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:

 

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A way to make labour shorter, easier and more comfortable

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

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

Janet Balaskas – “Water Birth”

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

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

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

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

You are supported by the buoyancy of the water.

This allows you to relax easily and more deeply.

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

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

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

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

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

This will stimulate strong contractions.

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

You are likely to dilate rapidly during this time.

You may choose to have your baby in water

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

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

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

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

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

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

 

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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.

A safe, simple solution for getting into the pool

We are often asked why we do not supply multi-step units with safety rails like other companies do with their pools.

The answer is simple – they are not needed and in our estimation present a significant safety and manual handling risk!


The Venus 360 with extra-wide wrap around rim, step unit and grab rail

Other pools are higher and have narrow rims which makes it difficult for mothers to enter the pool without a step unit.

When we discuss the issue with manual handling experts they strongly advise against the use of multi-step units as they present critical safety risks.

They say that, “to have mothers in strong labour climb up, step over the rim, and down onto a submerged platform in the pool is not safe or practical.

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

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

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

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

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

The maths: 

  • When we looked at the dynamics at play we focussed on shorter women of average height don’t even need the step!
  • A women 150cm (4’11”) tall has an inseam of about 68cm (27″).
  • The step is 15cm (6″)high. The rim is 75cm (29.5″)
  • Standing on the step she is has inner leg height of 83cm (33″) and can easily sit down on the rim and swivel in.

We’ve posted a short video on YouTube showing  just how easy it is for mothers to get into our water birth pools –please have a look

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Superior material results in superior performance

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

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

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A cross section of FICORE® composite

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

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

 Ficore® composite has many advantages:

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

Warm to the touch

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

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

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

Structural and engineering advantages

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

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

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

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

Extremely smooth and tactile 

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

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

Incredibly high adhesion factor

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

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

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

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

Durability

Ficore is more impervious to damage than other bath materials.

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

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

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

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Dealing with emergencies

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

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

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

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

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

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

Basics:

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

Example 1: Emergency evacuation utilising the labour support seat

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

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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

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Example 2) Emergency evacuation utilising the safety seat

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The mother is moved into position under the safety seat

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The midwives glide her up the side of the pool

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Onto the safety seat,

and then onto the rim for transfer onto the trolley

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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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Cleaning and Care

Safety comes 1st!

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

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

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

Active Birth Pools Cleaning and Disinfection Guidelines

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

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

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

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

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

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

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

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

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

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

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

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

Protocols from hospitals using Active Birth Pools.

 

How to restore your old birth pool to pristine condition

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

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

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

Not to worry.

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

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

It will restore your pool to pristine condition.

Here’s a link:

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

Related information:

 

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

Water Birth Safety Initiative

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

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

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

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

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

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

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

Guidelines for Water Birth Pools Installed in Hospital

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

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

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

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

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

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

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

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

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

The 7 sins of water safety

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

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

1) Overflow drains

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

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

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

2) Internal water inlets

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

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

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

3) Handheld showers

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

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

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

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

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

4) Systems with flexible hoses or extended pipes

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

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

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

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

5) Integral or secondary plumbing systems

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

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

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

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

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

6) Recirculating or pumped water systems

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

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

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

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

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


7) Heating systems

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

There are two types of heating systems in use:

1. Recirculating system with a heat exchanger

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

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

2. Electric heating systems

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

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

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

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

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

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

Recommendations

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

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

Rim mounted taps present two areas of risk:

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

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

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

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

Filling the birth pool

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

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

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

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

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

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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.

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End notes

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

References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Bibliography

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

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

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

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

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

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

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

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

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

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

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

The buoyancy of water helps mothers benefit from upright positions

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

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

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

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

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

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

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

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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.

 

Toppen av vannfødselsbasseng design og utvikling

Våre prisbelønte vannfødselsbassenger av sykehuskvalitet har vært på toppen av markedet i over 35 år!
De gir uovertruffen hygiene og sikkerhet, uslåelig verdi, bedre resultater og overlegen ytelse.
De er laget for hånd i England ved bestilling, bygget for å vare i flere tiår og garantert for livet.

“Toppen av vannfødselsbasseng design og utvikling. En uforlignelig kombinasjon av design, materialer og produksjon” Building Better Healthcare Awards

Vi var med på å pionere bruken av vann til fødsel ved å designe bassengene som gjorde denne revolusjonen i barselomsorgen mulig.

Siden 1987 har vi levert tusenvis av fødselsbassenger til sykehus rundt om i verden og etablert et rykte for kvalitet og service.

