Building Regulations and Guidelines for Midwives Archives

Innovative ergonomic design makes our water birth pools safer, more comfortable and easier to use

Posted on 5 August 202425 September 2024 by K.D.Brainin

The first thing that people notice when they look at our water birth pools is the curvaceous, extra-wide rounded rim and the sculpted surround that hugs it’s form.

The basis for this unique design approach stems from work we did with a health service ergonomist in 1995 in an effort to improve the design of our pools to make them safer, more comfortable and easier for mothers and midwives to use.

When you look our water birth pools from the early 90’s you notice the solid, vertical surround and narrow rims.

It is not possible for midwives to sit in comfort.

To get close midwives have to splay their legs and bend forward – not only is this very uncomfortable but, the strain can lead to back ache, tension in the neck and shoulders and time off work.

As a result the ability of midwives to do their jobs is compromised, results and job satisfaction are diminished.

Most birth pools on the market today closely resemble our early designs and still have the same vertical sides and narrow rims.

Not only does this cause midwives discomfort but they way in which mothers get into the pool is impacted as well.

To get into these pools multi- step units with handrails are required at substantial cost and added risk.

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

The can sit naturally in comfort with their legs tucked well under the rim and their arms resting gently on the surface.

They move instinctively with ease around the circumference of the pool.

The wrap around, bull-nosed shaped rim is absolutely perfect for mothers to grab onto for support from anywhere in the pool.

It provides comfort and support for mothers in the wide variety of upright positions natural to labour and birth.

The simple act of getting into the pool is the most misunderstood aspects associated with water birth.

There is the widespread fallacy that multi-step units with handrails are required.

Perhaps that is because with other birthing pools with narrow rims they are needed?

But, not with Active Birth Pools!

With our pools mothers don’t have to climb up, and over the rim to get into the pool.

They just sit on the extra-wide rim with three points of contact at all times and and simply swivel into the water.

The unobtrusive single step gives mothers a height advantage and makes it safe and easy for women of any shape or size to easily get into our pools.

They are grounded at all times and fully safeguarded from risk,

Facilitating emergency evacuations is a vital component of water birth protocols.

This is where the extra-wide rim ands concave skirting panel really comes into play.

In case of an emergency mothers can be held safely on the internal seat and then with the aid of the buoyancy of the water gently moved across the rim and onto a trolley.

As an added bonus the deeply sculpted surround allows portable hoists to be moved into position if this method of evacuation is preferred.

Fabrication in Ficore composite has allowed us to take these design features to the next level with flowing forms, round bull-nosed shape rims and more deeply sculpted skirting panels.

As a result our water birth pools are even more supportive, comfortable and user-friendly.

This is why given a choice midwives will always choose Active Birth Pools.

Improving Birthing Pool Design: Case Study 18 – Chartered Institute of Ergonomics & Human Factors

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

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

Active Birth Pools Water Birth Safety Hub

Posted on 1 August 20242 October 2024 by K.D.Brainin

A wealth of information relating to all aspects of water safety, infection control and manual handling.

Designed to optimise safety, negate risk and deliver safer birthing environments

Water Birth Safety Initiative

Manual handling risks associated with water birth pools

Health and Safety risks you need to be aware of before buying a water birth pool

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

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

Guidelines: Cleaning and Care

Health and Safety Advisory: WARNING Swan Neck Taps Present a Significant Infection Control Risk

This unique feature makes our water birth pools safer and more user-friendly!

Water Safety Management

Legionella – blowing bugs out the water

Safe Water in Healthcare Premises: United Kingdom Department of Health

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

Health Building Notes – Maternity Care Facilities: Department of Health

Guidance for the prevention and control of infection from water systems: Health Service Executive

Water Systems – Health Technical Memorandum: Department of Health

Guidelines for the Prevention and Control of Infection from Water Systems in Healthcare Facilities

Legionella management and control procedures: Nottingham University Hospital

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

Posted on 5 December 202312 November 2024 by K.D.Brainin

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

We’ve considered this deeply over the past 37 years and have designed water birth pools that are internationally regarded as the safest on the market.

The combination of the extra-wide rim and single step are a game changer that make Active Birth Pools safer and easier for mothers to get in and out of.

Mothers are grounded and have three points of contact at all times.

The distinctive extra-wide (15cm-20cm) rim is easy for mothers to sit on while they make the transition from land to water.

With support from her midwife mothers simply step onto the sturdy step unit turn and sit on the big, wide, comfortable rim.

They then gently swivel on the rim and into the pool – simple and safe!

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

The single step helps makes it even easier for mothers to get in the pool by giving them height advantage in relation to the pool .

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

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

Midwives are safeguarded from the risk associated with physically supporting mothers.

