Download - Labour and Birth In Water
Labour and Birth In Water
Kate SaidiCoral Morby
Why choose a waterbirth?Natural form of pain relief
Used for labour and / or birth
Birthing pools help you achieve a natural birth and reduce the need for drugs
Waterbirth Facilities in LeedsDelivery suite at the LGI has two pools located in the
home from home rooms. We have around 100 hospital waterbirths a year.
Can self-hire pools for home births. Cannot bring hired pools into hospital.
Most of midwives are trained in waterbirthIt is possible that rooms are in use and will have to waitInform staff when you ring up that you would like to use
the pool and again on admission
Why does water help?
A long hot bath helps to sooth aching musclesWomen who labour in the pools often stay for the birth
because of the natural pain relief effectsRelax and comfortable in the waterReduces stress hormonesPromote the progress of labour
Beneficial effects of the poolBuoyancy effectWater increases support reducing muscular tensionThis conserves energy and lowers painEasier mobilityUpright position and squatting position is easierWomen with SPD find alternative positions easierIncrease women’s feelings of controlThe pool provides a private environmentYou are free to move around in your own spaceCalming effect benefits everyone
What the research saysNo evidence to show that there are any significant risks
to babies born underwaterStudies have shown that using water for labour and birth
can:Shorten the length of labour Increase feelings of control and enjoymentReduce the use of pain relief and drugs to speed up labour Increase the chances of a normal delivery
Hospital guidelinesOne midwife provides one-to-one care during labour, and
two present for the birthWhen admitted – all observations recordedIf your waters go with no contractions – seen by a
midwife and if everything well you may return home until labour starts
If your labour starts within 24 hours a waterbirth is still an option
If this does not occur induction will be required and a waterbirth is not possible
Who can use the hospital pool?In general must be considered ‘low risk’ meeting the
following criteria:Maternal weight less than 100kgs/15 1/2 stoneSingleton pregnancyHead downNo medical problems e.g. diabetes, epilepsyNo pregnancy problems e.g. high blood pressureNo previous caesarean37-42 weeks pregnantHave gone into labour yourself and be in established labour If waters have broken must be clear and not been broken longer than
24 hoursAll observations (BP, temperature, baby’s heartbeat) normal
Admitted with contractionsVaginal examination will be performed to determine the
stage of labour
If you are not in labour you will be advised to return home to await further progress
This is important if you are planning a natural birth
When would you ring delivery suite to come in?
Latent phase of labour
Head Decent
Pain relief options before entering the pool (also to be used at home)
TENS (Transcutaneous Electrical Nerve Stimulation)ShowerMassageHot towels on your lower backWheat packHot water bottles
Established labour/first stageMust be in established labour before entering the poolOccurs when contracting approx every 2 minutesAnd if this is your first baby you should be 5cmIf you have had one or more babies previously you should
be 3cmIf you have not reached this stage you will be encouraged
to mobiliseDo not get on the bed for prolonged periods, this will
slow your labour
Once in the birthing pool
Monitoring – temperatures, baby’s heart rate with underwater sonicaid, vaginal examinations every four hours, can be done underwater
During the waterbirthPain relief- gas and air (entonox)Encouraged to drink plenty,
change position and go to the toilet
Water will be kept as clear as possible, a sieve may be used
Second stage of labourOccurs when no cervix is left in front of the baby’s head
Your baby’s head will now descend and you should feel strong urges to push
The midwife will now monitor your baby’s heart rate more regular
The delivery Water temperature increased to 37oCNo assistance is required; the midwife keeps her hands
off until your baby is bornOnce your baby’s head is visible you must keep your
bottom under the waterThe midwife will use a mirror to watch the delivery and
encourage you to breathe at certain pointsYour baby is delivered completely immersed under water,
then lifted head first to the surfaceDeliver in any position which feels comfortable
Reasons why you may be asked to leave the poolAbnormal observationsSlow progressMeconiumBleedingMurky waterProblems with your baby’s shoulders
Third stageDelivery of the placentaAsked to leave the pool about 10 minutes following
deliveryThe placenta is delivered on landThis can be done naturally or using a syntometrine
injectionSkin to skin contact with your baby will be encouragedIf stitching is required this will be delayed for an hour to
allow water to drain from the tissues
Common concernsInfection – there is no evidence for this; we have strict
standards of pool hygieneCord around neck – this is very common and not usually
a problemDrowning – babies born under water don’t get the
stimulation to take their first breath. The baby instinctively recognises that it should not inhale water but that this can be swallowed. However if the baby has become distressed during labour this mechanism may be overridden.
Useful AdviceDon’t listen to the negative, think positive- most women
have a normal birth and healthy babies. Have confidence in yourself and your ability to cope
Bring anything that makes you comfortable- pillows, birthing ball, wheat bag, drinks, snacks, massage oil, lip balm, music
Useful ResourcesInformed Choice Leaflets-11. ‘Do you want a
waterbirth?’(women’s) Women’s Informed Choice Consumers pack (21 titles) £6.80 www.infochoice.org 0800 581009
The National Childbirth Trust - Using water in labour and birth, Straightforward birth, Home birth information sheet (50p each)www.nctsales.co.uk 0870 112 1120
Birth pool hire www.birthpoolinabox.co.uk