frequently asked questions
QUESTIONS ABOUT WATER BIRTH
Is water birth for me?
How do I find a sympathetic midwife for a water
birth?
Isn't it all a bit messy?
Why not just use my bath?
Why do I need to hire a pool when my local hospital
has one?
How do you ensure good hygiene?
What happens at a typical underwater birth?
Why doesn't the baby breathe under the water?
Is water birth for me?
Water birth, with its many possible benefits such as relaxation and pain-relief, should ideally be one of the options available to all women. In most cases there will be no reason against the use of a birth pool, at least during labour, for a baby at full term.
There are certain medical situations where an underwater birth can be ruled out, but with no national guidelines, these vary from place to place. In some areas you will be asked to leave the water for the delivery.
Discuss in advance with your midwife the local policy, and under what circumstances she would advise you to leave the water during labour.
How do I find a sympathetic midwife for a water birth?
Every woman in Britain has the right to give birth how and where she chooses. We are fortunate to have a health service that has so readily embraced the idea of water birth. The chances are that you will find your local midwife has water birth experience or training, and will support your decision to use water.
However, if she appears to be unwilling or not confident, the Supervisor of Midwives at your local maternity unit is obliged to help you to find a more suitable midwife. If this is unhelpful you may wish to go to a different maternity centre, perhaps in a different area, or consider paying for a private, independent midwife. They generally have lots of experience of homebirth and water birth.
See our Resources page for organisations and publications that offer help and advice. The AIMS booklet 'Choosing a Water Birth' explains what to do if your plans to use water at home or in hospital are met with resistance.
Isn't it all a bit messy?
Very little blood is lost normally until the actual birth of the baby, so the water should stay clean throughout the labour. If the baby is delivered in the pool, a small amount of blood will be diluted in the large volume of water. After the birth, the pool is quickly and easily emptied with our submersible pump.
Why not just use my bath?
Although many women do use their bath during labour, the size seriously restricts mobility. In the Babymoon birth pools you can move easily into a variety of positions - and there is room for your birth partner if desired.
And a bath is really too shallow - your belly should be covered by the water if you are to gain maximum benefit from buoyancy. In addition, the pool gives more space for the midwife to see what is going on, and to assist if necessary.
Why do I need to hire a pool when my local hospital has one?
Over half the maternity centres and hospitals in Britain have installed a birth pool. However, just because there is a pool there does not mean that you will be able to use it for your labour or birth.
- The pool may be already in use by another woman. They are usually allotted on a 'first come, first served' basis.
- The pool may be out of order.
- There may be a shortage of suitable midwives.
- The midwives may be reluctant to attend you. They may not feel confident about water birth if they have insufficient training or experience.
- Hospital policy may state that the pool is to be used only for labour (and not to give birth in).
See our Resources page for advice on how to get the most out of a hospital water birth.
Should you wish to take your Babymoon pool into hospital, you will need to contact your local hospital or maternity unit to find out whether this is possible.
How do you ensure good hygiene?
At Babymoon we ensure the highest standards of hygiene.
- all our equipment is thoroughly inspected, cleaned and disinfected between each hiring, according to procedures used in NHS hospitals.
- we supply each mother with her own sealed disposable liner. We believe this is essential for good hygiene because it means that the water is only in contact with this new, clean liner. You may wish to order an extra disposable liner to use just in labour.
- we do not advocate/provide a heated water system. It is harder to maintain hygiene when the water is kept recirculating.
- our pools are supplied with comprehensive guidelines on how you can maintain good hygiene when using them, including what to do if you should wish to use the pool before and after labour.
Surveys of 1,000s of water birth figures world-wide show no increase of the risk of infection to mother or baby.
What happens at a typical underwater birth?
The baby may be born in one contraction but usually the head will emerge first, under the water and then, after a couple of minutes, the body is delivered with the next contraction. During this pause, the baby's lungs are unable to expand as they are still within the birth canal. Oxygen is being provided from the placenta. The baby will not take a breath until its face meets the cool air.