Mødre og jordmødre elsker vannfødselsbassengene våre fordi de er utrolig komfortable, praktiske og enkle å bruke.

Sykehus kjøper bassengene våre fordi de leverer overlegen ytelse, uovertruffen sikkerhet og uslåelig verdi.

Vi har oppnådd suksess ved å kontinuerlig innovere, holde ting enkelt og fokusere på våre kjerneprinsipper for sikkerhet, verdi og ytelse.

Vår enestående kunnskap og vell av erfaring gjør det mulig for oss å tilby vannfødselsbassenger som minimerer risiko, optimaliserer resultater og maksimerer verdien.

Dommerne sa at “Kombinasjonen av evidensbasert, brukersentrert, ergonomisk design, spesialiserte materialer og skreddersydd produksjon har resultert i vannfødselsbassenger som virkelig er i en klasse for seg selv”

Aktive fødselsbassenger er håndlaget på bestilling av dyktige håndverkere i England og sendes over hele verden.

De er fremstilt i et proprietært materiale kalt Ficore®, en komposittharpiks med ekstraordinære egenskaper.

Denne korte, enkle videoen har fått nærmere 12 000 000 visninger på YouTube. Det viser hvordan mødre forholder seg instinktivt til bassengene våre og beveger seg for å finne de mest komfortable og fordelaktige stillingene.

Hvis du leter etter et vannfødselsbasseng, er vi unikt kvalifisert til å være til tjeneste.
Finn ut hvorfor.

Interessert i å finne ut mer om vannfødsel eller hvordan sette opp et vannfødselsanlegg?
Besøk vårt utdanningssenter.

 

 

La cúspide del diseño y el desarrollo de las piscinas de nacimiento en el agua.

Nuestras galardonadas piscinas de agua para partos de grado hospitalario han sido las mejores del mercado durante más de 35 años.

Ofrecen una higiene y seguridad inigualables, un valor insuperable, mejores resultados y un rendimiento superior.

Se fabrican a mano por encargo en Inglaterra, se construyen para que duren décadas y están garantizadas de por vida.

“La cúspide del diseño y el desarrollo de las piscinas de nacimiento en el agua. Una combinación incomparable de diseño, materiales y fabricación” Premios Building Better Healthcare

Ayudamos a ser pioneros en el uso del agua para el parto y el nacimiento diseñando las piscinas que hicieron posible esta revolución en la atención a la maternidad.

Desde 1987 hemos suministrado miles de piscinas para partos a hospitales de todo el mundo y hemos establecido una reputación de calidad y servicio.

Las madres y las comadronas adoran nuestras piscinas para partos en el agua porque son increíblemente cómodas, prácticas y fáciles de usar.

Los hospitales compran nuestras piscinas porque ofrecen un rendimiento superior, una seguridad inigualable y un valor inmejorable.

Hemos logrado el éxito innovando continuamente, manteniendo las cosas sencillas y centrándonos en nuestros principios básicos de seguridad, valor y rendimiento.

Nuestros incomparables conocimientos y nuestra gran experiencia nos permiten ofrecer piscinas de nacimiento en el agua que minimizan el riesgo, optimizan los resultados y maximizan el valor.

Los jueces dijeron que “la combinación de un diseño basado en la evidencia, centrado en el usuario diseño ergonómico, materiales especializados y fabricación a medida había dado como resultado unas piscinas de nacimiento en el agua que estaban realmente en una clase propia”

Las piscinas de nacimiento Active están hechas a mano por encargo por artesanos altamente cualificados en Inglaterra y se envían a todo el mundo.

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

Este breve y sencillo vídeo ha conseguido cerca de 12.000.000 de visitas en YouTube. Muestra cómo las madres se relacionan instintivamente con nuestras piscinas y se mueven naturalmente para encontrar las posiciones más cómodas y beneficiosas.

Si está buscando una piscina de nacimiento de agua, estamos especialmente cualificados para servirle.
Descubra por qué.

Está interesado en saber más sobre el parto en el agua o cómo montar un centro de parto en el agua?
Visite nuestro Centro Educativo.

 

 

Reasons to consider a water birth

Bridge to Health –  Sian Smith

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

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

Here are some of the reasons why:

Water is relaxing!

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

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

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

Water is a natural pain reliever

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

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

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

It reduces stress and anxiety

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

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

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

It reduces the risk of perineal tearing

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

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

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

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

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

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

Hp7

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

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

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

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

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

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

It is safe!

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

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

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

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

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

The benefits of labouring in water for overweight and obese mothers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BigBirtha.co.uk...

