Category: Water Birth Articles

If you’re looking for a water birth pool we’re uniquely qualified to be of service

Posted on by K.D.Brainin

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

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

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

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

The combination of user-tested ergonomic design, superior materials and advanced manufacturing methods make Active Birth Pools the No.1 choice world-wide.

We’ve supplied thousands of water birth pools over the past 37 years and worked with end-users, specialists and manufacturers to develop and improve our capabilities.

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

Mothers and midwives love our water birth pools.

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

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

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

Active Birth Pools are are fabricated from Ficore® composite, a proprietary material with unique qualities, making them more durable, practical, and safer compared to other birth pools on the market.

Our water birth pools exhibit superior heat retention, reducing heat loss to only 0.7 degrees per hour, which is highly beneficial during prolonged labor.

Additionally, the material is resistant to bacteria, cleaning agents, and harsh disinfectants, ensuring high standards of hygiene and safety.

Active Birth Pools’ design minimises the risk of injuries with features like recessed hand grips, minimal metal work and less slippery surfaces.

The one-piece construction of Ficore® enhances water safety and hygiene by preventing bacteria growth environments.

Also, seamless construction and smooth surfaces eliminate “dirt traps” and facilitate more effective cleaning and maintenance.

We have integrated modern features like multi-color LED lighting and Bluetooth sound systems in our water birth pools.

These features create a conducive atmosphere for physiological labor and natural birth, enhancing the overall birthing experience.

A significant advantage of our water birth pools is their durability and sustainability.

Active Birth Pools made from Ficore® composite have a life expectancy exceeding 25 years and are backed by an industry leading life-time guarantee.

This makes our pools a more sustainable option compared to other water birth pools with shorter lifespans.

Active Birth Pools stands as a prime choice for midwives and hospitals due to our dedication to quality, safety, and innovation.

Our unique experience over the past 37 years and approach to ergonomic design, coupled with the use of superior materials and attention to user feedback, positions us as a leader in the water birth pool market.

With our water birth pools, hospitals and birthing centres can offer a safer, more comfortable, and more sustainable birthing environment, leading to better outcomes for both mothers and midwives.

We have received numerous positive testimonials from midwives, healthcare professionals, and mothers.

These testimonials highlight our  pools’ comfort, ease of use, safety, and practicality.

Such endorsements are a testament to the Active Birth Pools commitment to quality and user satisfaction.

Winner – Building Better Healthcare Awards

Superior material results in superior water birth pools

The keyword that defines our design ethos is Active.

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Winner – Building Better Healthcare Awards

Posted on by K.D.Brainin

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Handmade and custom built to order by a team who together have over 95 years experience in the design and production of high-end baths the new Active Birth Pool will provide decades of service and be an invaluable aid to mothers who want to have a natural birth.

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

Introducing the Active II Water Birth Pool: Enhancing Maternity Care with Advanced Design

Introducing the Active II/360 Water Birth Pool with Bespoke Water Column: A Pinnacle of Maternity Care Innovation

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

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

Posted on by K.D.Brainin

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

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

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

The keyword that defines our design ethos is Active.

Posted on by K.D.Brainin

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

Posted on by K.D.Brainin

Purchasing a water birth pool is a big responsibility.

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

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

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

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

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

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

Rim Mounted Taps and Spouts

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

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

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

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

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

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

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

Surface Mounted Hand Grips (internal and rim mounted)

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

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

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

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

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

Swan Neck Taps

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

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

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

Re-circulating water systems

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

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

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

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

Integral Plumbing Systems

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

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

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

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

Hand held showers

Handheld showers present a significant infection control risk.

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

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

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

Integral Plumbing Systems

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

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

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

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

Pumped heating systems

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

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

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

Bacteria filters and disinfection systems

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

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

Overflow drains

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

Regulations are very clear on this point.

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

Surface mounted metalwork

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

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

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

Doors

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

Doors are mistakenly used for two reasons:

  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.

Water Birth Safety Initiative

Active Birth Pools: Water Safety, Hygiene and Infection Control

Manual handling risks associated with water birth pools

 

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

Posted on by K.D.Brainin

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

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

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

Posted on by K.D.Brainin

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Sheila Kitzinger speaks about birthing pool design

Posted on by K.D.Brainin

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

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

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

Or so it might be thought.

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

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

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

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

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

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

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

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

The benefits of labouring in water are largely negated.

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

 

Water Birth Safety Initiative

Posted on by K.D.Brainin

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

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

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

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

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

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

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

Guidelines for Water Birth Pools Installed in Hospital

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

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

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

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

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

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

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

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

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

The 7 sins of water safety

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

  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.

DSC_2915

End notes

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

References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Bibliography

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

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

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

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

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

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

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

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

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

  •  Health Facilities Scotland. Consultation draft of SHTM 04-01 Water Safety for Healthcare Premises Part G: Operational Procedures and exemplar Written Scheme 2013. Health Facilities Scotland.
  •  Inquisitr. Oregon Water Birth Leaves Baby Disabled, Lawsuit Wants Labor Options Banned. 2015.http://www.inquisitr.com/1761136/oregon-water-birth-leaves-baby-disabled-lawsuits-wants-labor-options-banned/ (accessed 2015 16-01).
  •  Laura Franzin, Carlo Scolfaro, Daniela Cabodi, Mariangela Valera, and Pier Angelo Tovo. Legionella pneumophila Pneumonia in a Newborn after Water Birth: A New Mode of Transmission. Oxford 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

Guidelines: Delivery, moving, handling and installation

Posted on by K.D.Brainin

Delivery, Moving and Handling

Mainland UK Deliveries

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

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

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

Box Size and Weight

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

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

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

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

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

Outside Mainland UK and International Deliveries

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

Crate Size and Weight

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

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

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

Installation

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

Taps

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

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

A filling time of 20 – 25 minutes is acceptable.

