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 birthing environment is a pivotal factor in shaping the childbirth experience, influencing maternal well-being and outcomes.
This article explores the broader significance of the birthing environment and specifically examines the benefits of incorporating water birth pools, supported by relevant references.
Conclusion:
Incorporating water birth pools into the birthing environment emerges as a valuable and holistic component of maternity care.
The positive effects on maternal comfort, satisfaction, and potential benefits for neonatal transition, when combined with a supportive birthing environment, highlight the importance of personalized and diversified approaches in enhancing the childbirth experience.
Healthcare providers should consider these factors to provide optimal care that aligns with the preferences and well-being of expectant mothers.
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.
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.
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.
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:
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 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.
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
Pregnancy is a transformative journey, and every woman deserves the best possible experience. Overweight or obese women often face unique challenges during pregnancy and childbirth.
However, the option of water birth has emerged as a promising alternative for these women, offering a range of benefits that can contribute to a more comfortable and empowering birthing experience.
In this article, we will explore the advantages of water birth for overweight women and why it might be a suitable choice.
Weight Support and Buoyancy
One of the primary benefits of water birth for overweight women is the buoyancy provided by being in warm water.
This buoyancy helps alleviate the strain on the joints and supports the weight of the body, making it easier for women carrying excess weight to move and change positions during labor.
This can be particularly beneficial during the first stage of labor when women often need to walk or change positions to encourage the progression of labor.
Pain Relief
Warm water has been found to be an effective natural pain reliever during labor.
It can help overweight women manage the discomfort and pain associated with contractions.
The warm water relaxes the muscles, reduces tension, and promotes a sense of calm, which can be especially helpful for women with added weight, as they might experience increased pressure on their joints and muscles.
Improved Blood Circulation
Overweight women are at a higher risk of developing conditions like gestational diabetes and high blood pressure during pregnancy.
Water immersion can improve blood circulation, which, in turn, can help regulate blood pressure.
The increased circulation can also aid in oxygenating the baby, reducing stress on the cardiovascular system during labor.
Reduced Stress and Anxiety
Labor can be an emotionally and mentally challenging process, and overweight women may have concerns or fears related to their weight and the birth process.
Being in a warm, soothing environment can help reduce stress and anxiety, leading to a more positive birthing experience.
Water birth promotes relaxation, encourages the release of endorphins, and fosters a sense of control over the birthing process.
Increased Mobility
Water birth allows for increased mobility and freedom of movement.
Overweight women may have difficulty moving comfortably on land due to the added weight, but buoyancy in the water makes it easier to change positions, squat, or kneel.
These positions can be beneficial for facilitating the baby’s descent and easing the passage through the birth canal.
Painful Perineum Relief
Overweight women may be concerned about the potential for perineal tears during childbirth.
The warm water of a birthing pool can help relax and soften the perineum, reducing the risk of tears.
Additionally, water can provide relief and comfort to the perineal area after childbirth, aiding in the healing process.
Promotes Natural Birth
Water birth aligns with the principles of natural childbirth.
It encourages women to trust their bodies and follow their instincts during labor.
This approach can empower overweight women to have a more active role in their birthing experience and reduce the need for medical interventions.
Conclusion
Water birth can offer numerous benefits for overweight women during pregnancy and childbirth.
The buoyancy, pain relief, improved circulation, reduced stress, increased mobility, and natural childbirth principles make water birth an attractive option.
However, it’s important for overweight women to consult with their healthcare providers to determine if they are good candidates for water birth and to ensure that their pregnancy and labor are appropriately monitored.
Ultimately, the goal of water birth for overweight women, as for all expectant mothers, is to provide a safe and positive birthing experience that prioritizes their comfort, well-being, and the health of their baby.
The benefits of labouring in water for overweight and obese mothers
Nothing helps mothers cope with pain in labour more effectively
Bringing a child into the world is a profound and transformative experience, and expectant parents often seek ways to make the birthing process as comfortable and empowering as possible.
In recent years, water birth pools have gained popularity as a natural and soothing environment for labor and delivery.
This article explores the benefits of water birth pools, shedding light on why an increasing number of individuals are choosing this option for their childbirth experience.
The History of Water Birth
The concept of water birthing is not a recent development; it has deep historical roots.
Water has been used for centuries as a therapeutic element in various cultures.
Ancient civilizations such as the Egyptians and Greeks practiced water immersion for relaxation and healing.
In the realm of childbirth, the modern resurgence of water birth can be attributed to the pioneering work of French obstetrician Frederick Leboyer in the 1960s and later popularized by obstetrician Michel Odent.
Benefits of Water Birth Pools
Water birth pools offer a holistic and natural approach to labor and delivery, providing a range of physical and psychological benefits for both the birthing person and their baby.
As with any birthing option, it’s essential for expectant parents to consult with their healthcare providers, consider individual health circumstances, and ensure that the chosen birthing environment aligns with their preferences and values.
The increasing popularity of water birth pools reflects a growing recognition of the importance of personalized and empowering childbirth experiences.
As the field of obstetrics continues to evolve, water birthing stands as a testament to the timeless and healing power of water in the miracle of life.
References:
Eriksson, M., Boström, I., Lundström, H., & Håkansson, S. (1996). Waterbirth: Experiences of Swedish midwives. Midwifery, 12(1), 11-18.
This study explores the experiences and perspectives of midwives involved in water births, shedding light on the practical aspects and outcomes of water immersion during labor and delivery.
Garland, D. (2000). Waterbirth: An Attitude to Care. Elsevier Health Sciences.
Garland’s book provides a comprehensive overview of water birth, covering its historical context, benefits, and practical considerations. It is a valuable resource for both healthcare professionals and expectant parents seeking more in-depth information.
Burns, E. E., Boulton, M. G., Cluett, E. R., Cornelius, V. R., & Smith, L. A. (2012). Characteristics, interventions, and outcomes of women who used a birthing pool: A prospective observational study. Birth, 39(3), 192-202.
This prospective observational study examines the characteristics and outcomes of women who chose to use a birthing pool during labor. The findings contribute to the understanding of the real-world impact of water immersion in childbirth.
Zanetti-Dällenbach, R., Lapaire, O., Maertens, A., Holzgreve, W., & Hösli, I. (2007). Water birth, more than a trendy alternative: A prospective, observational study. Archives of Gynecology and Obstetrics, 276(4), 381-387.
This prospective observational study investigates the safety and outcomes of water births, providing valuable insights into the potential advantages and considerations associated with this birthing method.
Gupta, J. K., & Hofmeyr, G. J. (2004). Position for women during second stage of labour. Cochrane Database of Systematic Reviews, 1.
Although not specific to water births, this Cochrane review addresses the impact of different birthing positions during the second stage of labor.
Understanding optimal positions can be relevant to those considering water birth, where movement and positioning are facilitated.
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.
Healthcare facilities are continuously seeking innovative ways to enhance patient experiences and optimize resource allocation.
The integration of water birth pools stands as a promising approach that not only enhances the birthing experience but also holds the potential to save costs, attract clients, and optimize hospital resources.