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

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

Groundbreaking research confirms benefits of water birth

Systematic review and meta-analysis to examine intrapartum interventions, and maternal and neonatal outcomes following immersion in water during labour and waterbirth

Library of Medicine

Abstract

Objectives: Water immersion during labour using a birth pool to achieve relaxation and pain relief during the first and possibly part of the second stage of labour is an increasingly popular care option in several countries. It is used particularly by healthy women who experience a straightforward pregnancy, labour spontaneously at term gestation and plan to give birth in a midwifery led care setting. More women are also choosing to give birth in water. There is debate about the safety of intrapartum water immersion, particularly waterbirth. We synthesised the evidence that compared the effect of water immersion during labour or waterbirth on intrapartum interventions and outcomes to standard care with no water immersion. A secondary objective was to synthesise data relating to clinical care practices and birth settings that women experience who immerse in water and women who do not.

Design: Systematic review and meta-analysis.

Data sources: A search was conducted using CINAHL, Medline, Embase, BioMed Central and PsycINFO during March 2020 and was replicated in May 2021.

Eligibility criteria for selecting studies: Primary quantitative studies published in 2000 or later, examining maternal or neonatal interventions and outcomes using the birthing pool for labour and/or birth.

Data extraction and synthesis: Full-text screening was undertaken independently against inclusion/exclusion criteria in two pairs. Risk of bias assessment included review of seven domains based on the Robbins-I Risk of Bias Tool. All outcomes were summarised using an OR and 95% CI. All calculations were conducted in Comprehensive Meta-Analysis V.3, using the inverse variance method. Results of individual studies were converted to log OR and SE for synthesis. Fixed effects models were used when I2 was less than 50%, otherwise random effects models were used. The fail-safe N estimates were calculated to determine the number of studies necessary to change the estimates. Begg’s test and Egger’s regression risk assessed risk of bias across studies. Trim-and-fill analysis was used to estimate the magnitude of effect of the bias. Meta-regression was completed when at least 10 studies provided data for an outcome.

Results: We included 36 studies in the review, (N=157 546 participants). Thirty-one studies were conducted in an obstetric unit setting (n=70 393), four studies were conducted in midwife led settings (n=61 385) and one study was a mixed setting (OU and homebirth) (n=25 768). Midwife led settings included planned home and freestanding midwifery unit (k=1), alongside midwifery units (k=1), planned homebirth (k=1), a freestanding midwifery unit and an alongside midwifery unit (k=1) and an alongside midwifery unit (k=1). For water immersion, 25 studies involved women who planned to have/had a waterbirth (n=151 742), seven involved water immersion for labour only (1901), three studies reported on water immersion during labour and waterbirth (n=3688) and one study was unclear about the timing of water immersion (n=215).Water immersion significantly reduced use of epidural (k=7, n=10 993; OR 0.17 95% CI 0.05 to 0.56), injected opioids (k=8, n=27 391; OR 0.22 95% CI 0.13 to 0.38), episiotomy (k=15, n=36 558; OR 0.16; 95% CI 0.10 to 0.27), maternal pain (k=8, n=1200; OR 0.24 95% CI 0.12 to 0.51) and postpartum haemorrhage (k=15, n=63 891; OR 0.69 95% CI 0.51 to 0.95). There was an increase in maternal satisfaction (k=6, n=4144; OR 1.95 95% CI 1.28 to 2.96) and odds of an intact perineum (k=17, n=59 070; OR 1.48; 95% CI 1.21 to 1.79) with water immersion. Waterbirth was associated with increased odds of cord avulsion (OR 1.94 95% CI 1.30 to 2.88), although the absolute risk remained low (4.3 per 1000 vs 1.3 per 1000). There were no differences in any other identified neonatal outcomes.

Conclusions: This review endorses previous reviews showing clear benefits resulting from intrapartum water immersion for healthy women and their newborns. While most included studies were conducted in obstetric units, to enable the identification of best practice regarding water immersion, future birthing pool research should integrate factors that are known to influence intrapartum interventions and outcomes. These include maternal parity, the care model, care practices and birth setting.

Prospero registration number: CRD42019147001.

Keywords: Maternal medicine; PRIMARY CARE; Pain management.

Research review backs benefits of water births for mothers and babies  

Nursing Times

Water births provide “clear benefits” over standard care for healthy mothers and their newborns, according to UK researchers.

They found water births were associated with fewer interventions and complications during and after the birth, as well as higher levels of satisfaction for the mother.