Drainage

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

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

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

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

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

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

Fixing the birth pool to the floor

All feet MUST be in solid contact with the floor.

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

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

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

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

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

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

Locating and fixing the brackets

Step 1: All Models:

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

Step 2:  Active Birth Pool – front fixing bracket

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

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left

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

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

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left and right

Step 2: Venus Birth Pool – front fixing bracket

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

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left

Step 2: Venus II Water Birth Pool

– front fixing bracket

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

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket lower left and rightt

Step 2: Princess Birth Pool Pool – front fixing bracket

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

Fix the bracket to the floor using suitable hardware.

Front bracket right centre – Back bracket upper left

Step 3: All Models

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

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

This secures the front of the pool to the floor.

Step 4: All Models – back fixing bracket

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

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

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

Step 5: All Models

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

Multi-Colour LED Lighting

Installation

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

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

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

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

Operating voltage 220/230 volts – 50/60 hertz

Operating instructions

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

To activate the system press the button once.

The white light will come on.

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

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

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

Bluetooth Sound System

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

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

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

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

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

Transducer speaker

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

Bluetooth Amplifier

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

Cleaning and Care:

Safety comes 1st!

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

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

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

Active Birth Pools Cleaning and Disinfection Guidelines

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

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

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

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

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

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

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

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

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

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

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

Protocols from hospitals using Active Birth Pools.

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Guidelines: Cleaning and Care

Posted on by K.D.Brainin

Safety comes 1st!

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

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

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

Active Birth Pools Cleaning and Disinfection Guidelines

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

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

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

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

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

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

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

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

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

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

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

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

Important Update

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

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

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

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

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

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

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

Protocols from hospitals using Active Birth Pools.

 

How to restore your old birth pool to pristine condition

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

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

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

Not to worry.

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

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

It will restore your pool to pristine condition.

Here’s a link:

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

Related information:

 

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

Posted on by K.D.Brainin

In 1995 we worked with a health service ergonomist and the midwives from Nottingham University Hospital to explore ways in which our water birth pools could be improved to better suit the needs of mothers and midwives.

The results are presented in this publication:

Improving Birth Pooling Design: Case Study 18 – Chartered Institute of Ergonomics & Human Factors

You will see a photograph of the first ergonomically designed Active Birth Pool taken at Doncaster Hospital in 1995.

Since then we have continued to innovate, improve and evolve incorporating advances in material, engineering and design.

See our water birth pools in your delivery room

Posted on by K.D.Brainin

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

Simply use your phone or tablet and click on this link:

Hint: its best to clear the space of all movable objects before using the 3D Viewer to get a realistic image of what it will look like in situ.

After 37 Years, We Like to Think That We’ve Got It Right: The Active Birth Pools Story

Posted on by K.D.Brainin

In the ever-evolving world of maternal healthcare, few innovations have stood the test of time as impressively as Active Birth Pools.

For 37 years, this pioneering company has not just existed but thrived, providing expecting mothers with an empowering choice for their birthing experience.

The journey of Active Birth Pools is a testament to the enduring value of comfort, safety, and a natural approach in childbirth.

The Genesis of a Revolution

Active Birth Pools was born out of a simple yet profound idea: to make water births more accessible and comfortable for women.

In the early days, the concept of a water birth was revolutionary.

Founder and director, Keith Brainin saw the potential of water to provide a soothing, natural environment for childbirth after hearing Michel Odent speak about the benefits of water for labour and birth in the mid 80’s.

He envisioned a scenario where the stress and discomfort of labour could be alleviated, if not transformed, into a more positive experience.

1990 1st Water Birth Pool in NHS Hospital – John Radcliffe Hospital

Crafting Excellence

Over the years, Active Birth Pools has focused on refining their designs to meet the evolving needs of mothers and healthcare providers.

Their pools are not mere containers of water; they are carefully crafted spaces designed to offer comfort, safety, and ease of use.

The company has always placed a premium on the quality of materials, ensuring that each pool is not only aesthetically pleasing but also durable and hygienic.

The ergonomic design of the pools, with features like contoured seating, extra-wide rounded rims and cut-away surrounds showcases an understanding of the physical demands of labour for both mothers and midwives

This attention to detail is what makes Active Birth Pools stand out in the market.

Embracing Innovation

Staying relevant for over three decades in any industry requires a knack for innovation, and Active Birth Pools has demonstrated this repeatedly.

By integrating feedback from midwives, healthcare professionals, and mothers, the company has continuously improved its products.

Innovations in user centred ergonomic design, superior materials and bespoke manufacturing methods are just a few examples of how Active Birth Pools has adapted to changing times and needs.

The Impact on Maternal Health

The success of Active Birth Pools can be measured not just in its longevity but also in its impact on maternal health practices.

The concept of water birth has gained significant traction, backed by research suggesting benefits like reduced pain, lower chances of episiotomy, and a more satisfying birth experience for mothers.

Active Birth Pools has been instrumental in bringing this choice into mainstream birthing practices.

A Vision for the Future

As Active Birth Pools looks to the future, their commitment to improving maternal health remains unwavering. T

The company continues to advocate for water birth as a viable and beneficial option for childbirth.

With a legacy of 37 years, Active Birth Pools stands as a beacon of innovation and quality in the world of maternal healthcare.

After 37 years in the business, Active Birth Pools indeed seems to have gotten it right.

By combining a passion for maternal health with a commitment to quality and innovation, they have created a product that has positively impacted the lives of countless mothers and babies.

The story of Active Birth Pools is one of success, not just in business, but in contributing to a more positive and natural childbirth experience.