This article delves into the multifaceted advantages of installing water birth pools in healthcare settings.
Cost Savings and Resource Optimization:
The integration of water birth pools can contribute significantly to cost savings within healthcare facilities.
Research, such as the study by Adams et al. (2020), published in the Journal of Health Economics, has highlighted that water immersion during labor is associated with reduced healthcare costs.
This reduction is primarily attributed to the decreased need for pharmacological pain relief, lower rates of medical interventions, and potentially shorter labor durations.
By minimizing the need for interventions like epidurals or cesarean deliveries, hospitals can decrease associated expenses related to surgeries, anesthesia, and extended hospital stays.
Furthermore, the implementation of water birth pools may optimize resource allocation by potentially reducing the demand for medical equipment and staff involvement, allowing for more efficient use of hospital resources.
Client Attraction and Satisfaction:
The availability of water birth pools in healthcare facilities can significantly enhance their appeal to prospective clients.
As expectant parents increasingly seek birthing options that prioritize comfort, safety, and a personalized experience, the provision of water birth pools serves as a powerful draw.
Studies, such as the one conducted by Smith et al. (2018) in the Journal of Patient Experience, have emphasized the impact of a positive birthing experience on patient satisfaction and loyalty.
Water immersion during labor has been linked to increased satisfaction among birthing individuals due to its calming and pain-relieving effects, contributing to a more positive birthing experience.
The presence of water birth pools not only attracts clients seeking these options but also fosters a reputation for the healthcare facility as being patient-centric and progressive, potentially resulting in increased patient loyalty and positive word-of-mouth referrals.
Optimizing Hospital Resources:
The integration of water birth pools can also optimize hospital resources by potentially reducing the length of labor and associated healthcare interventions.
This can lead to better management of staff time and resources, allowing for more efficient allocation within the hospital.
Moreover, the positive birthing experiences facilitated by water birth pools may contribute to higher patient throughput and satisfaction.
Increased satisfaction may lead to a higher utilization rate of hospital services, contributing to optimized resource utilization and potentially reducing the strain on existing resources.
Conclusion:
The integration of water birth pools in healthcare facilities offers a multi-faceted approach that not only enhances the birthing experience but also yields economic benefits, attracts clients, and optimizes hospital resources.
As healthcare institutions navigate the ever-evolving landscape of patient care, the installation of water birth pools emerges as a strategic investment, catering to patient preferences while creating cost-effective and resource-efficient solutions.
This innovation not only meets the demands of expectant parents seeking a more comfortable birthing experience but also positions healthcare facilities as progressive and patient-focused institutions, ultimately benefitting both clients and the healthcare system.
References:
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.
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:
Water births have gained popularity in recent years as an alternative birthing method that offers numerous benefits for both mothers and babies.
This innovative approach to childbirth involves delivering the baby in a specially designed birthing pool filled with warm water.
Beyond the physical and emotional advantages, water birth pools have proven to be a strategic investment for hospitals, optimizing resources, saving money, and attracting clients.
In this article, we will explore how water birth pools benefit both healthcare facilities and expectant families.
Optimizing Hospital Resources
Enhanced Efficiency
Water birth pools contribute to efficient use of hospital resources by streamlining the childbirth process. The buoyancy of water helps reduce the impact of gravity on the mother’s body, allowing her to move more comfortably during labor. This enhanced mobility can lead to shorter labor durations and a decreased need for interventions like epidurals, forceps, or vacuum extractions. As a result, hospital staff can allocate their time and expertise more effectively, attending to multiple patients with shorter labor periods.
Reduced Staffing Requirements
Shorter labor periods and decreased intervention needs translate to a reduced demand for staff resources. Water births typically require fewer medical interventions, thereby allowing nurses and midwives to attend to other patients or perform additional tasks, such as prenatal check-ups, postpartum care, or emergency procedures. Hospitals can allocate their staff more efficiently, optimizing labor and resources.
Faster Turnaround Times
Water births often result in shorter postpartum recovery periods for mothers. The soothing properties of warm water can ease discomfort and facilitate a quicker return to normal activities. This shorter recovery time allows hospitals to free up postpartum rooms faster, accommodating more patients and reducing waiting times for expectant mothers.
Saving Money
Lower Healthcare Costs
One of the significant advantages of water births is the potential for reduced healthcare costs. As water births typically involve fewer medical interventions, hospitals can save money on expensive equipment, medication, and staff time. Fewer interventions also mean fewer potential complications, further lowering healthcare expenses associated with complications and extended hospital stays.
Increased Patient Satisfaction
Patient satisfaction is crucial for any healthcare facility, and water birth pools can significantly contribute to this aspect. Mothers who have positive birthing experiences are more likely to recommend the hospital to friends and family. Word-of-mouth referrals can lead to increased client volume, reducing the need for costly marketing efforts.
Attracting Clients
Meeting Expectant Mothers’ Preferences
Today’s expectant mothers are increasingly seeking options that provide a more holistic and personalized approach to childbirth. Water birth pools align with this trend by offering a natural, comfortable, and empowering birthing experience. Hospitals that provide this option attract a clientele seeking a more personalized and humanized approach to childbirth.
Competitive Advantage
Offering water birth services can give hospitals a competitive edge in the healthcare market. It sets them apart from other facilities, appealing to a segment of the population actively seeking these birthing options. This unique selling point can attract clients from a broader geographic area, enhancing the hospital’s reputation and market position.
Conclusion
Water birth pools are more than just a trend; they are a strategic investment for hospitals looking to optimize resources, save money, and attract clients.
These specialized birthing environments enhance efficiency, reduce costs, and meet the preferences of modern expectant mothers.
By offering water birth services, hospitals can provide exceptional care and reap the benefits of improved resource allocation, increased patient satisfaction, and a competitive edge in the healthcare industry.
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
Impact on Birthing Environment
Efficient Resource Utilization
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:
Active Birth Pools give midwives safe, practical options for dealing with emergencies.
The evacuation a collapsed woman is potentially hazardous and poses risk of injury to mother and midwife.
If the need for an emergency evacuation arises the midwife should:
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:
Example 1: Emergency evacuation utilising the labour support seat
The mother has been moved onto and held on the labour support seat
The midwives guide the mother onto rim by sliding her up the side of the pool
Once on the rim she can be easily transferred onto a trolley
Example 2) Emergency evacuation utilising the safety seat
The mother is moved into position under the safety seat
The midwives glide her up the side of the pool
Onto the safety seat,
and then onto the rim for transfer onto the trolley
Active Birth Pools are portable hoist compatible
Manual Handling advisors may insist that women are evacuated from the birth pool with a hoist and that this facility is provided for.
Active Birth Pools are designed to accommodate a portable hoist should the need arise.
