Aims and objectives for waterbirth study sessions

A parents guide to using water for labour and birth

W Water has relaxation qualities which enable you to move and be buoyant in the pool. It is calming for both you and your baby and has long been known for its therapeutic properties. It provides a soothing and comforting environment for your labour and possibly birth your baby in. Water can help calm your birth companions  if you relax so do they.

A Allowing midwives to support you in the normal process of childbirth is one way water can help you. It can enhance labour once established at about 4cms but does not preclude you using water before that time if in latent labour or during the early stages of first stage. Midwives will be working within a framework of care which may include who it is recommended could use the pool, this is usually that you are at term (38-41 weeks) go into labour spontaneously, have a single pregnancy and that the baby is head down. Other criteria may exist regarding any medical (pelvic girdle pain) or obstetrical problems (induction of labour / previous caesarean section) and any mobility problems including a high BMI (your weight) always ask locally so that you are not disappointed in labour if you are not able to use a pool.

T The theories of water follow a cycle, if you relax and go into a regressive state (Zoning out  into your own space) your stress hormones will reduce and your own natural pain killers  endorphins will increase. Attracted to endorphins are the hormones of labour  oxytocin which makes the uterus contract. The regression is enhanced by the physiological properties of water (buoyancy/ mobility) and psychological (relaxation/ familiar warm environment).

E Engaging with parents. If water is to have the beneficial properties of floating and buoyancy it is important it is deep enough for you. Pools maybe hired or bought for home use, in a birth centre or hospital they could be permanent (built in) or portable (ones that inflate).Investigate which is available locally  some pool companies are linked via my web site. There could also be the opportunity to visit the pool room during a tour of the birth facility, parent classes maybe available or aquanatal swimming. These can all assist in your preparation for using water during labour or birth.

R Robust clinical care provided by your midwife will monitor and support you and your baby during labour. The midwife will take regular observations of your temperature, pulse and blood pressure. The room and water temperature are important and will be document in labour and at birth. Basically water should be at comfort level for labour, you need to drink plenty of fluids when in the pool and you should regularly pass urine  either out of the water or in the pool. Whilst we want you to relax in the pool you should change position during labour to assist the babies head to descend. Babies heart beat will be monitored throughout labour and birth, and if any changes occur you will be asked to leave the pool.

B The babies first breathe will not occur until he / she leaves the water into your arms. There are some protective mechanisms which we believe protect your baby from breathing under water. These include that there are no known risk factors and is currently in condition during labour with no anticipated problems. The midwife will monitor his heart rate  see above  ensure the amniotic fluid (if ruptured) is clear and that in her professional judgement labour is progressing normally. Water temperature should be at 37-37.5(normal adult body temperature) if you are delivering in the water. The midwife will also deliver non touch to prevent the baby from being stimulated under water. If there are any concerns you will be asked to stand up and leave the pool.

I Investigating options. If hiring or buying a home pool you will be asked to take responsibility for setting the pool up, where to place it, ensure you check how long it takes to fill or empty and possibly check any insurance issues. You should make sure it is big enough for you to kneel, squat and float during labour  dimensions of pools are on company web sites. All of these issues will have been organised within a birth centre or hospital pool room.

R Research has shown that in skilled practitioners care, water has similar outcomes to dry land birth. It does appear that many mothers have fewer tears (although some tears do still occur). Your baby may appear calmer as you enjoy skin to skin contact, and it may assist in initiating breast feeding.

T Teaching of waterbirths is included in student midwife education, and many midwives have attended sessions to support you with this choice. There are many resources available from both this web site and others that are linked. You may wish to read more about early labour preparing yourself physically/psychologically and other options for pain relief and delivery.

H Help is available from your midwife and local NHS trust. They should be able to provide you with how many mothers use their pools and if there are midwives always available who will offer you water during labour. Find out as much as possible before you go into labour. Web links on this site provide a range of sites both in the UK and international organisations.

To promote waterbirth as a peaceful and safe option of delivery for mother, baby and practitioners.

W - Why Water  introduce the benefits of water to mother, baby and practitioners

A - Accentuate normality  promote the efficiency of water to enhance normality within a safe and caring environment.

T - Theories  understand the theories of using water including hormonal effects.

E - Engaging with parents  utilise and develop all opportunities to engage with parents regarding the use of water.

R - Robust care  discuss and evaluate the clinical care required to support waterlabour and birth.

B - Breathing  understand the concepts of the first breathe including some of the controversies surrounding birth underwater.

I - Investigate options  introduce other disciplines involved in waterbirth i.e infection control.

R - Research  discuss and appraise research surrounding safe waterbirth practice.

T -  Teaching  expanding clinical and educational needs of individual practitioners.

H - Help  offer ongoing support through international contacts.