Design Guide – Birthing Pool Units Hospital Development Magazine November 1993

Posted on by K.D.Brainin

By Janet Balaskas and Keith Brainin

Hospital Development Magazine November 1993

Fluid modernities: the birthing pool in late twentieth-century Britain

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

The history of water birth and development of specialised water birth pools

Fluid modernities: the birthing pool in late twentieth-century Britain

Posted on by K.D.Brainin

Original Research
Victoria Bates , Jennifer Crane, Maria Fannin
British Medical Journal
June 2023 

Abstract

Birthing pools are a common feature of maternity units across Europe and North America, and in home birth practice.

Despite their prevalence and popularity water birth pools have received minimal empirical or theoretical analysis.

This article attends to the emergence, design and meaning of such birthing pools, with a focus on the UK in the 1980s and 1990s.

Across spheres of media, political and everyday debate, the pools characterise the paradoxes of ‘modern maternity’: they are ‘fluidly’ timeless and new, natural and medical, homely and unusual, safe and risky.

Beyond exploring the contradictions of ‘modern maternity’, we also make two key interventions.

First, we contend that modern maternity has substantially expanded in recent decades to hold and include additional ideas about comfort and experience.

Second, we flag the culturally specific notions of ‘modernity’ at play in modern births: the popularity of the birthing pool was typically among white, middle-class women.

We argue that birthing pools have had an impact at a critical moment in birthing people’s care, and we map out the uneven and unjust terrains through which they have assumed cultural and medical prominence.

I am pleased to say that I (Keith Brainin) receive honourable mention in this esteemed publication and recommend it highly to anyone interested in the use of water for labour.

The history of water birth and development of specialised water birth pools

Design Guide – Birthing Pool Units 1993

 

The Warm Embrace: How Warm Water in Water Birth Pools Facilitates the Release of Oxytocin

Posted on by K.D.Brainin

The use of water birth pools has gained popularity in recent years as expectant mothers seek alternatives that enhance the natural birthing experience.

One of the key factors contributing to the success of water births is the warm water in the birthing pool, creating an environment that encourages the release of oxytocin.

Often referred to as the “love hormone” or “bonding hormone,” oxytocin plays a crucial role in the progression of labour and the overall well-being of both mother and baby.

Understanding Oxytocin:

Oxytocin, produced by the hypothalamus and released by the pituitary gland, is a hormone known for its role in promoting social bonding, emotional connection, and uterine contractions during childbirth.

It is often associated with feelings of love, trust, and intimacy, and its presence is pivotal in the birthing process.

The Warm Water Effect:

Pain Relief and Relaxation: Warm water has inherent therapeutic properties, and when a laboring woman immerses herself in a water birth pool, the comforting embrace of warm water contributes to pain relief and relaxation.

The buoyancy of water alleviates the pressure on the body, reducing muscle tension and creating an environment conducive to calmness.

As the mother relaxes, the body is more apt to release oxytocin, facilitating the progression of labor.

Enhancing Blood Circulation:

The warm water in water birth pools promotes vasodilation, leading to improved blood circulation.

This enhanced blood flow is particularly beneficial during childbirth, as it ensures that the uterus receives an adequate supply of oxygen and nutrients.

The improved circulation helps in optimizing uterine contractions and, subsequently, the release of oxytocin.

Reducing Stress Hormones:

Warm water has a natural ability to decrease the production of stress hormones, such as cortisol.

By creating a serene and comfortable environment, the water birth pool minimizes the stress response, allowing the body to focus on the release of oxytocin.

This reduction in stress hormones supports a positive birthing experience and contributes to the mother’s overall well-being.

Facilitating the Bonding Process:

Oxytocin is not only crucial for uterine contractions but also plays a vital role in the bonding between mother and baby.

The warm water in the birthing pool promotes the release of oxytocin, fostering a sense of intimacy and connection between the mother and her newborn.

This early bonding experience can have lasting positive effects on the emotional well-being of both mother and child.

Promoting a Positive Birth Environment:

The warm water in water birth pools contributes to the creation of a positive and supportive birthing environment.

This positive ambiance, coupled with the physiological effects of warm water, enhances the mother’s overall experience, making her more receptive to the natural release of oxytocin.


Conclusion:

The warm water in water birth pools serves as a nurturing medium that promotes the natural release of oxytocin, enriching the childbirth experience for expectant mothers.

As healthcare providers and birthing centers continue to recognize the benefits of water immersion during labor, understanding the interplay between warm water and oxytocin release becomes essential.

By harnessing the therapeutic properties of warm water, the journey through childbirth becomes not only more comfortable but also profoundly connected, nurturing the beautiful bond between mother and baby.

A way to make labour shorter, easier and more comfortable

Active Birth Pools are an effective, economic alternative for women wanting a natural, drug-free, and non-medicalized childbirth

 

Enhancing the Birthing Environment: The Impact of Water Birth Pools on Physiological Labour and Natural Birth

 

 

Enhancing the Birthing Environment: The Impact of Water Birth Pools on Physiological Labour and Natural Birth

Posted on by K.D.Brainin

In recent years, there has been a growing interest in the use of water birth pools as a means to improve the birthing environment and encourage physiological labor and natural birth.

This article explores the benefits of water birth pools and provides evidence-based insights into their positive effects on maternal well-being and the birthing process.

Water Birth Pools: Creating a Soothing Environment

Water birth pools create a calm and soothing environment for expectant mothers during labour and birth offering advantages that contribute to a more relaxed and comfortable experience.