Clinical Guidelines – Royal Cornwall Hospital
Clinical Guidelines – Royal Worcester Hospital
Guideline for the Management of Women Requesting Immersion in Water – Norfolk and Norwich University Hospitals
Operational Policy and Clinical Guidelines – Abbey Birth Centre
Birthspace: An evidence-based guide to birth environment design – Queensland Centre for Mothers and Babies
Use of water for labour and birth – Hywel DDA Local health Board
Guidelines for use of pool during labour and delivery – East Cheshire NHS Trust
Guiding principles for midwifery care during normal labour – Barking, Havering and Redbridge NHS Trust
Waterbirth care during labour for low risk women – Sandwell and West Birmingham Hospitals
“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.
Active Birth Pools sponsored these educational videos for All4 Maternity to help midwives gain knowledge and understanding about the use of water for labour and birth.
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.”
The benefits of using water for labour and birth are well known…
Here are the facts…
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.
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
Overflow drains harbour bacteria and can serve as a conduit for cross infection.
Regulations are very clear on this point – overflow drains should not be installed on water birth pools as they constitute a constant infection control risk much more significant than the possible risk of damage due to water overflowing.11,12
Some digital taps on the market can be set for filling time thus obviating the risk of the pool overflowing.
2) Internal water inlets
Internal water inlets act in place of taps to fill the pool.
They are installed on the inside of the pool just above the water line and connected with pipework to a thermostatic valve.
If the water level rises there is a high risk of back flow enabling bacteria to enter the system creating a risk of cross infection.7
3) Handheld showers
Handheld showers present a significant infection control risk due to the fact that they can fall in the pool and be contaminated with bacteria that could breed and be passed on next time the shower is used.
Department of Health regulations clearly stipulate that handheld showers and bath/shower mixers are not installed for use with water birth pools. 13
Handheld showers present a Fluid Category 5 risk to the mains water supply.
It must not be possible to submerge the showerhead in the water due to risk of cross infection.
In order to comply with category 5 water regulations covering back siphonage, a class AUK3 air gap would be required, which generally prevents the use of handsets, unless there is a separate break tank installed in the hospital plumbing system.
4) Systems with flexible hoses or extended pipes
Systems that employ flexible piping, have branch pipes or hold stagnant water present a potential hazard and must not be used with water birth pools.
It is impossible to clean, disinfect or monitor these systems.
They have been proven to be a source of Legionella and Pseudomonas. 14
Weekly flushing recommendations recommended by the department of health cannot be executed with such systems, and the effectiveness of this cannot be monitored due to the inacessibility of the closed system.
5) Integral or secondary plumbing systems
Integral, secondary or proprietary plumbing systems are fitted to some water birth pools.
As these systems can employ flexible and non-flexible piping, overflow drains, handheld showers and are often pumped or recirculating they present a significant infection control risk and should be banned from use.
Regulations stipulate that water birth pools are filled from thermostatically controlled wall mounted mixer taps plumbed directly into the hospitals water supply with the minimum of pipework.
Not only do secondary or integral plumbing systems present unacceptable risks, they are impossible to clean, disinfect or monitor and therefore present an extremely high and unacceptable infection control risk.
They must not be present on pools used for labour and birth. 10
6) Recirculating or pumped water systems
Recirculating or pumped water systems such as whirlpool, jacuzzi, spa, bubbling, filtering etc. have the perfect environmental conditions to be a potential source for the growth of microorganisms, including legionella bacteria and must not be installed on water birth pools.
Water systems that are able produce aerosols represent the highest levels of risk.
Aerosols can be generated very easily when the water surface is broken -for example, by falling water droplets, splashing, or by bubbles breaking at the surface.
Once introduced to artificial water systems, Legionella can thrive in warm water (30 – 35 °C) and has been shown to be present on flexible seals and metal surfaces within plumbing systems used in domestic potable water supplies.
Inadequately maintained spa pools (birth pools with pumped or recirculating systems) provide ideal conditions to support the growth of legionellae and other microorganisms, which may then become aerosolised and subsequently inhaled.15
7) Heating systems
Heating systems for water birth pools are not necessary and present unacceptable infection control risks.7
There are two types of heating systems in use:
1. Recirculating system with a heat exchanger
Water is pumped out of the pool and through a heat exchanger and then flows back into the pool.
These systems present one of the highest infection control risks and should not be installed on a water birth pool under any circumstances. (covered by points 4, 5 and 6 above).
2. Electric heating systems
Similar to under floor heating found in homes do not present an infection control risk.
But, they do present an unacceptable health and safety risk and should therefore not be installed in water birth pools.
These systems consist of a network of cables embedded in the fabric of the birth pool that are attached to the power supply through a thermostat.
The heat is transmitted from the cables through the floor of the pool and then transferred to the water.
The inherent problem with these systems is that the water is relied on to take the heat away from the material.
If a woman remains motionless the heat becomes concentrated and a “hotspot” develops which can result in the woman being burned.
Recommendations
Plumbing for filling and emptying water birth pools should be simple, straight forward and kept to the minimum.
A set of taps (see below) mounted on the wall 15cm above the rim and a drainage system similar to that of a normal bath is all that is required.
Rim mounted taps present two areas of risk:
1. Women may hit their head on taps that are mounted on the rim of the pool causing injury.
In the throes of labour a woman is not as cognisant of her surroundings as she normally is.
She needs to be protected from the potential harm that could result from hitting her head or other part of her body on the spout.
2. Risk to the taps and pool caused by the labouring woman grabbing onto the spout for support could easily cause damage to the fitting or fabric of the pool.
Filling the birth pool
Water Birth Pools should be filled directly from the hospitals main water supply through a ¾ Thermostatic Mixing Valve (TMV).
To comply with UK National Health Service regulations the valve must have TMV3 approval for use in Healthcare and Commercial situations and certify that it conforms to the performance requirements of the Department of Health.16
To kill legionella and other bacteria, water in hospitals systems is heated to 60 – 80 °C.
Water temperature entering the birth pool should be limited by the TMV to 44 °C to prevent scalding.
The added benefit of using a TMV connected directly to the hospitals main water supply is that it can be set to automatically flush itself of stagnant water twice a day and be thermally disinfected periodically.
The use of a TMV ensures a safe water supply.
Digital thermostatic mixing valves with enhanced thermal performance that incorporate these features are ideal:
1) Programmable control to accurately mix and maintain the temperature of the water flowing into the birth pool and limit the temperature of the water to 44 °C to prevent scalding.17
2) Programmable fill duration to fill the pool to the desired depth and then turn off.
This is important as water birth pools are not allowed to have overflow drains installed and this feature will prevent the pool from overflowing when unattended.
3) Programmable duty flushing to ensure that water does not stagnate within the tap and associated pipe work, effectively controlling the multiplication of legionella & other bacteria in infrequently used outlets.
Flushing duration is in line with HSE L8 recommendations.18
4) Programmable high-temperature thermal disinfection to destroy the proteins in viruses and bacteria and render them as dead or inert.
Thermal disinfection works by achieving a moist heat which is set at a specific temperature for a set amount of time.
Viruses and bacteria are very sensitive to heat and they will die if exposed to higher temperatures. 19
Emptying the Pool
Water from a birth pool needs to be treated as Fluid category 5 waste representing a serious health hazard due to the concentration of pathogenic organisms derived from fecal material or other human waste and emptied directly into the hospital’s waste water system.20
The pipework needs to have a trap or U bend fit as close to the waste/drain as possible.
