Whilst studies have shown that Water can be effective in helping to reduce pain during labour, there is no evidence that actually giving birth in water has any real benefits. In fact some hospitals are not keen on women giving birth in a birthing pool as it is more difficult to monitor the baby and also to see what is going on as the baby comes out, and therefore they may be unable to prevent you from tearing as they may be able to do if you were on a bed.
However, despite these issues, it can be a very positive and pleasant way to give birth if the conditions are right.
We will talk you through what you can expect if you give birth in a birthing pool.
When the midwife or doctor thinks you are ready to go in the water, the pool will be prepared. You should be aware that this may take some time, maybe up to half an hour, as the pool must be run freshly for you and the temperature must be exactly right. It is of great importance that the temperature of the water, mimic the temperature of your blood. The baby’s only way of regulating its temperature is thought the mother, and if you are too hot, then the baby will not be able to cool itself down.
When you get in the pool, you will realise quite quickly if it is an experience you are going to enjoy or not. For some women, the feeling of the water is relaxing and calming. For others, it feels scary and unpleasant, in which case you should tell your midwife and she may encourage you to get out. You will be able to move around and find a position that is comfortable to you, perhaps on your knees leaning against the side of the pool, or sitting down with your back leaning on the side. Some pools are big enough so that your partner may get in with you, but most are only really big enough for you. The midwife will need room in the pool so that she can lean over and monitor you and the baby.
The midwife or doctor will monitor your pulse and temperature and the heartbeat of the baby regularly. This will be approximately every 30 minutes or if your contractions are more regular, then after each contraction. You may have to stand up for this, or she may have a waterproof monitor.
If your labour develops any complications, you may b advised to get out of the pool.
Reasons that you might have to get out of the water include:
- A problem with the baby’s heartbeat detected during the monitoring
- Labour progressing too slowly, contractions slowing down.
- The baby passes mecconium (poo) showing that it might be in distress
- Your blood pressure increases or decreases too much
- You feel unwell or faint or too hot
- You start to lose blood.
If the midwife asks you to get out, you must listen to her and do as she says, no matter how disappointed you may be about not giving birth in the water.
Some women enjoy being in the pool as their labour progresses, using the water as a form of pain relief, but wish to get out to have an epidural, or to deliver the baby on a bed. However, many wish to stay in the pool and deliver the baby in the water. As long as all the conditions remain good and stable, it may be possible for you to give birth in the pool if that is what you would like to do.
As the labour progresses (see Stages of Labour) you may have to step out of the pool so that the midwife can see how dilated you are and confirm that you are ready to start pushing.
The midwife will probably ask you to get into a position that will allow her to see the baby’s head as it is coming out. She may also tell you that she will not help the baby’s head out or even touch the bay until it is completely born. His dive reflex will stop him from breathing under water, but he should not be startled or this may interfere with this reflex.
As you begin to push, she will be able to look down through the water to see how the baby is progressing. You should listen to her carefully and if she tells you to stop pushing at anytime, you must take note. She will be trying to make sure that the baby does not come out too fast and tear you.
When you have pushed the baby’s head out you will have to wait for the next contraction before you can push the rest of the body out. This thought may scare you or your partner as you may worry that the baby will inhale water, but his dive reflex will make sure he keeps his airway closed until he reaches the surface.
With your final push, the baby will come out, the midwife will usually take him and guide him to the surface and put him straight on your chest. The cord is normally cut whilst you are in the pool and the injection for the delivery of the placenta can be given whilst you are still in the water. You will need to stand up and get out in order to deliver the placenta. You may need a hand getting up if you feel wobbly. After the placenta is delivered, you will be checked to see if you need any stitches.