Water birth

For some women the use of a pool during labour and birth can be beneficial in helping them feel calm and secure.

Here at Barnsley our midwives can support your choice of using water for labour and birth, either at home or in one of our three built in birth pools within the birthing centre itself. 

Advantages of using water for labour and delivery 

Water immersion in labour has several perceived benefits including less painful contractions, less need for other methods of pain relief, shorter labour leading to an increased likelihood of achieving a natural birth.

You may also find you have a more enjoyable labour experience feeling in control achieving a calm and normal birth of your baby. The water supports your weight allowing you to feel buoyant with easier mobility, conserving energy for labour.

Who can have a water birth?

Healthy women with low risk pregnancies in labour over 37 weeks are offered the choice of using a birthing pool for labour and birth if they wish to do so. 

There are several maternal and clinical conditions that  may make labouring or birthing in water more risky:

• If you have a medical condition or serious infection.
• If you have had complications in this or previous pregnancies.
• If we need to monitor your baby’s heart rate in labour.

If you think you fall into the above criteria or have any other queries please contact your midwife who will be able to discuss this further.

Optimum pool time entry 

You may enter the pool when you are in established labour with the optimal time for pool entry being cervical dilatation of 4-5cm and your midwife will guide you with this. 

If using a birth pool at home it is not recommended to pre fill the pool prior to labour and maintain the temperature by use of a heater or pump.

Midwives role

A midwife will care for you during your labour and delivery, providing emotional support and encouragement throughout. The midwife will listen to the baby’s heartbeat every 15 minutes and more frequently when you begin pushing in the second stage of labour. Your blood pressure, temperature and pulse will be regularly checked throughout. You will 
be asked to leave the pool if there are any complications, for any internal examinations, if there are concerns with your baby’s heartbeat or if your labour does not go as expected.

Pain relief in the water

Immersion in water is itself a method of pain relief and some women may only use the water to labour in and choose to give birth out of the water. Should you require any further coping strategies you may try relaxation and breathing techniques, massage and gas and air all whilst in the pool. If you decide to use of a TENS machine or to have Diamorphine, Pethidine or an Epidural you will be required to leave the pool. 

Labouring and delivering in water

You may leave the pool at any time although you will not be encouraged to leave the pool when the baby’s head is delivering unless in an emergency.

The midwives monitor and maintain the temperature of the water very closely to minimise the risk of the baby breathing under water. You will be able to get in any position that is comfortable for you as long as the water is deep enough to ensure the baby’s head is completely submerged during the birth.

Giving birth in the pool is carried out with a hands off approach from the midwife. Following the birth your baby’s head will be gently guided out of the water by the midwife or yourself. Your midwife will give you verbal guidance and emotional support during this time. 

There is little available evidence to support birth under water however there is evidence of rare risk to the baby including respiratory problems and infection. Clinical guidelines are followed by staff to minimise these risks.

Third stage of labour/ Delivery of the afterbirth (placenta) 

If you have chosen to have the delivery of your afterbirth actively managed you will be advised to leave the pool following the birth of your baby where this will then occur. If you have chosen to have a physiological third stage of labour you may stay in the pool if you wish to do so. However, there is little research regarding the safety of being emerged in water during this stage and you may be asked to leave the pool should complications arise.

We are unable to accurately measure how much blood you may loose when you deliver your placenta in the pool although if it appears excessive you will be asked to leave the pool. 

Warm water is thought to increase the stretching of perineal muscles and reduce your risk of tearing. Should you need to have any perineal suturing it will be done out of the water. 

Is there anything I need?

It is important you feel relaxed and comfortable when you are in the pool so the choice of what you wear is entirely up to you. A sports bra, large t-shirt or nothing at all are all suggestions. It is important you are kept warm after you have left the pool so a dressing gown may be useful to assist this. It is vital you do not get dehydrated whilst using the pool so a water bottle for easy handling is encouraged and you may bring a light diet or isotonic drink if you wish.

Emergency situations

If an emergency occurs in the pool there may be problems encountered relating to the logistics of leaving the pool which could impact upon the management. Ultimately there is a possibility the emergency will not be managed as effectively as on land. Emergency equipment and staff will always be available. 

A plan of exit will be discussed prior to you entering the pool and you will be expected to leave the pool with minimal support from staff. 

Prior to entering the pool you will have to demonstrate you can safely get yourself in and out of the pool as staff will not be able to assist you with this.