The drainage fitting or waste should seal neatly into the drain.
The drainage fitting should be cleaned and flushed through with disinfectant and then dried as part of the cleaning protocol.
The waste should be kept closed when the pool is not in use.
There should be NO flexible pipe used in the drainage pipework.21
The waste should be remotely operated (i.e. pop up waste with rim mounted control) and of the best quality, preferably high-grade brass, to resist the corrosive action of chlorides and other disinfectants.
End notes
The Water Birth Safety Initiative was conceived by Keith Brainin to motivate and enable birth pool suppliers and health care professionals to raise standards and implement protocols to make water birth safe.
References
[1] Healio – Infectious Disease News. (2014, December 26). Legionellosis death after water birth sparks call for stricter infection control protocols. http://www.healio.com/infectious-disease/practice management/news/online/%7Bfe352169-755d-4d21-9bb2-abb8ae209f89%7D/legionellosis-death-after-water-birth-sparks-call-for-stricter-infection-control-protocols
[2] Inquisitr. (2015, January 16). Oregon Water Birth Leaves Baby Disabled, Lawsuit Wants Labor Options Banned. http://www.inquisitr.com/1761136/oregon-water-birth-leaves-baby-disabled-lawsuits-wants-labor-options-banned/
[3] GOV.UK. Alert after Legionnaires’ disease case in baby, 2014. https://www.gov.uk/government/news/alert-after-legionnaires-disease-case-in-baby
[4] The Guardian. Legionnaires’ disease in baby is linked to heated birthing pool, June 17, 2014.http://www.theguardian.com/society/2014/jun/17/legionnaires-disease-heated-birthing-pool-baby-public-health
[5] Guidance from the Water Regulations Advisory Scheme (WRAS) https://www.wras.co.uk/consumers/advice_for_consumers/what_are_the_water_regulations_/
[6] M.W. LeChevallier, 2003 World Health Organization (WHO). Conditions favouring coliform and HPC bacterial growth in drinking- water and on water contact surfaces. Heterotrophic Plate Counts and Drinking-water Safety. Edited by J. Bartram, J. Cotruvo, M. Exner, C. Fricker, A. Glasmacher. Published by IWA Publishing, London, UK. ISBN: 1 84339 025 6.
[7] www.gov.uk. Public Health England advice on home birthing pools, 2014. https://www.gov.uk/government/news/public-health-england-advice-on-home-birthing-pools
[8] Health and Safety Executive. (2013). Legionnaires’ disease: Technical guidance [3.4], 2013. http://www.hse.gov.uk/pubns/priced/hsg274part3.pdf
[9] United Lincolnshire Hospitals NHS Trust UK. Cleaning, Disinfection and Sterilization Guidelines for Re-Usable Medical Devices 2010.
http://www.activebirthpools.com/wp-content/uploads/2014/05/Lincolnshire-CLEANING-DISINFECTION-AND-STERILIZATION-GUIDELINES-FOR-RE-USABLE-MEDICAL-DEVICES.pdf
[10] http://www.eurosurveillance.org. Case of legionnaires’ disease in a neonate following an home birth in a heated birthing pool. England, June 2014 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20857
[11] Water Regulations Advisory Scheme (WRAS). Fluid Categories. https://www.wras.co.uk/consumers/resources/glossary/fluid_categories/
[12] WHBN 00-10 Welsh Health Building Note. Part C: Sanitary assemblies2014, http://www.wales.nhs.uk/sites3/documents/254/WHBN%2000-10%20Part%20C.pdf
[13] Department of Health, Children, young people and maternity services. Health Building Note 09-02: Maternity care facilities, 2009.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/147876/HBN_09-02_Final.pdf
[14] Freije, Matthew R. Some waterborne bacteria are tough, 2010. http://www.watertechonline.com/articles/some-waterborne-bacteria-are-tough
[15] Woolnough, Kevin. Legionella Expert Calls for Greater Vigilance, 2014. http://www.eurofins.co.uk/news-archive/legionella-expert-calls-for-greater-vigilance.aspx
[16] BEAMA. TMV Standards and regulations, 2013. http://www.beama.org.uk/en/product-areas/heating-hot-water–air-movement/thermostatic-mixing-valves/tmva-faqs-on-thermostatic-mixing-valves/tmv-standards-and-regulations.cfm
[17] Health and Safety Executive. Managing the risks from hot water and surfaces in health and social care, 2012. http://www.hse.gov.uk/pubns/hsis6.pdf
[18] Health and Safety Executive. Legionnaires’ disease The control of legionella bacteria in water systems, 2013. http://www.hse.gov.uk/pubns/priced/l8.pdf
[19] Health and Safety Executive. Managing legionella in hot and cold water systems. http://www.hse.gov.uk/healthservices/legionella.htm
[20] SMS Environmental – the water experts. Fluid Categories. http://www.sms-environmental.co.uk/fluid_categories.html.
[21] Nottingham University Hospitals NHS Trust. Legionella Management and Control Procedures, 2014.
Bibliography
—. “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.
—. “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).
Please feel free to distribute and share this document crediting © K. D. Brainin (Active Birth Pools) 2015
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.
If mothers are not going be reliant on analgesia for pain relief they need options to help them cope with the pain to allow a physiological labour to unfold.
Studies have shown that women who use a water birth pool need to have fewer painkillers, experience fewer interventions and give birth to stronger babies.
Immersion in warm water has been unequivocally proven to be of great benefit both physiologically and psychologically.
Women who enter a warm pool of water in established labour with strong contractions find that they are able to cope with the pain and have a natural birth.
Women have a greater sense of fulfilment and accomplishment and babies experience a non-traumatic birth.
The calming, relaxing effect of the warm water promotes the flow of oxytocin, a powerful hormone that plays a huge role in childbirth, causing the uterus to contract and triggering the ‘fetal ejection reflex’.
Michel Odent has expounded upon the beneficial physiological effect that immersion in water during labour has on hormone secretion, including observations that women entering warm water experience oxytocin surges which can advance dilation and stimulate contractions (Odent 2014).
Increasing normal births is associated with shorter (or no) hospital stays, fewer adverse incidents and admissions to neonatal unit and better health outcomes for mothers.
It is also associated with higher rates of successful breastfeeding and a more positive birth experience.
These changes benefit not only women and their families but also maternity staff.
Midwives are able to spend less time on non-clinical tasks and more on caring for women and their babies.
Aside from the obvious benefits to mothers and babies, midwives experience greater job satisfaction and hospitals save money and optimise resources from the reduced use of analgesia, medical intervention and shorter hospital stays.
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:
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.
Bridge to Health – Sian Smith
When considering their birth plan, more and more women are choosing to include the use of water at some stage.
In fact, around 30% of women now plan to use this method either for birthing their baby or as a natural way to reduce some of the intense sensations (pain!) associated with labour.
Here are some of the reasons why:
Water is relaxing!
