This page gives you information about the use of a birthing pool during labour and birth. A midwife can support you in using a birthing pool at home or in our pool room on Delivery Suite. Please talk to your midwife during the antenatal period who will be able to answer any questions.
What are the benefits of using a birthing pool during labour and birth?
Many people find a warm bath relaxing, and this can be useful for labour. A birthing pool is deeper than an ordinary bath to allow you to move around more easily. The water supports your weight and helps you to feel more comfortable.
Water immersion may help you feel less pain during labour and reduce the need for other methods of pain relief. You may also find you have a more enjoyable labour experience, feeling in control to achieve a calm birth of your baby.
Who can use a birthing pool?
Generally, use of the pool is suitable for those who fit the following criteria:
- Pregnant with one baby (singleton pregnancy)
- Your pregnancy needs to be of 37-42 weeks gestation
- Your membranes (waters) should not have ruptured (broken) for more than 24 hours
- Your amniotic fluid (waters) should be clear
- Your baby should be in the head down position (not breech)
- You should not have had a previous caesarean section
- You should not have a current serious infection
Most people can use the pool during labour and/or birth. Certain medical conditions and complications during this or previous pregnancies may mean use of the pool carries more risk for you or baby. It is important that those wishing to use the birthing pool are sufficiently mobile to ensure rapid exit from the pool in case of emergency. If you have a Body Mass Index (BMI) over 40, we will not recommend using the birthing pool due to the increased risk of complications during the birth.
If you would like to use the birthing pool, please discuss this with the midwife or doctor caring for you. They will give you information to enable you to make an informed decision.
We only have one birthing pool at Harrogate District Hospital, so if it is already in use, waterbirth may not be an option.
Preparation for home waterbirth
If you would like to use a birthing pool for a home birth you can either hire or buy one. We recommend using a single-use liner with any pool. Please discuss with your midwife where you may wish to place the pool at home, including 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 If using a birth pool at home, it is not recommended to pre-fill the pool prior to labour or to maintain the temperature by using a heater or recirculation pump due to risk of bacterial growth.
If you are going to have a home waterbirth, it is advisable not to enter your birth pool until your community midwife arrives as the water may accelerate your labour.
Labour and birth in water
A midwife will care for you during your labour and delivery, providing support and encouragement throughout. The midwife will listen to the baby’s heartbeat to confirm their wellbeing throughout labour. Your observations, including blood pressure, pulse and temperature will also be regularly checked.
The midwife will also monitor and maintain the temperature of the water very closely for your comfort and to minimise risks to baby. You will be able to get in any position that is comfortable for you. The water should be deep enough to ensure the baby’s head is completely submerged during birth.
You will be asked to leave the pool if there are any complications, if you choose to have a vaginal examination or if there are concerns with your baby’s heartbeat. Two midwives are usually present at the birth of your baby, and this would be the same for births in the pool. We request that you always have someone with you when you are in the pool.
You can get in and out of the pool as often as you wish. You may choose to stay in the pool for pain relief in the first stage of labour and remain in the water for the birth, or you may prefer to leave the pool for the birth of your baby. It is your choice and you can decide your preference at the time.
Giving birth in the pool is carried out with a ‘hands-off’ approach from the midwife. Following birth, your baby will be gently guided out of the water by yourself or the midwife. Your midwife will give you verbal guidance and emotional support during this time. Babies born in water tend to have their eyes open and be very calm. Sometimes the baby may take a short time to become pink. This is because the birth has been very gentle and is normal, the midwives will monitor your baby throughout.
Will my baby breathe while it is under the water?
This is a very common question. Babies typically breathe when they sense a change in the environment from the water into the air. A complex chain of chemical, hormonal and physical responses initiates the baby’s first breath, so it doesn’t occur under water.
The water temperature is monitored carefully during birth to make sure the environment is right. We also make sure that the baby’s head is totally submerged during birth, so the breathing reflex is not triggered too early.
Are there other risks?
Waterbirth is considered safe for those with a low-risk pregnancy and evidence from numerous studies has confirmed the many advantages of giving birth in water, for both mothers and babies.
Warm water is thought to increase the stretching of perineal muscles and reduce your risk of tearing. Results from some studies also suggest that waterbirth may be associated with a lower incidence of significant perineal tears; however, the evidence is mixed. As waterbirth is carried out with a hands-off approach, your midwife will be unable to provide effective support to your perineum, and this could lead to an increased risk of a more significant tear (obstetric anal-sphincter injury).
Should you need to have any stitches for a perineal tear, it will be done out of the water – though this is usually delayed for a little while to enable your skin to return to normal after being submerged in water.
How is the placenta (afterbirth) delivered?
If you have had a normal labour and birth you can stay in the water to birth your placenta without the assistance of drugs. If you prefer, you can have an oxytocic drug via an injection to help your placenta to come out but you need to get out of the pool after your baby is born for this. It is your choice and the midwife will discuss this with you in order for you to make an informed choice.
We are unable to accurately measure how much blood you may lose when you give birth or deliver your placenta in the pool, although if it appears excessive you will be asked to leave the pool so we can provide you with the relevant monitoring and care.
You may be asked to leave the pool for the following reasons:
- To use the toilet
- For additional pain relief
- If there is any evidence of meconium staining (when the baby opens their bowels) when your waters break
- If there is difficulty in hearing your baby’s heart rate or any concerns about your baby’s heart rate
- For vaginal examinations to assess progress in labour
- If your blood pressure, pulse or temperature become abnormal
- If your labour does not progress as expected, including if you require a hormone drip to increase contractions
- To deliver the placenta
Can I book the pool in advance?
The pool cannot be booked in advance and is available on a first come, first served basis. It can be useful to let us know your wishes to use the pool when you contact Maternity Assessment Centre (MAC) or Delivery Suite prior to coming in.
We have one pool at Harrogate District Hospital, so if it is in use, you won’t be able to use it immediately but we will do our best to accommodate your wishes. We will support you to stay relaxed and mobile and use other facilities such as a shower, bath or active birth equipment until the pool becomes available, or to consider the other forms of pain relief that we offer.
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. Some women like to be naked when they give birth and find clothing gets in the way, being naked also allows skin-to-skin contact to take place straight away.
Others feel more comfortable if they are wearing a T-shirt or a sports bra. It is important you keep warm after you have left the pool so a dressing gown may be useful to assist this.
Due to the warm environment, it is important that you do not get dehydrated whilst using the pool so a water bottle is encouraged, and you may bring a light diet or isotonic drink if you wish.
How can my birth partner help?
The main role of the birth partner is to support their partner both physically and mentally, helping them to feel relaxed and cared for. We respectfully request that birth partners refrain from getting into the pool but would encourage their support in other ways. Keep the room calm, encouraging them to stay in control and to keep their breathing steady.
Massaging shoulders or lower back may help you to stay relaxed. Birth partners can also help by assisting you to change position, offering drinks and using a facecloth rinsed in cold water to you them cool.
Emergency situations
We have procedures in place to help you to exit the pool in an emergency and specialist equipment and staff will always be available. However, if an emergency occurs in the pool there may be problems or delays 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.
Prior to your entry into the pool, we will conduct a short safety assessment to ensure that you can safely get yourself in and out of the pool. For your own safety, and for that of your baby, the midwife will make you aware of the circumstances when we may ask you to get out of the pool.
What should I do if I think I would like a water birth?
If you are interested in a water birth, please discuss this with your midwife or obstetrician during the antenatal period. We will do everything we can to support you with your preferences for labour and birth. Your wishes will be documented in your electronic records.