To put this in perspective:

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

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

Warning: Risks associated with Multi-Step Units

There is a wide-spread misunderstanding that multi-step units that are equipped handrails are necessary for mothers to use for getting in and out of water birth pools.

Most birth pool companies offer big multi-step units with handrails for mothers to get in and out of their pools.

The design of their water birth pools with narrow rims and higher sides necessitates them.

Multi-step units are dangerous and in the case of Active Birth Pools unnecessary

Health and Safety experts advise against multi-step units as they present unacceptable safety risks.

They say that,

“The thought of wet room conditions with mothers in strong labour climbing up a multi-step unit, stepping over a rim and down onto a submerged plinth is abhorrent.

When not in use these these bulky step units take up too much space, obstruct movement around the pool and are present a trip hazard.”

Guidelines: Dealing with emergency evacuation

Manual handling risks associated with water birth pools

Water safety and infection control risks you should know about before choosing a birth pool

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Health and Safety risks you need to be aware of before buying a water birth pool

Posted on 20 November 202317 September 2024 by K.D.Brainin

Purchasing a water birth pool is a big responsibility.

Not only must financial considerations be taken into account, but more importantly Health and Safety risks.

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

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

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

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

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

Rim Mounted Taps and Spouts

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

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

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

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

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

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

Taps and spouts for water birth pools should be wall mounted 25cm above the pool and fitted with back flow protection as shown in the photo of the Active II Water Birth Pool below:

Surface Mounted Hand Grips (internal and rim mounted)

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

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

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

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

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

Swan Neck Taps

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

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

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

Re-circulating water systems

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

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

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

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

Integral Plumbing Systems

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

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

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

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

Hand held showers

Handheld showers present a significant infection control risk.

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

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

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

Integral Plumbing Systems

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

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

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

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

Pumped heating systems

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

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

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

Bacteria filters and disinfection systems

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

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

Overflow drains

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

Regulations are very clear on this point.

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

Surface mounted metalwork

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

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

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

Doors

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

Doors are mistakenly used for two reasons:

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

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

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

From manual handling perspective doors are not practical or fit for purpose.

They actually complicate emergency evacuations and put mothers and midwives at risk.

Water Birth Safety Initiative

Active Birth Pools: Water Safety, Hygiene and Infection Control

Manual handling risks associated with water birth pools

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

Posted on 5 April 202317 September 2024 by K.D.Brainin

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:

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

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

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

Basics:

The mother should be screened to ensure that she meets the inclusion criteria prior to entering the birth pool.
Continuous risk assessment is essential to reduce the incidence of emergencies in the pool.
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.
If the mother is unable to leave the pool under her own power or has collapsed an emergency evacuation will need to be conducted.
A trolley should be available
for the mother to be moved onto.
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

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Water Birth Safety Initiative

Posted on 1 January 202317 September 2024 by K.D.Brainin

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

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

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

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

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

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

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

Guidelines for Water Birth Pools Installed in Hospital

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

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

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

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

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

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

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

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

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

The 7 sins of water safety

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

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

1) Overflow drains

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

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

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

2) Internal water inlets

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

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

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

3) Handheld showers

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

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

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

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

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

4) Systems with flexible hoses or extended pipes

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

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

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

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

5) Integral or secondary plumbing systems

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

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

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

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

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

6) Recirculating or pumped water systems

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

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

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

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

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

7) Heating systems

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

There are two types of heating systems in use:

1. Recirculating system with a heat exchanger

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

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

2. Electric heating systems

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

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

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

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

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

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

Recommendations

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

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

Rim mounted taps present two areas of risk:

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

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

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

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

Filling the birth pool

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

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

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

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

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

The use of a TMV ensures a safe water supply.

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

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

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

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

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

Flushing duration is in line with HSE L8 recommendations.18

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

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

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

Emptying the Pool

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

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

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

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

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

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

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

End notes

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

References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Bibliography

Ashford and St. Peter’s Hospitals, Women’s Health and Paediatrics Division (Abbey Birth Centre). Operational Policy and Clinical Guide, 2014.

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

Guidelines: Delivery, moving, handling and installation

Posted on 5 December 202112 November 2024 by K.D.Brainin

Delivery, Moving and Handling

Mainland UK Deliveries

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

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

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

Box Size and Weight

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

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

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

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

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

Outside Mainland UK and International Deliveries

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

Crate Size and Weight

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

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

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

Installation

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

Taps

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

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

A filling time of 20 – 25 minutes is acceptable.

Drainage

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

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

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

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

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

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

Fixing the birth pool to the floor

All feet MUST be in solid contact with the floor.

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

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

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

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

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

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

Locating and fixing the brackets

Step 1: All Models:

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

Step 2: Active Birth Pool – front fixing bracket

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