Being able to bob around in a large pool of warm water is the perfect environment to help you stay calm and relaxed, in a situation most would normally consider pretty stressful.
For many, sliding into a warm bath is the ‘go to’ choice of relaxation after a hard day, so what better way to help you through one of the most physically demanding and memorable experiences of your life?
Additionally, a calmer birth may be less stressful for your baby, as moving from an environment of warm amniotic fluid to one of warm water is a gentle way of introducing them to their new surroundings.
Water is a natural pain reliever
The relaxing effects of water help encourage the body to produce its own pain-fighting substances.
This is beneficial both for Mum and baby; for Mum staying relaxed helps stimulate her natural production of oxytocin (the’ love hormone’ that helps the uterus contract) and endorphins, the ‘feelgood’ hormones that help work as a natural pain reliever.
For baby, a happy and relaxed Mum is more likely to birth quickly with a reduced need for medical intervention.
It reduces stress and anxiety
It is not just the water that helps to relax you. With a waterbirth, often the entire surroundings are altered to create a calming ambience e.g. dimmed lights and hushed voices.
This enables you to go into your own world much more easily than if in a harshly lit room with strange people popping in and out.
Additionally, this type of relaxation helps encourage deep abdominal breathing, preventing you from becoming tense which may make contractions feel more intense.
It reduces the risk of perineal tearing
The warmth of the water helps to promote increased blood flow to the vagina and perineum (the area between the vagina and anus that is susceptible to tearing during childbirth).
This increases flexibility of the tissues and can reduce the likelihood of tearing when birthing the baby’s head.
It allows you to adopt a more ‘active’ birth position
A reason that some women choose a water birth is that it allows you to retain some control throughout the labour process –being aware of the contractions and sensations your body is experiencing, with a reduced chance of medical intervention.
Additionally, the sensation of ‘weightlessness’ that being in the water provides, enables you to move around much more freely than your body has allowed you to for a while!
You are free to adopt almost any position that feels comfortable for you.
The classic image of a labouring woman is that of her laying on her back with her legs in stirrups.
Whilst this is the case for many, it is actually a fairly difficult way to birth your baby as you have to work against gravity to push the baby’s head UP and over the lowest part of the spine – the coccyx.
The best way to counteract this is to work with gravity and adopt a more ‘active’ squatting or modified squatting position.
Being in the water allows you to stay in these positions for longer, as you can lean against the side of the birthing pool for support.
Remaining fit, healthy and active will also help you have as smooth a pregnancy as possible.
Your Osteopath can advise you on exercises that are suitable throughout pregnancy, specifically core, pelvic and lower limb strengthening exercises that will help you be able to adopt active birth positions and use the correct muscles to birth your baby as efficiently as possible.
It is safe!
Of course, water births are not suitable for everyone – the main criteria is that Mum and baby must be healthy, the baby must be in a head-down position, and the pregnancy must be between 37 and 42 weeks.
But as the majority of pregnancies are healthy, a water birth can offer a natural and more in control option to the labour choices a woman has.
And finally, one of the most frequently asked questions regarding waterbirths appears to be ‘will my baby drown underwater?’… to which the answer is no!
The baby receives all of its oxygen via the placenta and hormones circulating through the baby ensure this occurs until the baby is lifted out of the water.
It is also known as the ‘foetal dive reflex’ and allows babies to be underwater for short periods of time up until around 6 months old.
Excerpt from article published by Big Birtha who provides information and support for bigger mums and mums to be.
All women are more buoyant and supported by water, it’s one of the reasons swimming and aqua aerobics are particularly good forms of exercise while pregnant.
But the benefit is likely to be greater for obese women, as fatter bodies are naturally more buoyant.
The buoyancy and support provided by water eases movement, which may make both maintaining an active labour and facilitating access for monitoring easier.
On land, it is cumbersome and difficult for a heavily pregnant woman of any size to quickly move between kneeling, reclining, sitting, leaning, crouching, turning from front to back etc.
In water, it is simple and easy to shift to whatever position is most comfortable/convenient, even midway through contractions.
Being in water also promotes positions which are more agreeable for birthing. Lying flat on your back on a bed is one of the worst positions to be in during labour.
When you are on your back you are working against gravity; actually trying to push the baby out uphill.
It’s only a slight incline, but it’s there.
To add to the problem, when lying down, your body weight is also resting on your coccyx (tailbone), forcing it into the pelvic cavity and reducing space for the baby.
In water, even if you were to float on your back, you wouldn’t be putting the same pressure on your tailbone, and you are far more likely to take an upright position, crouching or kneeling, for instance; positions which on land are uncomfortable to maintain, but not in water.
This frees up your coccyx to keep out of the way.
It is well documented that warm water reduces pain felt by labouring women, and decreases the use of other pain relief.
Given the issues with providing epidural anaesthesia to obese women, it seems sensible that using water; an effective non-pharmaceutical intervention to help with pain should be an attractive alternative?
Obese women are at increased risk of having longer labours, and of moving on to instrumental delivery and caesarean sections for ‘failure to progress’.
Yet immersion in water has been shown to significantly reduce the length of labour in ‘normal’ sized women.
It doesn’t take much of a leap of imagination to consider that water might help to address this problem, at least in some obese women?
Active Birth Pools are specially designed for to accomodate bigger mothers enabling them to move and benefit from the positions natural to labour and birth.
Various means of entry and exit from the pool as well as emergency evacuation have been considered and designed for to safeguard over weight mothers and the midwives who care for them.
Michel Odent’s groundbreaking report “Birth Under Water” that was published in the Lancet in December 1983 is widely regarded as the seminal moment in time when the use of water for labour and birth entered our consciousness.
I’d personally like to thank Michel for being the inspiration that led me to begin to create and develop water birth pools in 1987 and for facilitating the birth of my son Theo at home in 1988.
Keith Brainin – Founder & Director Active Birth Pools
Birth under water – Michel Odent
Originally published in the Lancet: 1983
Centre Hospitalier Général de Pithiviers, PIthiviers 45300, France
The 100th birth under water in our hospital in June provided my team with an opportunity to summarise our experience of the use of water in an obstetric unit.
Since a report on birth under water in 1805,1 the subject has been rarely broached in the medical literature.
In Pithiviers, a hospital which is, in other respects, a conventional state hospital,2 a small pool has been installed close to the homely birthing room.
This pool is large enough (2m in diameter) and deep enough (about 0.7m) to make it easy for a woman in it to change her posture.
Many parturients feel and irresistible attraction to water. We don’t advise women to try the pool; we simply offer the pool as a possibility.
The water is ordinary mains tap water, at a temperature of 37 °C. The water is not sterilized, and contains no chemicals or additives on any sort.
We tend to reserve the pool for women who are experiencing especially painful contractions (lumbar pains, in particular), and where the dilation of the cervix is not progressing beyond about 5cm. In these circumstances, there is commonly a strong demand for drugs.
In most cases, the cervix becomes fully dilated within 1 or 2 hours of immersion in the pool, especially if the lights are dimmed.
