,
Birmingham Women s
NHS Foundation Trust
Using water for
pain relief in
labour and birth
Birmingham Women’s Hospital is a no smoking hospital
Women
describe warm
water aswaterbirth
a wonderful comfort during labour.
Preparation
for home
Water assists you to move around more easily than on dry land. Moving
into
comfortable
positions
reduces
the discomfort
of not
labour,
whichthe
in pool
If you
are going to
have a home
birth,
it is advisable
to enter
turn
help labour
to This
progress.
Someyour
women
choose
to give
untilcan
a midwife
arrives.
is because
babythen
could
be born
without
birth
to their
baby in the
water.to support you safely.
the skill
of a midwife
available
Water
one ofwith
the many
options where
available
support
Please isdiscuss
your midwife
youtomay
wish women
to placeduring
the pool at
labour.
home, with regard to the following:
It• is Location
a good idea
to find out
aboutand
everything
that is available in case
of electrical
sockets
equipment
your needs change.
• Whether the floor can bear the load of a full pool
We like to offer women the opportunity to use water in labour
particularly:
you have had
a straightforward
• Providingif adequate
space
around the poolpregnancy with a well
grown baby; anticipate a normal birth and labour is progressing
normally.
It is covering
a good idea
to let
us know if you wish to use the pool
• Providing
for the
floor
when you make contact with us in labour:
• Birth Centre:
0121 623 6907/8
• Delivery suite
0121 472 3032
Should you
have any0121
questions
that are not covered here please
• Homebirth
Team
623 6670
ask your community midwife or Birth Centre on 0121 623 6907.
Further information can be found on our developing website:
Early labour
at home
www.bwhct.nhs.uk birth centre/Homebirth
and leaflets for women
Don’t forget to use the bath at home during early labour. The warm
water will help you to relax (don’t have the water too hot because
ALSO
this might be harmful). Try to remain in the bath for about an hour
or so at a time so that you get the full benefit. Also consider using a
www.sheilakitzinger.com/Waterbirth.htm
TENS unit after your bath (see our early labour support leaflet for more
information).
BWFT is not responsible for the content of third-party information
and does not endorse any product, view or process or opinion
from such sources. You may need to use your discretion when
accessing such information.
51
Established labour
We usually recommend getting into the pool when labour is well established
(If a vaginal examination is done, your cervix would ideally be at least 5cm
dilated). If you get into the pool too soon, it can slow labour down. It will
take about 20 minutes for the pool to fill. Most women wear nothing, but
you may wish to wear a short top in the pool.
We will observe you and your baby’s wellbeing during the time you are in
the pool, as we would if you were on dry land. Your baby’s heartbeat will
be listened to every 15 minutes with a waterproof sonic aid during the first
stage and more often when you are in the second stage of labour. To do this
you may be asked to float so that we can reach your abdomen more easily.
The water will be maintained at a temperature comfortable for you.
If you are booked with an obstetrician, it might be recommended that your
baby’s heartbeat is continuously monitored during labour. The pool might
still be an option using waterproof ‘telemetry’. Ideally this needs to be
discussed with your medical team during pregnancy.
A vaginal examination may be necessary to ensure that labour is progressing
normally and the midwife caring for you will advise how often it is
recommended.
You may get out of the water and back in again as you wish. You may be
encouraged to leave the pool for a short walk around, as this can assist
labour to continue normally.
You may wish to use “gas and air” whilst in the water, but we do not usually
encourage Pethidine if you are considering using the pool. If you have had
Pethidine, we advise that you use the water for labour but get out for the
birth. This is because pethidine can make your baby sleepy.
If you have aromatherapy oils on your skin we suggest a shower before
getting in the pool.
If for any reason the midwife has any concerns about your or your baby, you
will be asked to leave the water.
2
Birth in the pool
A midwife will look after you during your labour and birth. If you
choose to give birth into the water then a second person will be present.
We may ask you if a student midwife can be present. Your partner may
get into the pool if you wish and will need to wear swimwear.
Your midwife will support and encourage your instincts to push and
when you feel ready to. Providing the water is deep enough for your
baby’s head to be born underwater, you will be able to get into any
position that is comfortable for you.
Once the baby’s head is born the body follows, usually with the next
contraction.
At this point you or your partner will be encouraged to help lift the baby
gently out of the water.
Whilst under the water your baby will not breathe and may look quite
pale or blue. Don’t worry; s/he will still be getting oxygen through your
afterbirth (placenta).
Babies are often born with their eyes open and continue to move their
arms and legs. A baby born under water is often much quieter than one
born on dry land. Don’t be surprised if s/he does not cry too loudly at
first!
Afterbirth (Placenta)
Shortly after the birth of your baby you will deliver the placenta and the
midwife will discuss this with you. Baby can be wrapped up with you
during this time for a cuddle
and skin to skin contact. You may like to have a towelling dressing gown,
so bring one with you if you are planning a hospital birth.
The use of warm water in labour is thought to increase the stretching of
the muscles in the perineum and reduce your chance of tearing. Should
you need to have any stitches done, we will do them when you are on
the bed.
3
Are there any risks?
Our aim as midwives is to ensure that you have a safe and positive birth
experience. There are risks with all things in life, as well as birth itself.
Midwives follow guidelines and your co-operation in following any advice
the midwife gives you will maximise your and your baby’s safety.
If an emergency does arise you will be advised to leave the water as
quickly as possible.
Who may be excluded from using the pool?
Being booked under midwifery led care implies that you will have a
straightforward pregnancy and birth, and therefore could consider using
the pool. However, please ask (ideally in advance of labour starting) if you
are booked under the care of an obstetrician.
Generally you would not be able to use the pool if:
• you are considered to be clinically unsuitable
• you are unable to get in and out of the pool yourself, as we will
not be able to lift you (we have an emergency procedure in the
event of collapse).
• Staffing levels or workload are unsafe.
There may be times when we suggest that you use the pool for labour
but not for the birth itself. If water for labour appeals to you, ask your
midwife to discuss the options with you.
4
Preparation for home waterbirth
If you are going to have a home birth, it is advisable not to enter the pool
until a midwife arrives. This is because your baby could be born without
the skill of a midwife available to support you safely.
Please discuss with your midwife where you may wish to place the pool at
home, with regard to the following:
• Location of electrical sockets and equipment
• Whether the floor can bear the load of a full pool
• Providing adequate space around the pool
• Providing covering for the floor
Should you have any questions that are not covered here please
ask your community midwife or Birth Centre on 0121 623 6907.
Further information can be found on our developing website:
www.bwhct.nhs.uk birth centre/Homebirth
and leaflets for women
ALSO
www.sheilakitzinger.com/Waterbirth.htm
BWFT is not responsible for the content of third-party information
and does not endorse any product, view or process or opinion
from such sources. You may need to use your discretion when
accessing such information.
5
Ref 82/03/2014 Review 03/2017
For further information visit the
Birmingham Women’s NHS Foundation Trust Website
www.bwhct.nhs.uk
Birmingham Women’s
NHS Foundation Trust
Edgbaston, Birmingham B15 2TG. Tel: 0121 472 1377 Fax: 0121 627 2602
Printed by Collector Set Printers Ltd. CSP071835. Tel: 01622 716636
Authors: Paula Clarke, A McBennett, L Casey - Midwives