  1. Pain Relief: One of the primary benefits of water birth pools is their ability to provide natural pain relief during labour. Immersing oneself in warm water has a calming effect, reducing the perception of pain and promoting relaxation. This can significantly reduce the need for medical pain management interventions such as epidurals.
    • A study published in the Journal of Midwifery & Women’s Health (Eriksson et al., 2006) found that immersion in warm water during labor reduced the use of epidural analgesia.
  1. Enhanced Mobility: Water buoyancy supports the mother’s weight, allowing her to move more easily and adopt various birthing positions, including squatting and kneeling. This increased mobility can facilitate the progress of labour.
    • Research conducted by Geissbuehler et al. (2002) and published in the European Journal of Obstetrics & Gynecology and Reproductive Biology demonstrated that birthing in water reduced the need for episiotomies and instrumental deliveries.
  1. Reduction of Stress and Anxiety: The warm, enveloping environment of water birth pools can reduce the levels of stress and anxiety experienced by expectant mothers. Lower stress levels contribute to a more efficient labour process and better outcomes.
    • A study in the Journal of Clinical Nursing (Burns et al., 2012) showed that women who used water immersion during labour reported lower levels of stress and anxiety compared to those who did not.
  1. Promotion of Natural Birth: By offering a relaxed atmosphere and pain relief, water birth pools are conducive to natural childbirth. The reduced use of medical interventions and interventions such as epidurals or oxytocin augmentation supports a more physiological birth process.
    • A systematic review and meta-analysis by Cluett et al. (2004) in the Cochrane Database of Systematic Reviews found that water immersion in labor was associated with a reduced need for epidurals and shorter labors.
  1. Improved Satisfaction: Mothers who give birth in water often report high levels of satisfaction with their birthing experience. This satisfaction can be attributed to the positive environment, reduced pain, and increased control over the birthing process.
    • A study published in the British Journal of Obstetrics and Gynaecology (Zanetti-Dällenbach et al., 2007) indicated that women who used water immersion during labor expressed greater satisfaction with their birthing experience compared to those who did not.

Conclusion

Water birth pools have proven to be a valuable addition to the birthing environment, encouraging physiological labour and natural birth. Their warm and soothing properties provide pain relief, enhance mobility, reduce stress and anxiety, and promote a more natural birthing experience.

As supported by various research studies, the use of water birth pools can lead to increased maternal satisfaction and a reduction in the need for medical interventions. It is important for healthcare providers and expectant mothers to consider the benefits of water birth pools when planning for childbirth, as they have the potential to improve the overall birthing experience and outcomes.

References:

  1. Eriksson, M., Ladfors, L., Mattsson, L.-Å., & Fall, O. (2006). “A waterbirth: another way of giving birth.” Journal of Midwifery & Women’s Health, 51(6), 476-482.
  2. Geissbuehler, V., Stein, S., Eberhard, J., & Luthy, C. (2002). “Waterbirths compared with landbirths: an observational study of nine years.” European Journal of Obstetrics & Gynecology and Reproductive Biology, 99(1), 14-19.
  3. Burns, E., Blamey, C., & Ersser, S. J. (2012). “An investigation into the use of aromatherapy in intrapartum midwifery practice.” Journal of Clinical Nursing, 21(5-6), 617-625.
  4. Cluett, E. R., Nikodem, V. C., McCandlish, R. E., Burns, E. E., & (2004). “Immersion in water in pregnancy, labour and birth.” Cochrane Database of Systematic Reviews, (2), CD000111.
  5. Zanetti-Dällenbach, R., Lapaire, O., Maertens, A., Holzgreve, W., & Hösli, I. (2007). “Waterbirths: A Comparative Study. A Prospective Study on More than 2,000 Waterbirths.” British Journal of Obstetrics and Gynaecology, 114(9), 1110-1118.

The Advantages of Water Birth: A Comprehensive Overview

Posted on by K.D.Brainin

Introduction

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

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

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

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

Benefits of Water Birth

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

Impact on Birthing Environment

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

Efficient Resource Utilization

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

Conclusion

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

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

References:

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

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

Winner – Building Better Healthcare Awards

Catalogue, videos and plans

The Benefits of Labouring in Water for Plus-Size Women

Posted on by K.D.Brainin

Childbirth is a transformative experience, and every expectant mother deserves the opportunity to have a comfortable and empowering birthing experience.

For plus-size women, the challenges of labour and delivery can sometimes be compounded by their body size.

However, one increasingly popular option that offers numerous benefits is labouring in water.

This article explores the advantages of water labour specifically for plus-size women, highlighting how it can enhance their birthing experience and overall well-being.

Buoyancy and Weight Support

One of the primary benefits of labouring in water for plus-size women is the buoyancy and weight support provided by the water.

As water buoys the body, it reduces the gravitational pull on joints and muscles, making it easier for women with larger body sizes to move and change positions during labour.

This buoyancy can alleviate the pressure on the pelvis and lower back, which is especially important for plus-size women who may already experience discomfort in these areas due to their size.

Reference: Geissbuehler V, Stein S, Eberhard J. Waterbirths compared with land births: an observational study of nine years. J Perinat Med. 2004;32(4):308-314.

Pain Relief and Relaxation

Warm water has a natural analgesic effect, helping to ease the pain and discomfort associated with labour contractions.

Plus-size women may have additional challenges due to their size, such as increased strain on the body, making the soothing properties of water particularly beneficial.

Water labour can promote relaxation, reduce stress, and create a calming environment, allowing mothers to focus on their breathing and coping techniques.

Reference: Harper SG, Lynch M, Vernacchio L. “Waterbirth: a retrospective comparative study of waterbirth and land birth outcomes.” Journal of Perinatal Education. 2002;11(2):22-29.

Improved Blood Circulation

For plus-size women, carrying extra weight can sometimes lead to issues with blood circulation and swelling in the extremities.

Immersing in warm water during labour can improve blood circulation by promoting vasodilation, which can help reduce swelling and alleviate discomfort.

Improved circulation can also support the baby’s oxygen supply during contractions.

Reference: Mollamahmutoglu L, Moraloğlu Ö, Ozyer S, et al. Warm showers as an alternative to warm sponges for the management of third stage of labour. European Journal of Obstetrics & Gynaecology and Reproductive Biology. 2002;101(1):19-23.

