident since 2006. She graduated with a bachelors degree in Biology and Chemistry from Notre Dame of Maryland University. Upon graduation, she worked as a zookeeper at the Maryland Zoo in Baltimore, where she became immersed in natural living. Jessica developed her passion for birth during her first pregnancy in 2012, and spent the following years educating herself on natural birth and birthing techniques. She is currently certifying as a doula with Birth Arts International.

Evidence on the safety of water birth

9 February 2015

Evidence Based Birth – Rebecca Dekker

In April 2014,  waterbirth—an alternative method for pain relief in which a mother gives birth in a tub of warm water—made national headlines.

The event that pushed water birth safetyinto the spotlight was a joint Opinion Statement from the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), denouncing the practice.

In their opinion statement, ACOG and the AAP firmly admonished that waterbirth should be considered an experimental practice that should only occur in the context of a clinical research study.

Their conclusion, which echoed a previous AAP Opinion Statement from 2005, was based on their opinion that water birth does not have any benefits and may pose dangers for the newborn.

In response, the American College of Nurse Midwives (ACNM),(Midwives 2014) the American Association of Birth Centers (AABC), and the Royal College of Midwives (RCM) all released statements endorsing waterbirth as a safe, evidence-based option.

Meanwhile, the AABC released preliminary data from nearly 4,000 waterbirths that occurred in birth centers all over the U.S., supporting water birth as safe for mothers and infants.

Despite the response from midwifery organizations and the AABC, hospitals all over the U.S. began suspending or shutting down their waterbirth programs.

At St. Elizabeth’s Regional Medical Center in Lincoln, Nebraska, mothers and families organized rallies and started a petition to bring waterbirth back.

All of this controversy left us with these questions— Is the ACOG/AAP statement based on a complete and accurate review of the literature?

What is the evidence on waterbirth?

Is it safe?

Does it have any potential benefits or harms for mothers and infants?

These are the questions we will address in the Evidence Based Birth article on the evidence on waterbirth.

This article was published July 10, 2014, by Rebecca Dekker, PhD, RN, APRN
© Evidence Based Birth, All Rights Reserved.

Click here for a copy of Rebecca Dekker’s paper on the safety of water birth

The growing trend of birth in water…

Milli Hill explains why more and more women, including celebrities like Maia Dunphy and Rebecca Adlington, are choosing a birth pool.

More and more women are saying yes to water birth; thanks in part to the many celebrities who are extolling it’s virtues, including broadcaster and wife of Johnny Vegas, Maia Dunphy, and Olympic swimmer Rebecca Adlington, both of whom are planning to have their babies in a birth pool in the next few weeks.


As so many women are discovering, there’s literally nothing not to like about water birth. I’ll admit, though, that when I first heard about the trend in 2007, I was sceptical.

I was pregnant with my first, and maybe I already felt daunted enough by the idea of giving birth, without adding in another whole set of anxieties and ‘unknowns’. I was definitely in the “Why would you do that?” camp.

This scepticism is common, explains Beverley Turner, birth expert and LBC presenter. She used a birth pool in all three of her own births and now encourages pregnant women on her London based antenatal course, The Blooming Bunch, to give it a try:

“It’s hard to explain the benefits of water birth in words. You can read all about how it’s great for pain relief, how it helps you to move and find comfortable positions, how it supports the perineum and can prevent tearing, and how it makes your chances of a normal, natural birth more likely.

But ultimately, this can all seem academic – it’s only when you slide your labouring body into the warm water that you really ‘get’ it.”

Water birth is often spoken of in terms of being a ‘pain relief option’, but I’m not sure – having finally let my scepticism be washed away during the birth of my second child – that this entirely does it justice. It’s true, when you get into the pool, the warmth and the weightlessness seems to ‘take the edge’ off the contractions.

Research supports the idea that being in water helps with labour pain: one study found that water birthing mums rated their pain as not only lower than women giving birth on dry land but lower than land birthers who had had epidurals.


Another study, however, found that there was no difference in pain levels between women giving birth in water or on dry land. If you’re pregnant I’m sorry to have to break the news that, no matter where women in the study gave birth, their general view seemed to be: It Hurts.

However – and this is where it gets interesting – what the researchers did find was that the water birthers remembered birth as less painful, once it was over.