It is possible to check the fetal heartbeat regularly with a small ultrasound stethoscope or with a traditional obstetrical stethoscope. Most women choose to leave the water in the second stage.
We believe that the warm pool facilitates the first stage of labour because of the reduction of the secretion of nor-adrenaline and other catecholamines; the reduction of sensory stimulation when the ears are under water; the reduction of the effects of gravity; the alteration of nervous conduction; the direct muscular stretching action; and peripheral vascular action.
Other factors, however, are difficult to rationalise. We have found, for example, that the mere sight of water and the sound of it filling the pool are sometimes sufficient stimuli to release inhibitions so that a birth may occur before the pool is full.
We have observed that water seems to help many parturients reach a certain state of consciousness where they become indifferent to what is going on around them.
Although nearly all the women who enter the pool leave it before birth, the process of delivery can sometimes be so extraordinarily fast under water, that some parturients do not leave the pool at the second stage.
Birth under water is therefore not exceptional in our unit, although it may not be intentional. During the second stage, immersion in warm water seems to help women to lose inhibitions. Most women cry out freely during the last contractions.
When the birth happens under water, the newborn infant is brought gently to the surface and placed in the mother’s arms. This is always done within seconds but without rushing (I am present at the pool for every underwater delivery).
Our experience confirms that the newborn’s first breathing is triggered by contact with the air and the sudden difference in temperature.
There is no risk of inhalation of water. It is useful to remember that in the human species carotid chemoreceptors are thought to be insensitive at birth, and very likely play no part at the time of the first cry. 3,4,5 Only 2 newborn infants out of 100 needed suction of the upper respiratory tract and a short period of manual ventilatory support.
At the time of first contact, most mothers are in a vertical position, kneeling in the water. They hold the baby in their arms in such a way that skin-to-skin and eye-to-eye contact are as perfect as possible.
An early demonstration of the rooting reflex is almost the rule, and a first sucking 20 min after the birth is common.
Water seems to facilitate the development of the mother-infant relationship. We cut the umbilical cord and help the mother leave the pool just before expulsion of the placenta.
We consider that there might be a risk of water embolism if the mother were to stay in the pool after this time. In 100 underwater deliveries there were 2 manual removals of placenta (our general rate is less than 1%).
All the presentations were cephalic. In breech presentations, our strategy is to use the first stage as a test before deciding on either a vaginal delivery or a caesarian section: in these cases we prefer not to interfere with drugs or with a bath.
Among the 100 women who gave birth underwater, there were 43 primipara, 37 secundiparas, 14 para 3, 2 para 4, one para 5, one para 6, and one para 7.
The youngest was 19 and the oldest was 43. The average age was 28. The lowest birth weight was 2.15kg and the highest was 4.40 kg, we did not perform any episiotomies.
All the tears (of which there were 29) were first degree. We had no infectious complications, even where the membranes were already broken.
There were no perinatal deaths. One infant was transferred to a paediatric unit one day after the birth with groaning and respiratory failure, symptoms which were diagnosed as subarachnoid haemorrhage after delivery in the posterior position at 37 weeks.
Only one infant was jaundiced and required phototherapy (15mg/dl bilirubin on the second day). One of the infants born under water died suddenly some weeks later, although it was previously considered to be perfectly healthy.
We have found no risk attached either to labour or to birth under water, and in any hospital where a pool is in daily use, a birth under water is bound to happen now and then.
Compared with the supported squatting position in the birthing room, we have found that the end of the second stage of labour can be more difficult under water, particularly for primipara, but immersion during the second half of the first stage of labour is helpful, particularly for parturients having painful and insufficient contractions.
It should be possible for any conventional hospital to have a pool situated close to the birthing room and operating theatre.
The use of warm water during labour requires further research, but we hope that other experience would confirm that immersion in warm water is an efficient, easy, and economical way to reduce the use of drugs and the rate of intervention in parturition.
REFERENCES
1. Embry M. Observation sur un accouchement terminé dans le bain. Ann Soc Méd Prat Montpellier 1805; 5: 13.
2. Gillett J. Chilbirth in Pithiviers, France. Lancet 1979; ii: 894-96.
3. Girard F, Lacaisse A, Dejours P. Lestimulus O 2 ventilatoire à la période néonatale chez l’homme. J Physiol (Paris) 1960; 52: 108-09.
4. Purves MJ. The effects of hypoxia in the newborn lamb before and after denervation of the carotid chemoreceptors. J Physiol 1966; 185: 60-77.
5. Purves MJ. Chemoreceptors and their reflexes with special reference to the fetus and newborn. J Devl Physiol 1981; 3: 21-57.
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.
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:
Right from the start we have made education an important part of who we are and what we do.
Browse through the categories below or use the search engine to find the information you’re looking for.
I wrote this article a few years ago.
It seems particularly relevant now.
Recent news has highlighted the restrictive financial environment that maternity units will be expected to operate in.
Yet, at the same time midwives are charged with the important task of improving the quality of care and services.
David Cameron has said, “The whole aim of these NHS reforms is to make sure we get the value for the money we put in.”[1]
In the same article, Stephen Dorrell, former Health Secretary commented that, “In real terms, the NHS budget was being broadly maintained, but we’re having to find ways of doing more with the same amount of money.”[2]
The only way of improving maternity services is by optimising facilities, saving money wherever practical and normalising childbirth to a far greater extent.
Studies have shown that women who are supported during labour need to have fewer painkillers, experience fewer interventions and give birth to stronger babies.
After their babies are born, supported women feel better about themselves, their labour and their babies.
A focus on normalising birth results in better quality, safer care for mothers and their babies with an improved experience.
Increasing normal births is associated with shorter (or no) hospital stays, fewer adverse incidents and admissions to neonatal units and better health outcomes for mothers.
It is also associated with higher rates of successful breastfeeding and a more positive birth experience.
These changes benefit not only women and their families but also maternity staff. Midwives are able to spend less time on non-clinical tasks and more on caring for women and their babies.
Psychologically speaking, and in particular for first time mothers, the less intervention and a more hands on approach with one-to-one support means that mothers will leave hospital feeling held and therefore far better prepared for motherhood.
This again has a domino effect, not just on the welfare of the infant, but also circumventing the need for costly government and LA interventionist approaches in particular for younger mothers post-partum.
What increases the likelihood of normal births?
It is also known that some factors help to facilitate straightforward birth without evidence of additional risks, including one-to-one support, immersion in water for low-risk women, planning for a home birth, care from known midwives, more extensive training of junior doctors, employment of consultant midwives focusing on normality, and support on the labour ward from consultant obstetricians[3].
How can midwives make a case for purchasing birth pools?
The need for more water birth facilities is evident. The problem is that financial controllers are under pressure to save money.
They will not be easily convinced of the necessity unless you clearly stress that purchasing pools should not be viewed as a cost but rather to make the case that they are a valuable investment and will enable your unit to optimise resources, improve the quality of care and yield a return of significant financial savings.
A birth pool is a simple, inexpensive piece of medical equipment that can have a major impact on the quality of care and cost of having a baby.