Underwater birth is generally 'hands-off' although sometimes the mother may reach down and gently touch her baby's head. This may help her to have a sense of her perineum and so prevent tearing.
After a moment, as the baby unfurls itself, the midwife or parents slowly lift the baby from the water, face-first, and gently pass it to the mother.
Now you can enjoy those ecstatic moments when you and baby meet for the first time. While you are in the pool, the baby can be held close with his/her head above the water while the body stays immersed in the warmth of the water. The baby may want to suckle straight away and take its first feed in the pool.
Allowing mother and baby undisturbed skin-to-skin contact for as long as possible (as least until the placenta is delivered) enhances production of the hormones responsible for bonding, breast feeding, and the expulsion of the placenta.
Why doesn't the baby breathe under the water?
There are many factors that explain why the healthy baby does not take its first breath under water.
- Because breathing is stimulated by a cool temperature, the baby will not breathe until it is lifted from the warm water (which should be around 37C) into the much cooler air. This is why the baby should always be lifted from the water face first.
- New-born babies have a 'diving reflex' that triggers when water touches their face. This reflex action prevents the baby breathing and closes the glottis of the throat.
- The baby has areas in its throat, similar to tastebuds, which are able to recognise different fluids. If water enters the baby's mouth they cause the throat to be closed and the baby to swallow the water instead of breathing.
- Before the cord is cut, the baby's breathing is inhibited by the hormones it is receiving from the placenta. This is one reason why the cord should never be cut while the baby is still under the water.
QUESTIONS ABOUT SETTING UP A BABYMOON POOL
Will my floor carry the weight of the pool?
Will the pool leak?
What temperature should the water be?
Will I have enough hot water?
How do I keep the water warm?
Why might I need an extra disposable liner?
Can I use the pool before and after the birth?
Will my floor carry the weight of the pool?
Our pools weigh 1600-1750lb when filled with water, equivalent to a pressure of around 100lb per square foot - less than that of an average person - and that weight is spread evenly over a wide area. Houses, flats and hospital floors are designed to carry heavier, and more concentrated, loads than this. It might be useful to think of a pool in terms of weighing around the same as eleven 10-stone adults standing shoulder to shoulder.
A concrete ground-level floor would be the strongest place to put a pool. Upstairs, the pool can be positioned in a corner (preferably alongside an outside wall) or above a lower weight-bearing wall or joist.
We are not aware of any case of a house being damaged due to the weight of a birth pool. If you are in any doubt, please consult a builder or structural engineer.
Will the pool leak?
So long as the liners are correctly installed, this is highly unlikely due to the double-skin nature of our pools. The oval pool has a rigid fibreglass outer, and both oval and hexagonal pools have an extra-tough, non-rip PVC outer liner as well as a strong inner one. Obviously we would ask you to not use any sharp objects near to, or in, the pool! If both liners were punctured, water would seep away very slowly and not in one big flood. You would be able to empty the pool and repair the puncture.
What temperature should the water be?
For the comfort of the mother, keep the water at about 32-36C. Too hot and she will overheat, cannot sweat and will get too tired. Too cold and she will get shivery.
It is important that the water be at 36-37C during the second phase, so you will need to check it from time to time, particularly when birth becomes imminent. Babymoon provides a free bath thermometer with every pool hire.
Will I have enough hot water?
If your home has a 'combi' (gas-fired, continuous-heating) water heater you will be able to fill the birth pool in about an hour or more. Other types of boiler, or an immersion heater, will take a little longer - depending on the size of your boiler - because you will need to heat a few tanks of water. You can speed things up by using the immersion heater to help your boiler. The heat-retention cover helps to keep the water warm while filling.
How do I keep the water warm?
With the ground pad and heat-retention cover in place, such a large volume of water will only drop by a maximum 1C an hour. To change the temperature during use, simply remove a couple of buckets of pool water and replace with very hot or cold water. This method is quick and efficient, so a heater is unnecessary. You will find it sufficient to maintain the water temperature for as long as necessary.