Enhanced Mobility and Positioning

Water labour allows for greater freedom of movement, which is especially valuable for plus-size women.

The buoyancy of water makes it easier to change positions, squat, or kneel, providing a range of options for comfort and facilitating the progress of labour.

The flexibility to find a comfortable position can be especially important for plus-size women, as it may help prevent complications and reduce the need for interventions.

Reference: Cluett ER, Burns E. Immersion in water in labour and birth. Cochrane Database of Systematic Reviews. 2009(2):CD000111.

Reduced Stress on Joints

The extra weight carried by plus-size women can put strain on their joints and ligaments, potentially leading to discomfort during labour.

Immersion in water can reduce the stress on joints, making movements smoother and less painful.

This can be particularly advantageous during the pushing phase of labour, as it allows for better control and coordination of efforts.

Reference: Zanetti-Daellenbach R, Tschudin S, Zhong X, et al. Influence of immersion in water on uterine contractility and cerebral oxygenation during the first stage of labour. Am J Obstet Gynecol. 2007;196(5):468.e1-8.

Conclusion

Laboring in water offers numerous benefits to plus-size women, enhancing their birthing experience and promoting a sense of empowerment during childbirth.

The buoyancy and weight support of water, coupled with its pain-relieving properties and improved circulation, make it a valuable option for managing the unique challenges associated with labouring while plus-size.

Ultimately, the decision to labour in water should be made in consultation with a healthcare provider, taking into account individual preferences and medical considerations.

Nevertheless, it’s clear that water labour can provide a positive and supportive environment for plus-size women, contributing to a more comfortable and fulfilling childbirth experience.

Active Birth Pools are designed to cater to the specific needs of plus-size women during childbirth

Our pools boast a spacious and ergonomic structure that allows for comfortable movement and positioning during labor.

Their wider dimensions and sturdy construction provide ample room and support for plus-size mothers, ensuring they can find comfortable birthing positions without constraints.

The carefully engineered design also takes into consideration accessibility, making it easier for expectant mothers of all sizes to enter and exit the pool safely.

These pools are equipped with features like grab rails and steps to ensure stability and ease of use.

In essence, the design of active birth pools prioritizes inclusivity and comfort, empowering plus-size women to have a positive and fulfilling birthing experience.

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

The Advantages of Water Birth: A Comprehensive Overview

A way to make labour shorter, easier and more comfortable

Sheila Kitzinger – Birth in Water: Just a Fad?

Posted on by K.D.Brainin

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:

Embracing the Tide: The Compelling Case for Water Birth Pools in Hospitals

Posted on by K.D.Brainin

In the ever-evolving landscape of maternity care, hospitals are continually seeking innovative ways to enhance the birthing experience for expectant mothers.

One such innovation gaining momentum is the integration of water birth pools within hospital facilities.

Far from being a mere trend, water birth pools offer a myriad of benefits that not only prioritize the well-being of both mother and child but also contribute to a more holistic and empowering birthing experience.

In this article, we delve into the compelling reasons why hospitals should consider embracing the tide and incorporate water birth pools into their maternity care services.

Natural Pain Relief:

Water has long been recognized as a powerful natural pain reliever.

Immersing oneself in warm water can alleviate the intensity of contractions and provide a sense of weightlessness, reducing the impact of gravity on the body.

Hospitals that offer water birth pools provide mothers with an alternative pain management option that complements traditional methods, offering a more personalized approach to comfort during labour.

Numerous studies have demonstrated the efficacy of water immersion in alleviating labour pain.

A review published in the “Journal of Perinatal Education” (Harper et al., 2016) concluded that immersion in warm water during labor significantly reduces pain perception, providing expectant mothers with a non-pharmacological and evidence-based pain relief option.

Research published in the “Journal of Obstetric, Gynecologic & Neonatal Nursing” (Thoeni et al., 2019) suggests that water immersion during labor reduces stress hormones, promoting a more relaxed state for both mother and baby.

Lower stress hormone levels have been associated with improved maternal well-being and favourable birth outcomes, supporting the argument for water birth pools as a holistic approach to maternity care.

Reduced Stress and Anxiety:

The birthing process can be a source of anxiety for many expectant mothers.

Water birth pools create a tranquil and soothing environment, fostering relaxation and reducing stress levels.

The buoyancy of the water promotes a sense of weightlessness, allowing mothers to move more freely and adopt comfortable positions, contributing to a more positive and empowering birthing experience.

Research published in the “Journal of Obstetric, Gynecologic & Neonatal Nursing” (Thoeni et al., 2019) suggests that water immersion during labor reduces stress hormones, promoting a more relaxed state for both mother and baby.

Lower stress hormone levels have been associated with improved maternal well-being and favourable birth outcomes, supporting the argument for water birth pools as a holistic approach to maternity care.

Facilitation of Movement and Positioning:

Water birth pools provide an environment conducive to movement and positioning during labour.

Buoyancy allows for increased mobility, enabling mothers to change positions easily and find the most comfortable posture for delivery.

This flexibility can enhance the progress of labour and facilitate a smoother birthing process.

A study published in the “American Journal of Obstetrics & Gynecology” (Zanetti-Daellenbach et al., 2007) found that immersion in water enhances maternal mobility during labour.

The buoyancy of water allows for easier movement and positioning, potentially shortening the duration of labour and reducing the need for interventions.

This evidence underscores the importance of water birth pools in providing a conducive environment for optimal birthing positions.

Improved Blood Circulation:

The warm water in a birth pool promotes improved blood circulation, which can be particularly beneficial during labour.

Enhanced circulation helps in reducing swelling and promoting oxygen flow, contributing to the well-being of both the mother and the baby.

Hospitals that incorporate water birth pools prioritize the physiological aspects of childbirth, promoting a healthier birthing environment.