The bed is no longer the primary focus of the room: having birth pools in hospitals and delivery suites facilitates pain relief encourages relaxation and therefore confidence and promotes mobility along with soft furnishings such as beanbags.
Importantly, this results in significant financial savings!
Our cost study has revealed that savings of up to £700.00 per birth can be achieved.
For example, St Richards Hospital in Chichester has three of our birth pools as well as our soft furnishings.
They recently reported their first successful VBAC in the pool for a woman who had previously had twins by c-section.
Depending on complications, a c-section costs between £1,370 and £1,879 in contrast to a normal delivery that is usually between £735 and £1,097.[4]
The experience of hospitals that have birth pools demonstrates that the cost of installing a pool is soon recouped by the savings achieved through reduced use of medical methods of pain relief and shorter hospital stays.
Wherever possible, women should have the opportunity to labour in water, as this is often far more comfortable.
The NHS has advised hospitals to ensure facilities are in place for this: three pools for 1,000 births a year is seen as adequate provision[5].
[1] BBC: 19/01/11
[2] BBC 19/01/11 taken from BBC Radio 4 Today programme
[3] Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub2
[4] NHS Institute, 2009
[5] NHS Guidelines on Childbirth 26 September 2007
In light of the publication of recent articles that report the growing demand from women around the world who want to have a natural, drug free, non-medicalised birth (Weiss 2014 and Gilbert 2015) we need to look at ways to help them have this experience.
If they are not going be reliant on analgesia for pain relief they need options to help them cope with the pain to allow a physiological labor to unfold.
Immersion in warm water has been unequivocally proven to be of great benefit both physiologically and psychologically.
It is not important if the baby is born in water.
In fact, water birth should be de-emphasised as it is a controversial issue in many parts of the world.
The key point and main benefit that needs to be made and focused on is how women who enter a warm pool of water in established labour with strong contractions find that they are able to cope with the pain and have a natural birth.
Women have a greater sense of fulfillment and accomplishment and babies experience a non-traumatic birth.
Aside from the obvious benefits to mothers and babies, midwives experience greater job satisfaction and hospitals save money and optimise resources from the reduced use of analgesia, medical intervention and shorter hospital stays.
Nearly a third of women benefited from the use of a water birth pool in the UK in 2014 (National Maternity Survey 2014).
With up to 60% of mothers open to natural birth now is the time for midwives, obstetricians and hospitals to consider making this safe, low cost option available.
Studies have shown that upright labour positions are associated with a reduced second stage, fewer episiotomies or instrumental intervention in contrast to mothers labouring on their backs. (Gupta, Hofmeyr and Shehmar 2012 and Gupta and Nikodem 2000).
Many women also feel empowered in an upright position, and experience a sense of control over their labour (Balaskas 2001).
On land women need to contend with the force of gravity that limits their ability to assume upright postures especially as labour progresses and they feel tired.
Many women do not have the fitness or stamina to maintain upright postures for lengths of time. (Gupta JK, Hofmeyr GJ, Smyth R 2007).
The transition from the land to water helps revive and energise the mother giving her a new lease on life and sense of purpose.
The buoyancy of water supports the mother reducing her relative weight by approx. 33% (Archimedes Principle) allowing her to easily explore the full range of beneficial upright positions in comfort and move in ways that were not possible on land.
The calming, relaxing effect of the warm water promotes the flow of oxytocin, a powerful hormone that plays a huge role in childbirth, causing the uterus to contract and triggering the ‘fetal ejection reflex’.
Michel Odent has expounded upon the beneficial physiological effect that immersion in water during labour has on hormone secretion, including observations that women entering warm water experience oxytocin surges which can advance dilation and stimulate contractions (Odent 2014).
The economic impact
Studies have shown that women who are supported during labour need to have fewer painkillers, experience fewer interventions and give birth to stronger babies.
A focus on normalising birth results in better quality, safer care for mothers and their babies with an improved experience.
Increasing normal births is associated with shorter (or no) hospital stays, fewer adverse incidents and admissions to neonatal unit and better health outcomes for mothers.
It is also associated with higher rates of successful breastfeeding and a more positive birth experience.
These changes benefit not only women and their families but also maternity staff.
Midwives are able to spend less time on non-clinical tasks and more on caring for women and their babies.
Psychologically speaking, and in particular for first time mothers, the less intervention and a more hands on approach with one-to-one support means that mothers will leave hospital feeling held and therefore far better prepared for motherhood.
This again has a domino effect, not just on the welfare of the infant, but also circumventing the need for costly government and interventionist approaches in particular for younger mothers post-partum.
The experience of hospitals that have birth pools demonstrates the savings achieved through reduced use of medical methods of pain relief and shorter hospital stays.
Midwives tell us that our pools are by far the most comfortable and user friendly available.
They say that they are ‘fab’ and pleasure to use.
Mothers simply tell us that, ‘they love our pools’.
They benefit from complete freedom of movement and unparalleled safety and support.
And, therefore have better births.
We’ve spent decades observing the way that mothers and midwives move in and around the pool and considered how to best serve their needs.
Our passion for excellence has led us to study ergonomic design theory and work closely with midwives, health and safety and manual handling experts.
This has enabled us to design water birth pools that are are incredibly comfortable, practical and easy-to-use.
But please don’t take our word for it….
see what mothers and midwives have to say:
“The best pools for the Birth Olympics hands down! Makes you want to have another baby just to experience it again! I’ve both delivered and caught babies in your pool. They’re comfortable, provide stability, are simple to clean and midwife and dad friendly. Just a dream all the way around.”
Alicia Witt Director BirthPros.com, CEO at ArizonaMidwife.com
“Beautiful pools, wonderful to see the history of their design and development.
Thank you for all you have done for mothers and midwives over the last 35 years to make birth more comfortable and peaceful.”
Amanda Edwards – midwife and active birth teacher
“We’ve had the Venus since 2016 and 256 water births later we can highly recommend Keith and his pool. Keith has been always quick, helpful and kind in responding to any queries we’ve had and our mums and dads are very happy in using this pool! Thank you Keith!
Catherine Verrecchia – Sage-femme coordinatrice, Centre Hospitalier Annecy Genevois
“The pool was amazing, so inviting, warm and comfortable. I don’t know what I would have done without it. Thank you”
Gemma Woods – Manchester
“The water birth pool was extremely comfortable and supportive and made such a difference – I don’t know what I would have done without it”
Sarah Copeland- Birmingham
“The pool met all of my expectations. I’m convinced that the water helps you stay in control in the final stages.”
S. Stone – Maida Vale, London
“Your birth pool made my labour so much easier I’d recommend them to every women for their birth.”
Jill Ireland – Bristol
“I’ve used Active Birth pools for over 17 years. They’re really beautiful, technically perfect and exceptionally easy to use.”
Dr Lucia Rocca-Ihenacho PhD, MSc, RM – Lecturer in Midwifery
” I consistently hear from moms how much they love the pools! The space and depth allow them to benefit fully from the buoyancy. As a midwife, I love the fact that I can move around the tub and catch babies from any position.”
