Water Birth Pool – Health and Safety Concerns

K.D.Brainin Founder & Director
Blog: 20.02.2019

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

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

Re-circulating water systems

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

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

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

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

Integral Plumbing Systems

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

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

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

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

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

Hand held showers

Handheld showers present a significant infection control risk.

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

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

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

Pumped heating systems

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

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

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

Bacteria filters and disinfection systems

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

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

2019: Venus Water Birth Pool, Peterhead Hospital

Overflow drains

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

Regulations are very clear on this point.

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

Surface mounted metalwork

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

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

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

The Active Birth pools approach:

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

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

Double step units

In breech of Manual Handling protocols.

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

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


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

Doors are mistakenly used for two reasons:

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

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

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

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

The Active Birth Pools approach:

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

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

Height adjustable pools

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

They are completely wrong!

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

It’s that simple.

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

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

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

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

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

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

The Active Birth Pools approach:

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

Look at the midwife in the photo above.

Notice how comfortable the she is?

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

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





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