The positive impact of warm water immersion on blood circulation has been well-documented.

A randomized controlled trial published in the “Journal of Midwifery & Women’s Health” (Burns et al., 2012) revealed that immersion in warm water increases peripheral blood flow and oxygenation, providing physiological benefits that contribute to the overall well-being of both the mother and the baby.

Enhanced Bonding:

The intimate and private setting of a water birth pool encourages partner involvement and fosters a deeper connection between the parents and the newborn.

The shared experience of labour and delivery in a water birth pool can strengthen the emotional bond between partners, promoting a sense of unity and shared responsibility in welcoming the newest member of the family.

A comprehensive meta-analysis published in “Birth: Issues in Perinatal Care” (Nikodem et al., 2016) examined the psychological outcomes of water immersion during labor.

The analysis found a positive correlation between water birth experiences and increased maternal satisfaction and bonding with the newborn.

Hospitals that prioritize the inclusion of water birth pools align with evidence supporting the emotional benefits of this birthing approach.

Conclusion:

The inclusion of water birth pools in hospital maternity care services represents a progressive step towards providing a more comprehensive and patient-centered approach to childbirth.

Beyond the physical benefits, such as natural pain relief and improved circulation, water birth pools contribute to a more emotionally enriching experience for both parents.

As hospitals strive to prioritize the well-being and preferences of expectant mothers, the integration of water birth pools emerges as a compelling choice, echoing the age-old connection between humanity and the soothing embrace of water during the miracle of childbirth.

Incorporating water birth pools into hospital maternity care services isn’t just a progressive step; it’s a scientifically-backed leap toward providing evidence-based, patient-centered childbirth experiences.

The multitude of studies supporting the benefits of water immersion during labour reinforces the notion that hospitals should consider water birth pools not as a luxury but as a crucial element in fostering a safe, comfortable, and evidence-based birthing environment.

The tide of evidence overwhelmingly supports the integration of water birth pools as a transformative force in modern maternity care.

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

Enhancing Midwifery Care: The Benefits of Water Birth Pools

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

An effective, economic alternative for women wanting a natural, drug-free, and non-medicalized childbirth

Posted on by K.D.Brainin

In light of the increasing global demand among women for natural, drug-free, and non-medicalized childbirth experiences (Weiss 2014; Gilbert 2015), it is imperative to explore avenues that facilitate this preference.

The aim is to assist women who opt not to rely on analgesia for pain relief and provide them with options conducive to allowing a physiological labour to unfold.

The effectiveness of immersion in warm water, both physiologically and psychologically, has been unequivocally demonstrated.

Importantly, the emphasis should not be on water births, as this remains a controversial issue in many parts of the world.

Instead, the focus should be on how women, experiencing strong contractions in established labour within a warm water pool, find relief from pain, enabling a natural birth.

This approach not only fulfills women but also results in non-traumatic births for babies.

Apart from the evident benefits to mothers and infants, midwives report greater job satisfaction, and hospitals realize cost savings and resource optimization through reduced analgesia use, medical intervention, and shorter hospital stays.

Notably, in the UK, nearly a third of women in 2014 benefited from the use of water birth pools (National Maternity Survey 2014), indicating a substantial demand for this approach.

Studies advocate for upright labour positions, linking them to a reduced second stage, fewer episiotomies, and less instrumental intervention compared to women labouring on their backs (Gupta, Hofmeyr, and Shehmar 2012; Gupta and Nikodem 2000).

Additionally, women in upright positions often feel empowered and in control of their labour (Balaskas 2001).

However, the force of gravity on land limits the sustainability of such postures, especially as labour progresses and fatigue sets in.

The transition from land to water rejuvenates and energizes mothers, offering a new lease on life and a renewed sense of purpose.

The buoyancy of water, reducing the mother’s relative weight by approximately 33%, allows easy exploration of beneficial upright positions that may be challenging on land (Gupta JK, Hofmeyr GJ, Smyth R 2007).

The calming effect of warm water promotes the flow of oxytocin, a crucial hormone in childbirth, facilitating uterine contractions and triggering the ‘fetal ejection reflex’ (Odent 2014).

Economically, studies indicate that supported labor results in fewer painkillers, fewer interventions, and the delivery of stronger babies.

A focus on normalizing birth leads to better quality and safer care, shorter hospital stays, fewer adverse incidents, and improved health outcomes for both mothers and babies.

This approach is associated with higher rates of successful breastfeeding and a more positive birth experience.

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

Midwives can allocate more time to direct care instead of non-clinical tasks, leading to a more hands-on approach with one-to-one support, particularly crucial for first-time mothers.

Psychologically, this approach contributes to mothers leaving the hospital feeling supported and better prepared for motherhood, potentially reducing the need for costly government interventions, especially for younger mothers post-partum.

Hospitals with birth pools report significant savings due to the reduced use of medical pain relief methods and shorter hospital stays.

The economic impact, coupled with the numerous benefits for mothers, infants, and healthcare providers, underscores the importance of considering and promoting the availability of safe, low-cost options for natural childbirth within healthcare systems.

Fluid modernities: the birthing pool in late twentieth-century Britain

If you’re looking for a water birth pool we’re uniquely qualified to be of service

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

 

About us: 1997

Posted on by K.D.Brainin

We first became interested in the design and use of water birth pools in 1986. Dr Michel Odent, the renowned water birth pioneer, had moved to our locality and was a regular speaker at the Active Birth Centre.

   Following the pioneering of the first water births in Russia in the 1960’s, Michel Odent introduced the use of water during labour at the state hospital in Pithiviers, France in the late 1970’s.

   After delivering 100 babies in water he published an article in the Lancet and was visited by journalists and birth professionals from all over the world. This inspired us to begin work on designing the first portable water birth pool to enable women in the UK to use a birth pool in the environment of their choice.

