Written by Midwife Sally Underwood
For many years, midwives have encouraged women to use water during pregnancy and labour because they have found it’s calming, and soothing properties really assist with progress and pain relief. I have observed over the years, that women react to pain in different ways and that although water does not give complete pain relief, it often reduces the pain women feel to a manageable level, so they do not need additional methods of pain relief during their labour. The principal being the same as using warm water to relax and unwind at the end of a hard day – a warm bath eases aches and pains and aids relaxation….. Research suggests that the warm soothing effect of the water helps the body produce endorphin hormones; these are the body’s own natural painkillers. These endorphins also act as mood uplifters and can also help to stimulate surges naturally making labour shorter.
Here are 8 facts I wanted to share with you…
- There are several different pools available for birthing today. Most midwife led units have static pools within their birthing rooms , whilst others have inflatable ones available. If you are opting for a home birth then you will be able to hire a pool – which will be delivered to your home when you reach 37 weeks gestation. I would advise you to practice filling and emptying your pool – as some take a while, and require tap adapters – you will need to be proficient for your big day and will not need any extra stress.
- The position you adopt once in your pool will obviously depend upon its size etc. You can kneel or lean on the side of the pool, you can squat, holding onto the sides of the pool, you can use floats under your arms for support or you can float on your back with your arms holding the sides and your head supported on a waterproof pillow. You can also float on your stomach with your head turned sideways, resting on a pillow. If your partner is in the water with you, sit with your back against them or with your arms around their neck. There are lots of different options to try out.
- You will need to keep hydrated in water because you will be using up energy and sweating so you’ll need to replace fluids. Drinking through a straw might be easier. But be prepared to empty your bladder regularly during labour so your baby has as much space as possible in your pelvis. You will be encouraged to leave the pool for short toilet breaks while you are in the birthing pool.
- Your midwife will carry out observations on you and your baby to ensure you remain well and safe. She’ll keep the temperature of the water between 36 ºC and 37.5 ºC at all times. It is important not to have the water too warm or you’ll overheat, causing distress to your baby and increased discomfort for you. The midwife will check your temperature, pulse and blood pressure are within healthy ranges, will monitor your baby and check how often your surges are coming. Your baby’s heart rate can be monitored while you’re in the water using a water proof hand-held Doppler. You can use Entonox (gas and air) whilst you are in the pool but will be advised to get out by your midwife, if you decide to have diamorphine/pethidine.
- There are clinical reasons why you might be asked to get out of the pool. These are all to do with either you or your baby’s safety. This is one of the reasons the midwife will undertake observations on both you and your baby in labour. The midwife will keep you fully informed of how both you and your baby are doing.
- It is not dangerous for your baby to be born under the water, although you can use the pool to labour then get out for the birth. A baby’s breathing reflex only starts when it comes into contact with air. The reason the midwife will ensure the pool water is kept at a regulated temperature is that being born into water that is the same temperature as your body will not stimulate your baby to breathe. Your baby will not take its first breath until he or she senses a change in temperature and has the feeling of air on their skin. Your baby will still receive oxygen during this period of time through the umbilical cord. You or your midwife can bring the baby to the surface of the pool face first as soon as they are born. You can then have skin-to-skin contact with your baby in the pool, with the baby kept warm by keeping their body under the warm water while you cuddle them. Babies born under water can be calmer following birth than babies born in air and may not cry or move vigorously. This is normal and no reason for worry. Your midwife will carefully observe you and your baby following birth, giving you any guidance and support needed.
- A water birth may not be suitable for everyone. However, for healthy women who have had an uncomplicated pregnancy, using water is generally considered to be safe. Women who have any complications in their pregnancy and do not fit the inclusion criteria for a midwife led birth, would need to have a discussion with their named consultant and midwife before they would be considered as suitable for a water birth.
- Despite the fact I have had 6 normal births – I sadly never tried a water birth…. Such a shame!