I think this shines a light on the aspect of water birth that so often gets missed – perhaps because it is hard to measure or quantify: women’s experience.

Women who have water births – whilst they may still feel as much pain as their contemporaries on the bed – enjoy their births more. Yes, you heard correctly, whilst it may or may not ‘hurt’ – they enjoy it.

In these times of increasingly high medical intervention in birth, water birth removes you from this stereotypical ‘one born every minute’ reality. You are – quite literally – in a different element. You are upright, active, mobile and out of easy reach – the absolute opposite of being immobilised on your back on a bed.

Version 2

The balance of power in the birth room, for several decades at least tipped strongly in favour of the midwives and doctors, is upended. We try to explain why women enjoy it so much by saying, “It’s great for pain relief”, but the real reason is this: water birth puts women back in charge.

“The most amazing thing was that I was in my own space, with no invaders”, Hannah Roe, a midwife who gave birth in water last November told me. “I called all the shots, it really felt like my territory. Midwives could only listen in when I truly consented (ie floated over to them!) and birth was completely ‘hands off’.

“Aside from the encouragement of my midwives and birth supporters I did it all by myself – touched his head to reassure myself that my cervix was fully dilated and lifted him out of the pool following the birth. It was amazing.”

Birth workers themselves are often fans of water birth. As Sarah Dodge, a student midwife at Kingston University told me, “I absolutely love caring for women who choose water, it allows you to do absolutely nothing apart from watch and listen.

I have learnt so much from doing this.” Doula Claire Morrow-Goodman is equally evangelical: “I love it when a mama-to-be slowly sinks down into the water and that wonderful blissful look that enraptures her face…as a doula I sigh with her”, she told me.


However, there are opponents – in April 2014 the American Congress of Obstetricians and Gynaecologists and the American Academy of Pediatrics issued a joint statement, denouncing water birth as without benefits and potentially unsafe.

This statement has made access to water birth more limited in the USA, although the Royal College of Midwives called it ‘disappointingly biased and partially incorrect’, and researcher Rebecca Dekker has written a review of the available literature on water birth in response, concluding the ACOG statement contained, “major scientific errors”.

Dekker’s review makes fascinating reading for anyone interested in the research on water birth. If you want the short version, however, the basics are this: there is no strong evidence against water birth for low risk women, and more research would be helpful.



Water VBAC: exploring a new frontier for women’s autonomy

McKenna JA; Symon AG, (2014). Midwifery , vol 30, no 1, January 2014, e20-5.

BACKGROUND: although Vaginal Birth After Caesarean section (VBAC) has been promoted successfully as one means of reducing the caesarean section rate, the practice of VBAC using water immersion (Water VBAC) is restricted.

Very little valid, reliable research evidence is available on this birth method, although initial small-scale audits indicate that Water VBAC has no adverse effect on maternal and neonatal outcomes.

METHOD: in-depth semi-structured interviews were carried out with a purposive sample of eight women who had undergone Water VBAC in one midwife-led unit.

The interviews aimed to explore their reasons for requesting this birthing method, and their experience of the process. An interpretative phenomenological analytical approach was adopted.

FINDINGS: the women pursued Water VBAC for two main reasons: in order to prevent a repeat of the obstetric events that previously led to a caesarean section, and to counteract their previous negative birth experiences.

The women reported improved physical and psychological outcomes from their Water VBAC experience when compared with their previous experience of caesarean section.

Three main themes emerged: ‘minimising’, ‘maximising’ and ‘managing’. Water VBAC entailed an attempt to minimise the medicalisation of the women’s childbirth experience.

This was achieved by limiting medical staff input in favour of midwife-led care, which was believed to minimise negative physical and psychological experiences.

Correspondingly, Water VBAC was perceived as maximising physical and psychological benefits, and as a means of allowing women to obtain choice and assert control over their labour and birth.

The women planning a Water VBAC believed they had to manage the potential risks associated with Water VBAC, as well as manage the expectations and behaviour of friends, family and the health care professionals involved in their care.

CONCLUSIONS: for the women participating in this research, actively pursuing Water VBAC constituted a means of asserting their autonomy over the childbirth process.

The value accorded to being able to exercise choice and control over their childbearing experience was high.

These women’s accounts indicated that information-giving and shared decision-making require improvement, and that inconsistencies in the attitudes of health care professionals need to be addressed.