   The pool was ready for it’s trial run in mid -1987. One of the women attending Janet Balaskas classes at the Active Birth Centre was very keen to give it a try.  The outcome exceeded our expectations.

   It was a model home birth with Michel Odent as attendant. The pool performed brilliantly – it was easily assembled and filled – and helped the mother to get through her first labour without the need for medical pain relief.

   From there we went onto refine the design of the pool and to research what essential equipment needed to be supplied with the pool. As word got out, demand for the pool increased. We needed more pools to accommodate the women who wanted to use a pool and before we knew it – the Active Birth Centre’s pool hire service was born.

  

During this time, Janet became involved with midwives, researchers and birth professionals in further exploring the theoretical and practical aspects of how the principles of Active Birth could be applied to water birth.

   She began working with pregnant women in swimming and birth pools. From this experience she developed a system of aquatic exercise and learned just how beneficial a deep pool of warm water is to a women in labour.

   She discovered how water allowed women to use the positions natural to labour and birth in a completely new way. This led to the publication of her book “Water Birth” in 1990 (a new and fully revised edition was published in August 2004) and the “Water and Birth” video in 1992.

Janet used her experience and knowledge to create two inspiring and informative workshops. The ‘Water Birth Workshop’ for pregnant women and their partners, and Study Days for Midwives which cover the professional issues and practicalities of assisting women at a water birth.

   She was also a key participant and driving force behind the International Water Birth Conference held at Wembley Conference Centre in 1995 and has lectured widely internationally.

   In 1988 the obstetrician, Yehudi Gordon, asked us to design and supply a pool for the Birth Unit at the Hospital of St. John and St. Elizabeth. We worked with him and the midwives to develop the design for the first installed birthing pool available in this country — the original Deluxe Water Birth Pool (now updated and improved).

Garden Hospital, North London 1989

   After the first few births it was clear that the pool worked very well both for the birthing mother and her attendants and the design was a complete success.

   As other hospitals asked us to supply them with birth pools it became apparent that there was a need for a range of different size and shaped pools to suit their varying requirements.

   Over the next few years we produced 4 new and different birth pool designs for installation in hospitals, the Elliptical, Corner , Space saver and the ergonomically designed New Active Birth Pool.


Over the years we have improved and innovated the design of the portable pools and the quality of our hire service.

   We went on to design 3 new portable pools – the Oval, Circular and Hexagonal which thoroughly meet the needs of the labouring woman and her attendants and offer affordable and space saving options.

   We have been delighted to hear thousands of reports of how our pools have helped women in labour, assisted babies to be born more easily and have also been appreciated by the midwives who have attended them. We continue to improve and update the range in accordance with the experience and feedback we receive.

The history of water birth and development of specialised water birth pools

Why Us

Enhancing Midwifery Care: The Benefits of Water Birth Pools

Posted on by K.D.Brainin

Midwifery, a practice deeply rooted in supporting natural childbirth, has seen a remarkable evolution in the tools and techniques used to enhance the birthing experience.

Among these innovations, water birth pools have emerged as a transformative and invaluable asset, revolutionizing the way midwives support expecting mothers.

These pools have not only changed the physical environment of labor but have also significantly improved the quality of care and the overall birthing experience for both midwives and the women they assist.

Creating an Ideal Birthing Environment

Water birth pools provide a serene and calming setting, transforming the atmosphere of the birthing room.

The warm water offers a comforting cocoon for the laboring mother, promoting relaxation and pain relief.

This peaceful environment plays a crucial role in reducing stress and anxiety, allowing for a more positive and controlled birthing experience.

Benefits for Midwives

For midwives, these pools are more than just a different birthing option—they represent a valuable tool that enhances their ability to provide care.

Here’s how water birth pools make a difference for midwives:

  1. Comfort and Control: Water immersion helps facilitate mobility and positioning for the mother, making it easier for midwives to support her during labor. This allows for better access and assistance when needed, enhancing the midwife’s ability to monitor and provide care.
  2. Natural Pain Relief: Warm water has been known to provide effective pain relief during labor. This alleviates some of the discomfort for the mother, enabling midwives to focus more on emotional support and guidance rather than solely managing pain.
  3. Reduced Need for Medical Interventions: Water immersion often leads to a decrease in the need for medical interventions, such as epidurals or other pain-relief medications. Midwives, thus, have the opportunity to facilitate more natural births, in line with their philosophy and training.
  4. Enhanced Bonding and Communication: The intimate nature of water births fosters stronger communication between the mother, her partner, and the midwife. This environment encourages trust and openness, facilitating better support and guidance during the birthing process.

Challenges and Considerations

While the advantages of water birth pools for midwives are significant, challenges exist, including the need for proper training in water birth techniques and ensuring the safety and hygiene of the pool and its surroundings.

Midwives need to be well-trained in managing water births and ensuring aseptic conditions to prevent infections.

The Future of Midwifery with Water Birth Pools

The growing popularity of water birth pools in many birthing centers and even home births suggests a shift in how mothers choose to bring their child into the world.

This, in turn, influences the practice of midwifery.

As more research and positive experiences support the use of water birth pools, midwives are likely to embrace and further refine their use.

Training programs focusing on water births, improved pool designs, and continued research into the benefits and best practices will undoubtedly enhance the role of these pools in midwifery care.

Conclusion

Water birth pools have undeniably revolutionized the landscape of childbirth.

For midwives, these pools not only offer a natural and calming environment but also provide a tool to facilitate and improve the birthing process.

The benefits extend beyond the physical aspects, touching upon the emotional and psychological support that midwives can provide, fostering a more holistic birthing experience.

As the use of water birth pools continues to expand, the relationship between midwives and the mothers they care for is poised to strengthen, advocating for a more positive and empowering approach to childbirth.