Why might I need an extra disposable liner?
See the answer below.
Can I use the pool before and after the birth?
We supply a new disposable liner with every pool. As this is exclusively for your own use, we believe it is safe to reuse it before or after the birth - provided you follow our guidelines for how to keep the liner clean and hygienic. If you are at all concerned, we recommend that you order an extra disposable liner when you make your booking. This can be kept unopened until you are in labour.
The pool must never be used without the disposable liner.
QUESTIONS ABOUT USING THE POOL DURING LABOUR
Should I give birth in the water?
When should I get in the water?
Does anyone get into the pool with me?
Do I deliver the placenta in the water?
How can the midwife check that everything is
ok?
Will I be able to use any other form of pain
relief?
Should I give birth in the water?
This is certainly a question that cannot be answered until you are actually approaching the time of delivery. It is great to make plans beforehand, but bear in mind that these can change once you are in labour, according to how you feel and how your labour progresses.
It is very important that everyone who is with the mother keeps an open mind, and that no one makes water birth a 'goal' or gets fixed on the idea of how the birth should be. A woman should feel free to follow her instincts at any time about using the birth pool, and indeed about any other aspects of labour.
When should I get in the water?
In general, water tends to be used more successfully if you wait before getting into the pool. The usual advice is to enter the water only once your contractions have become well established and not until you really feel the need of the extra help the water to manage them. Do whatever is needed to keep labour progressing well - whether that means getting in or getting out of the water.
Does anyone get into the pool with me?
The answer to this question varies from woman to woman, from labour to labour, and from moment to moment, according to each woman's preferences and needs. She must feel free to change her mind at any time.
Some women prefer to have the pool as their own personal and private place, where they can safely relax and lose their inhibitions. They find it easier to forget about the rest of the world and to concentrate fully on their contractions when on their own in the water. In this case, their birth partner is able to help by providing emotional and physical support from outside the pool and massage, drinks, music, etc. if required.
Others prefer to have a birth partner in the water with them. They may need the reassurance of close physical contact, or they may find that their partner is better able to support them emotionally when they are both in the pool. The partner can also give physical support, acting as a chair, or as cushion for her head, or helping the woman to float on the surface of the water.
The partner may find that after the birth is the best time to be in the pool - with all the new family together!
The midwife will not normally get onto the pool.
Do I deliver the placenta in the water?
After a water birth, the mother may wish to get out of the pool straight away with the baby, get dry and wrap up in cosy towels. She can then deliver the placenta by the side of the pool. Alternatively, she may prefer to spend some time relaxing in the warm water with her new baby, perhaps giving the first breast-feed. She may then wish to stay in the water for the third stage of labour.
You will need to talk to your midwife about this issue in advance. At some birth centres it is quite usual for the placenta to be delivered in the pool. Other midwives prefer her to get out of the water. There is a good discussion about this on the ARM website - there is a link on our Resources page.
How can the midwife check that everything is ok?
During labour, the midwife listens to the baby's heartbeat from time to time to check that all is well. At a water birth she can use either a water proof Sonicaid (an ultrasound device) or a Pinard stethoscope (the traditional 'trumpet'). In the latter case, the mother would need to stand up for a few moments or float on the surface of the water with the help of her partner.
If the midwife needs to do an examination the woman can kneel, squat, stand up, or her partner can help her to float to the surface. To have her blood pressure and pulse checked, the mother simply lifts her arm from the water.
Will I be able to use any other form of pain relief?
Yes! There is a whole range of self-help possibilities which can help you manage pain very effectively - including focused breathing, making noises or moving to release the pain, visualisation, different positions, hot or cold touch and massage. It can be helpful to think of contractions as bringing 'intense sensations' or 'energy rushes', rather than 'pain'.
In addition, you can organise alternative therapies for your labour such as acupuncture, homoeopathy, shiatsu, herbs, etc. A little entonox - 'gas and air' - can be safely used when in the water, but not other analgesics such as pethidine, which is a sedative. You can always come out of the water if you feel that you need those.