“Water immersion is an effective method to reduce pain in labour, without increasing risk”

Study authors

Researchers compared the extent of healthcare interventions needed during and after labour to see if outcomes differed between a water birth and standard care – without a birthing pool.

They noted that a water birth involves using a birthing pool to achieve relaxation and pain relief, with the mother either exiting the pool for the birth, so the newborn can emerge into air to breathe, or remaining in the pool and bringing the newborn to the surface to start breathing.

They trawled research databases looking for relevant studies published over 20 years between 2000 and 2021, finding 36 studies involving 157,546 women. Most were carried out in obstetric units.

The study results showed that a water birth, regardless of whether women birth in or out of the pool, “has clear benefits to women” in obstetric units, where most births take place and where interventions and complications are more likely than in midwife-led units.

A waterbirth was as safe as standard care for healthy mothers and their newborns, they said in the journal BMJ Open.

Compared with standard care, a water birth significantly reduced the use of epidurals, injected opioids, episiotomy, as well as pain and heavy bleeding after the birth.

In addition, it increased mothers’ satisfaction levels and the odds of an intact perineum. There was no difference in the rate of Caesarean sections, said the study authors from Oxford Brookes University.

“Water immersion can significantly increase the likelihood of an intact perineum and reduce episiotomy, an intervention which offers no perineal or foetal benefit, can increase postnatal pain, anxiety, and impact negatively on a woman’s birth experience,” they said.

However, they observed more instances of umbilical cord breakage among water births, but the rate was still low – 4.3 per 1,000 births in water compared with 1.3 per 1,000 births with standard care.

This finding may be linked to pulling on the umbilical cord when the newborn is brought up out of the water, the researchers suggested.

Overall, they stated: “Water immersion provides benefits for the mother and newborn when used in the obstetric setting, making water immersion a low-tech intervention for improving quality and satisfaction with care.

“In addition, water immersion during labour and waterbirth alter clinical practice, resulting in less augmentation, episiotomy, and requirements for pharmacological analgesia,” they said.

They concluded: “Water immersion is an effective method to reduce pain in labour, without increasing risk.”

However, they acknowledged that information on birth settings, care practices, interventions and outcomes varied considerably among the included studies, and few were carried out in midwife-led units or in the mother’s home, which may have affected the findings of the analysis.

To strengthen the evidence base, future research should include factors that are known to influence interventions and outcomes during and after labour or birth, they added.

For example, how many children a woman has already had, where she gives birth, who looks after her, and the care she receives.

“The challenge now is to ensure this choice is open to all women wherever they live”

Clare Livingstone

Commenting on the research, Clare Livingstone, professional policy advisor at the Royal College of Midwives, said: “This is really good news for women choosing to have a water birth or thinking of having one.

“There has been previous research outlining the benefits for women and this significant study adds weight to those. It is also positive because it is more information for women when deciding how they want to give birth.”

She said: “Water births are becoming more widely available for women across the UK, but this isn’t the case everywhere. The challenge now is to ensure this choice is open to all women wherever they live.”

Ms Livingstone added: “What is needed now is to see more research into water births in midwife-led settings and in women’s homes. This will give us a broader picture of the impact of water births.”

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.

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REFERENCES

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.

 

Ventilation for the birthing environment

Engineering experts Phil Nedin and Dr. Anna Coppel from Arup’s advanced Technology and Research team look at the science of ventilating a birthing room.

Water Birth Pools expel a high volume of moisture that must be considered when designing the ventilation system for a water birth room.

Ventilation for birthing pool facilities

 

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:

Health and safety concerns

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

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

Re-circulating water systems

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

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

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

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

Integral Plumbing Systems

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

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

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

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

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

Hand held showers

Handheld showers present a significant infection control risk.

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

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

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

Pumped heating systems

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

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

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

Bacteria filters and disinfection systems

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

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

2019: Venus Water Birth Pool, Peterhead Hospital

Overflow drains

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

Regulations are very clear on this point.

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

Surface mounted metalwork

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

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

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

The Active Birth pools approach:

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

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

Double step units

In breech of Manual Handling protocols.

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

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

Doors

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

Doors are mistakenly used for two reasons:

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

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

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

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

The Active Birth Pools approach:

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

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

Height adjustable pools

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

They are completely wrong!

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

It’s that simple.

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

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

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

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

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

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

The Active Birth Pools approach:

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

Look at the midwife in the photo above.

Notice how comfortable the she is?

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

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

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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.

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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.

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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.

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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.