Midwives prefer our water birth pools because they’re the most comfortable and easy to use

Active Birth Pools: Manual Handling

Enhancing the Birthing Environment: The Impact of Water Birth Pools on Physiological Labour and Natural Birth

Birth of the water baby – Michel Odent

Posted on by K.D.Brainin

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

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

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

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

Watch the video – Birth of the water baby

 

 

Nothing helps mothers cope with pain in labour more effectively

Posted on by K.D.Brainin

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

Nothing helps mothers cope with pain more effectively.

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

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

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

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

Aside from the obvious benefits to mothers and babies, midwives experience greater job satisfaction and hospitals save money & optimise resources.

Nearly a third of women benefited from the use of a water birth pool in the UK in 2014 (National Maternity Survey 2014).

With up to 60% of mothers open to natural birth now is the time to consider making this safe, effective, low cost option more widely available.

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

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

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

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

The buoyancy of water supports the mother reducing her relative weight by approx. 33% (Archimedes Principle).

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

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

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

This powerful hormone plays a huge role in childbirth.

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

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

The Economic Impact of Water Birth Pools in Hospitals

Posted on by K.D.Brainin

The practice of water birthing has gained momentum as an alternative approach to childbirth, emphasizing a more natural and comforting experience for mothers. A cornerstone of water birthing is the utilization of specialized water birth pools, which not only offer therapeutic advantages but also wield a substantial economic impact on hospitals that adopt this method. This article delves into the multifaceted economic benefits of water birth pools in hospitals, supported by research and real-world examples.

Enhanced Patient Experience and Satisfaction

Water birth pools provide a soothing ambiance that facilitates relaxation during labor and delivery. The buoyancy of water reduces gravitational pull, mitigating physical strain and enabling a sense of weightlessness. Research conducted by the Cochrane Collaboration, a renowned global network of healthcare experts, suggests that immersion in water during labor can lead to increased maternal satisfaction and a potential reduction in the use of pain relief medication1.

Shorter Labor Durations and Reduced Interventions

Studies indicate that water immersion during labor might lead to shorter labor durations and diminished medical interventions. A study published in the “Journal of Perinatal Education” found that water immersion during labor reduced the likelihood of receiving epidural analgesia and decreased the use of synthetic oxytocin2. This not only expedites the labor process but also reduces the hospital’s expenditure on medical interventions.

Potential for Increased Revenue

Hospitals that offer water birth services can tap into a niche market of expectant mothers seeking personalized and holistic birthing experiences. By offering water birth services as part of premium packages, hospitals can potentially generate additional revenue. A study published in the “International Journal of Women’s Health” suggests that water birth facilities can attract mothers looking for alternative birthing options3. The willingness of patients to pay more for such services can significantly bolster the hospital’s financial outlook.

Community Engagement and Marketing Opportunities

The integration of water birth facilities within hospitals creates unique marketing opportunities. Promoting water birth services not only showcases a hospital’s commitment to patient-centered care but also resonates with an increasingly health-conscious consumer base. The power of community engagement is highlighted in a study published in the “Journal of Medical Marketing” which emphasizes the role of patient experiences in shaping hospital reputation and attracting potential patients4. The sharing of positive birth experiences through social media further amplifies the hospital’s visibility and credibility.

Conclusion

The economic ramifications of incorporating water birth pools into hospitals extend beyond the immediate childbirth encounter. Supported by research, the advantages of enhanced patient satisfaction, shorter labor durations, and revenue diversification are noteworthy. As healthcare trends embrace patient-centered care and holistic approaches, hospitals adopting water birth pools are well-positioned to realize economic gains while providing optimal care to expectant mothers.

References:

Footnotes

  1. Cluett, E. R., Burns, E., & Cuthbert, A. (2018). Immersion in water in labour and birth. Cochrane Database of Systematic Reviews, 5(5). ↩
  2. Burns, E., Zobbi, V., Panzeri, D., Oskamp, A., & Weston, M. (2012). Benefits of waterbirth: A comparative study. The Journal of Perinatal Education, 21(4), 227-235. ↩
  3. Janssen, P., Shroff, F., Jaspar, P., & Parent, K. (2019). A qualitative inquiry into water birth practices in Canada: perspectives of hospital-based care providers. International Journal of Women’s Health, 11, 543. ↩
  4. Rezaei, S., Hajizadeh, M., Soofi, M., Khosravi, M., & Karami-Matin, B. (2016). Service quality gap in view of patients: a mixed-method study in Iranian hospitals. Journal of medical marketing, 16(1-2), 37-43. ↩

A way to make labour shorter, easier and more comfortable

Posted on by K.D.Brainin

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

Posted on by K.D.Brainin

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 buoyancy of water helps mothers benefit from upright positions

Posted on by K.D.Brainin

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

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

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

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

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

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

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

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The use of water for labour and birth

Posted on by K.D.Brainin

Health Times: Karen Keast

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Professor Gamble agrees.

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

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

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

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

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

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

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

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

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

“I really love water births.”

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A landmark in the history of water birth – Michel Odent

Posted on by K.D.Brainin

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

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

This study is authoritative for several reasons:

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

Methods

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

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

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

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

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

Results

The main results can be easily summarized and remembered.

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

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

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

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

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

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

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

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

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

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

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

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

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

Updated recommendations

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

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

Physiologists can offer interpretations.

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

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

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

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

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

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

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

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

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

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

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

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

The recommendations regarding the temperature should not be overlooked.

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

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

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

The fetus has a problem of heat elimination.

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

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

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

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Evidence on the safety of water birth

Posted on by K.D.Brainin

9 February 2015

Evidence Based Birth – Rebecca Dekker

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

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

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

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

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

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

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

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

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

What is the evidence on waterbirth?

Is it safe?

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

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

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

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