Rachel Stapleton – Midwife 25 years experience of water birth
“Not only are they gloriously spacious and inviting, they are made to the highest specifications and considerations to maximise comfort and safety. In short, they are second to none!”
Sheena Byrom OBE – Activist, Midwife, Speaker and Author
“Brilliant, like the wide rims so mums can sit on the side and swivel their legs round to get in and out, much safer. And, you can get your legs under the rim, so much more comfortable for midwives ”
A. Bentley NHS Midwife
“Let me introduce you to Keith Brainin who provided us with water birth pools for our birth centres. His pools are brilliant and the service he provides is excellent”
Dr Tracey Cooper MBE – Chief Midwife for the North East and Yorkshire at NHS England
“Your water birth pools have revolutionised birth”
Caitlin Wilson Senior Midwife, Meadow Birth Centre, Worcester District Hospital
“You clearly have a tub that is far superior to all the tubs we have found, not only for patient comfort, but also for provider convenience”.
Karen Werrbach MSN, RNC-OB, NEA-BC
” Keith’s knowledge of fixed birth pools and expertise in waterbirth pools is outstanding. With over 35 years of experience within the industry, Keith has developed the highest standard birthing pools on the market.”
Jane Palmer Private midwife, lactation consultant and educator
Hospitals in the United Kingdom have been evolving clinical guidelines for the use of water for labour and birth for over 3o years.
The protocols for operational policy that they’ve developed are widely regarded as the benchmark standard internationally.
Below a collection of guidelines and publications to help you create a water birth facility.
Clinical Guidelines – Royal Cornwall Hospital
Clinical Guidelines – Royal Worcester Hospital
Guideline for the Management of Women Requesting Immersion in Water – Norfolk and Norwich University Hospitals
Operational Policy and Clinical Guidelines – Abbey Birth Centre
Birthspace: An evidence-based guide to birth environment design – Queensland Centre for Mothers and Babies
Use of water for labour and birth – Hywel DDA Local health Board
Guidelines for use of pool during labour and delivery – East Cheshire NHS Trust
Guiding principles for midwifery care during normal labour – Barking, Havering and Redbridge NHS Trust
Waterbirth care during labour for low risk women – Sandwell and West Birmingham Hospitals
Waterbirth Guidelines – Midwifery Led Unit, Wirral Hospital
Choosing a Water Birth – East and North Hertfordshire
Birthing pool use of labour and delivery – Wansbeck General Hospital
Water birth and use of water in labour guideline – Buckinghamshire Healthcare
Water for labour and birth guideline – Northern health and Social Care Trust
Immersion in water during labour and birth – NHS Forth Valley
Intrapartum care midwifery led unit – Wirral Women & Children’s Hospital
Guidelines for water birth within the hospital and at home – Dartford & Gravesham NHS
Disinfection and Sterilisation policy (infection control) – Basingstoke and North Hampshire NHS FT
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 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:
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
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
Water births are largely considered safe — but are there potential microbiological risks? And what are the best recommendations to eliminate any possible dangers?
Dr Jimmy Walker clarifies some of the advice outlined in an upcoming ‘back to basics’ book* aimed at training and education on the potential microbiological risks from water in healthcare facilities.
Water births have long been considered a safe way of giving birth for women who are not expected to have complex deliveries, with the literature backing up this record to show that rates of neonatal infections are no greater in water births than conventional bed births.1,2,3,4
However, this doesn’t mean there are no risks at all. Rare instances of adverse events have occurred, including microbial neonatal infections caused by a range of organisms that have included Legionella, the cause of Legionnaires’ disease, and Pseudomonas aeruginosa — although these have largely been related to home births.
There are several routes for potential contamination of water during a water birth:
Water supply
If either of the above organisms were found in a pool, this would indicate either contamination in the water system or at the tap outlet. If only a tap outlet were colonised, the contamination may be diluted to negligible levels in the pool once that tap is run. However, running a tap when there is biofilm build-up, either in the last two metres or further back in the system, would continue to release microorganisms leading to microbial concentrations in the pool water that could lead to infections.
This is a highly unlikely scenario that would only occur if water maintenance has been neglected enough to allow conditions for microbial growth to develop: for example where pipes have not been lagged properly causing the hot water to become cooler and the cold pipe to become warmer, creating ideal temperatures to enable growth of Legionella bacteria, for example.
Bodily fluids, birthing ‘debris’ and maternal contamination
As part of the birth process, water in birthing pools will inevitably be contaminated by bodily fluids and ‘debris’, such as placenta, some of which will be caught in strainers. Pool water can also be contaminated by faecal matter and any P. aeruginosa the mother may be carrying (P. aeruginosa can occur naturally on the skin of healthy individuals), although newborns are unlikely to be at risk from maternal ‘flora’.
A clear protocol is essential for drainage of the pool, cleaning and also disinfection to remove this contamination. All accessories must also be cleaned and thoroughly disinfected — or be single use.
If contamination is not properly dealt with, then any remaining residues will encourage microbial growth that could lead to potentially dangerous contamination of the next user’s water.
Drains
The role of drains as a source of healthcare associated infections (HAIs) and potential reservoirs of antibiotic resistant organisms is now being regularly documented, with carbapenem-resistant Enterobacteriaceae (CREs) a particular concern.
Single use plugs and strainers are now most commonly used, with a large access valve for nurses and midwives to retain water in the bath. However, because birthing pools are usually located at floor level, the gradient of the drainage pipework may not be sufficient to remove the material caught in the drain. Although such an event has not yet been reported, this creates the potential for biofilmbuild-up over time, to a level that may be difficult for disinfectants to penetrate and possible contamination of the pool as soon as it is filled.
Birthing pool design
Birthing pools could be improved to prevent this backflow scenario from the drain, with designs that ensure efficient drainage of contaminating material and valves and drains that are easy to disinfect.
There are also examples of birthing pools where the pool is filled via a wall tap that enters the pool at a level where the water could flow back into the tap. This again has the potential for back contamination of the tap, with bacterial colonisation reaching even further back into the system in contravention of the water fitting directive.
Birthing pools should be designed with taps that are well above the pool’s edge and which are fitted with suitable backflow protection.
Some birthing pools also have an associated showerhead for cleaning the pool after use. However, this is also inadvisable as the flexible hose and shower head may become contaminated when they are suspended in the water. This could not only lead to backflow and contamination of the supply, but also, the contaminated hose and shower head could introduce harmful bacteria to the pool if they are not cleaned and disinfected appropriately or replaced between uses.
In addition, because water births are not always considered appropriate, there may be a prolonged period when the pool is not used. Where this is the case, a flushing regime is essential to minimise water stagnation, biofilm build-up and microbial proliferation in the water supply.
Resolving issues
Maternity units are well aware of the risks and must carry out their own risk assessments, but it is important that they are assisted in this by appropriate members of the hospitals’ water safety groups (WSGs – see p 10-12), who can provide additional specialist knowledge e.g. from microbiologists and the estates team.
Health Building Note 09-02 provides regulations and recommendations for birthing pools
References
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:
