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Information for patients
Using water for labour and birth
A guide for women and families in Sheffield
Jessop Wing
Why do women use water in labour?
Immersion in warm water during labour is an excellent
form of pain relief, and many women describe an
increased sense of privacy, calm and control. Warm water
encourages relaxation and reduces feelings of stress and
anxiety which allows the release of endorphins, the body's
own natural painkillers. Immersion in warm water during
labour is well documented as contributing to a feeling of
well-being, whilst buoyancy increases comfort and mobility
which can lead to a more active role in the birth
experience. It is thought that waterbirth allows the baby a
more gentle transition from the womb, by softening the
light and reducing noise.
Can anyone use the pool?
You must have had a straightforward pregnancy to be
able to use the pool during labour. There are some
circumstances in which it may not be suitable or
recommended, these include:
• If your labour starts before 37 weeks.
• If you have any medical conditions such as high blood
pressure, diabetes or an infection.
• If you are expecting twins.
• If your baby is in the breech position.
• If your labour is induced.
• If you are booked for Consultant-led care (although
always ask your midwife because you may still be able to
use the pool if a plan is made before you go into
labour).
• If you have any mobility problems which would make it
difficult for you to get in and out of the pool.
Your midwife will discuss your individual circumstances
with you.
Will I give birth in the pool?
You may choose to labour and give birth in the pool, or
you can choose to get out of the pool to give birth if you
wish.
What should I do if I want to use the pool?
Unfortunately you cannot book the hospital pool in
advance so we cannot guarantee that it will be available
when you go into labour. However, when you arrive at the
Jessop Wing you should tell the midwife that you would
like to use the pool and the staff will do their best to
support your request. If you are having a home birth and
would like to use a pool you should discuss this with your
community midwife so that she can organise it with you.
When do I get in the pool?
Water can be used effectively in early labour to help you
cope with the contractions and the midwife may well
advise you to try a warm bath or a shower first. Immersion
in a pool (which is deeper than a bath) is recommended
for when you are in established labour. Your midwife will
advise you when the time is right and support you in the
pool.
Will my care in labour be different in thepool?
No. The care the midwife provides will be the same and
will include listening regularly to your baby's heartbeat and
checking your pulse, blood pressure and temperature.
What if there is a problem?
Midwives are experts in caring for women in normal
labour. If the midwife is concerned about the condition of
either you or your baby the midwife will ask you to leave
the pool. A thorough assessment will be made and if all is
well you may be able to re-enter the pool. If a problem has
arisen you will be transferred to Consultant-led care where
you will be cared for by a midwife in partnership with the
doctor.
The National Institute for Health and Clinical Excellence
(2007) state that "the evidence shows that immersion in
water provides effective pain relief. As far as we know this
does not adversely affect maternal or neonatal outcomes".
Can I have any extra pain relief whilst I am inthe pool?
• You may use the gas and air whilst you are in the pool.
• You may wish to consider the use of complementary
therapies during your labour. You will need to discuss
this with your midwife during your pregnancy to find
out what is available.
Which methods of pain relief are notavailable whilst I am in the pool?
• If you decide you want a pain-killing injection (such as
pethidine) you will not be allowed to use the pool for a
minimum of two hours, or until the midwife feels you
are alert enough to be safe in the water.
• You will have to leave the water if you decide you want
an epidural.
• T.E.N.S. machines cannot be used in the pool.
Can I change my mind?
Of course you can. At any time during your labour you can
change your mind whether you are in hospital or at home.
If the pool is not for you the midwife will support your
decision. Alternatively, if you had planned only to labour in
the pool then choose to deliver your baby underwater, this
is fine. The midwife's role is to support you in your
decisions and advise where necessary.
What should I wear?
We aim to maintain privacy and dignity for all women in
labour, including those who choose to go in the pool.
Some women choose not to wear anything in the pool,
whereas other women choose to wear a t-shirt or a bikini
top.
What about the afterbirth?
You will need to decide how you would like to deliver your
placenta (the afterbirth). If you decide to have active
management which means that you would like to have an
injection of syntometrine to help deliver the placenta, then
you will be asked to leave the pool for this part of your
labour. If you decide to have a physiological third stage
which means that you would like to deliver your placenta
naturally then you may stay in the pool.
What if I need stitches?
If you need any stitches (suturing) you will need to leave
the pool. Suturing usually takes place one hour after you
have left the pool, when the tissues have had time to
settle.
Homebirth: Birthing Pool Information
The Jessop Wing has 18 home birth pools, so if you are
planning a home birth and would like to use a pool you
should discuss this with your community midwife so that
all the necessary arrangements can be made.
The home birth pool includes:
• An inflatable birthing pool and instructions for use.
• A pool liner.
• A manual/electric inflation pump
• Silver bubble wrap insulating pool cover.
• An electric emptying pump, wide bore hose, and a
jubilee clip.
You will need to supply:
• A thermometer suitable for measuring the pool
temperature.
• Plastic sheet to protect your floors/furniture.
• A hose to fill the pool. A basic garden hose is fine, you
will need to make sure that it reaches the pool easily
from the tap you intend to use.
• Tap adaptor to attach your filling hose to your tap.
• A plastic sieve and a bucket.
• Plenty of towels.
• You may like to use a bathrobe when leaving the pool,
but this is not essential.
• Snacks and plenty to drink - birth requires energy for all
involved!
You may also find the following helpful:
• A mirror for seeing the birth more clearly.
• Music you find relaxing.
• A face cloth.
• An inflatable pillow.
• Some drinking straws.
• Aromatherapy oils. You will need to discuss
aromatherapy with your aromatherapist or your
midwife during your pregnancy.
Your midwife will supply:
• All the other equipment required for a homebirth,
including emergency equipment.
• Entonox (gas and air) should you wish to use this.
Using your pool:
• Please have a trial of inflating the pool and leaving it
overnight to ensure that there are no punctures.
The pools are very durable, however it is always best
to check before your labour starts. Please notify your
midwife in the unlikely event of your pool being
punctured.
• Where you choose to put your pool is entirely up to you.
The pools are oval shaped with a step/seat at one end.
Some women find that having the end with no seat in a
corner works well, as it gives them a private area which
they appreciate in labour. The seat can then be used to
sit on after you have given birth as it raises you and
enables your midwife to easily assist you when you are
breastfeeding.
• We recommend emptying the pool as soon as is
practical. The emptying hose is long, and you need to
make sure that it can reach an outside drain or your
bath. You should take this into consideration when you
are deciding where to place your pool.
Further reading
The Waterbirth Book
Janet Balaskas (2004)
The Waterbirth Handbook
Dr Roger Lichy and Eileen Herzeberg (2005)
Labour and Birth in Water
National Childbirth Trust (2002)
www.aims.org.co
www.nctpregnancy&babycare.co
www.waterbirthinfo.com
NICE Clinical Guideline No 55 Intrapartum Care;
Care Of Healthy Women And Their Babies During
Childbirth September 2007.
PD5156-PIL1692v2Issue date: August 2011. Review date: August 2013.
© Sheffield Teaching Hospitals NHS Foundation Trust 2011. Re-use of all or any part of this document is governed by copyright and the “Re-use of Public SectorInformation Regulations 2005” SI 2005 No.1515. Information on re-use can be obtained from the InformationGovernance Department, Sheffield Teaching Hospitals. Email [email protected]
This information can be made available on request in alternativeformats including Braille, large print, audio, electronically and otherlanguages. For further details email: [email protected]
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