 

Water births provide ‘clear benefits’ for healthy mums and their newborns, with fewer complications

July, 6, 2022

I News – Paul Gallagher – health Correspondent

Compared with standard care, a water birth significantly reduced the use of epidurals as well as pain and heavy bleeding after the birth, researchers found

Water births provide “clear benefits” for healthy mothers and their newborns, with fewer interventions and complications during and after the birth than standard care, researchers believe.

Analysis of the available evidence also found that water births result in higher levels of satisfaction for mothers. A water birth involves using a birthing pool to achieve relaxation and pain relief, either exiting the pool for the birth, so the baby can emerge into air to breathe, or remaining in the birthing pool for the birth, bringing the baby to the surface to start breathing.

The Oxford Brookes University researchers compared the extent of healthcare interventions needed during and after labour between the two different types of water birth and to see if outcomes differed between a water birth and standard care – without the use of a birthing pool. They analysed 36 studies published between 2000 and 2021 involving 157,546 women.

The studies included a broad range of interventions and outcomes, including induced labour, artificial breaking of waters, stimulation of labour and epidural use among many others.

Data analysis of the study results showed that a water birth, regardless of whether women birth in or out of the pool, “has clear benefits to women” in obstetric units, where most births take place and where healthcare interventions and complications are more probable than in midwife-led units, note the researchers. A water birth was as safe as standard care for healthy mums and their newborns.

Compared with standard care, a water birth significantly reduced the use of epidurals, injected opioids, episiotomy, as well as pain and heavy bleeding after the birth. And it increased mothers’ satisfaction levels and the odds of an intact perineum. And there was no difference in the rate of C-sections, the Oxford Brookes University researchers found.

“Water immersion can significantly increase the likelihood of an intact perineum and reduce episiotomy, an intervention which offers no perineal or fetal benefit, can increase postnatal pain, anxiety, and impact negatively on a woman’s birth experience,” they concluded.

There were more instances of umbilical cord breakage among water births, but the rate was still low: 4.3/1000 births in water compared with 1.3/1000 births with standard care. This may be linked to pulling on the umbilical cord when the newborn is brought up out of the water, the researchers suggested.

They acknowledge that information on birth settings, care practices, interventions and outcomes varied considerably among the studies, and few were carried out in midwife-led units or in the mother’s home, which may have affected the findings of analysis.

But they conclude: “Water immersion provides benefits for the mother and newborn when used in the obstetric setting, making water immersion a low-tech intervention for improving quality and satisfaction with care.

“In addition, water immersion during labour and water birth alter clinical practice, resulting in less augmentation, episiotomy, and requirements for pharmacological analgesia. Water immersion is an effective method to reduce pain in labour, without increasing risk.”

The researchers, who publish their findings in the journal BMJ Open, called for future research to include factors that are known to influence interventions and outcomes during and after labour and birth. These include how many children a woman has already had, where she gives birth, who looks after her, and the care she receives, they said.

RCM welcomes research showing benefits of water birth

RCM welcomes research showing benefits of water birth

06 July 2022

RCM Maternity Services Midwifery Workforce Midwife Shortage MSWs – Maternity Support Workers Staffing Levels Waterbirth

Research showing the safety and positive benefits for women having a water birth has been welcomed by the Royal College of Midwives (RCM). The research showed that women having a water birth in a hospital obstetric unit had fewer medical interventions and complications during and after the birth.

Commenting on the research, Clare Livingstone, Professional Policy Advisor at the RCM, said: “This is really good news for women choosing to have a water birth or thinking of having one. There has been previous research outlining the benefits for women and this significant study adds weight to those. It is also positive because it is more information for women when deciding how they want to give birth.

“Water births are becoming more widely available for women across the UK, but this isn’t the case everywhere. The challenge now is to ensure this choice is open to all women wherever they live.”

The study did show a small increase in ‘umbilical cord snaps’ – where the baby’s umbilical cord breaks – though the rates remain very low. This will not hurt the baby and the midwife will respond quickly and clamp the cord to prevent any bleeding.

Clare Livingstone added, “What is needed now is to see more research into water births in midwife led settings and in women’s homes. This will give us a broader picture of the impact of water births across all the places in which women give birth.”

The research from Oxford Brookes University will be published in the open access journal BMJ Open tomorrow (6 July).

The Oxford Brookes University research can be read at https://bmjopen.bmj.com/content/12/7/e056517.full.

The Royal College of Midwives (RCM) is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team.  We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences, and online resources. For more information visit the RCM | A professional organisation and trade union dedicated to serving the whole midwifery team.