KandyKinz
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Been seeing alot of waterbirth threads lately and since I am planning on having my first waterbirth and have been spending ALOT of time reading up on it I thought I'd compile what I've got so far into one thread. I'd love for others to contribute your words of wisdom as well and let me know if there's any errors or anything I should add.
Benefits
* Pain management
-Increased buoyonacy (less pressure on muscles and joints)
-Weightlessness (easier to get comfortable)
-Vasodilation (decreased oxygen flow to muscles causes increased pain, vasodilation increases blood flow throughout the body)
-Hydrostatic pressure (reduces edema,swelling and the discomfort caused by those)
* Decreased incidence and severity of tearing
* Decreased incidence of neonatal infection, specifically GBS (due to dilution/washout effect)
* Decreased need for interventions (augmentation to speed up labour, episiotomies, pharmaceutical pain relief)
Risks
*Dehydration
-Can be avoided by ensuring adequate fluid intake
-It is VERY important to keep hydrated regardless of where you are labouring, but it ESPECIALLY important to drink lots while labouring in water.
*Water aspiration
-Hypoxia (oxygen deprivation) during labour can stimulate the baby's “gasping reflex” which can cause water aspiration at the time of birth. If oxygen deprivation is an issue for the baby heart rate abnromalities would be detected and the midwife would recommend that you leave the pool.
*Problems associated with temperature extremes
-Extremely hot water could result in maternal hyperthermia which could potentially result in fetal brain damage. The water would have to be very very very hot for this to be an issue.
-Very cold water could stimulate the baby to breathe underwater
-Both of these can be avoided by using common sense and checking the water's temperature.
*Estimating blood loss can be difficult (some practitioners may recommend that you deliver the placenta out of the pool for this reason).
*Anecdotal reports of increased “snapped cords” as a result of mothers/midwives rushing to bring baby out of the water. There has been no research to verify this and more often then not if a cord is "snapped" the process in which the cord in elongated and stretched will cause the blood vessels to constrict which alleviates the risks of extensive bleeding from the baby as is what often happens naturally in the wild during the birth of animals.
Contraindications for Waterbirth (may vary depending on care provider and location)
*Situations where continuous electronic fetal monitoring is indicated
(eg induction involving oxytocin, abnormal fetal heart rate)
*Suspected amnionitis or maternal infections
(eg maternal fever is present)
*Thick meconium stained amniotic fluid
*Excessive vaginal bleeding
*Epidural anesthesia
*Active genital herpes
*Hepatitis or HIV positive
*High BMI (certain places in the UK)
*GBS (certain places in the UK)
*Hospital birth (majority of the places in Canada
)
NOTE: It is very common for the baseline fetal heartrate to increase up to 30bpm (which may make it appear tachycardic) after getting into the pool. This should go back to normal within 20 minutes and should not be deemed as a reason to get back out.
Birth Pools, Supplies and the Technical Aspects of Having a Waterbirth
Birth Pool Comparison link: https://www.yourwaterbirth.com/editorfiles/file/Pool Comparison Chart 2-11.pdf
Supplies (Many are nice to haves but not essentials)
*Fish net for floaties just in case
*Hose
-Drinking water quality is preferable
-Shortest length that gets from the sink to the pool is preferable.
-Aquarium hoses tend to be both short and of drinking water quality.
-They can be purchased at pet stores for $10-20.
*Faucet Adapter
-Allows the hose to hook up to the faucet
-Plastic ones are labelled “G” and metal ones are labelled “F”
-These tend to be cheap and are only a couple of dollars
*Waterproof thermometer
*Tarp for underneath the pool
*Comforter/blanket for underneath the pool to make the bottom softer. (Birth pools more often then not have inflatable bottoms which accomplish this)
*Underwater mirror
Air pump
-Electronic air pumps are definitly preferable and much faster then manual ones.
-Generally costs between $10-$15
Pool liner
-Makes clean up easier
-Is more hygienic if you are planning to share the pool
Test Run: It can be very beneficial to do a test run prior to the actual birth to see how long it takes to inflate the pool, fill the pool and to ensure there are no defects with your pump or holes in the pool, etc etc.
Inflating Pool: Time it takes varies. Many recommended inflating it at term 37 weeks and keeping it inflated and ready until the birth.
Filling the Pool: Time it takes varies. Can take 30 minutes to several hours. May be a good idea to turn up the hot water heater beforehand. Water can be heated on the stove if you do run out of hot water.
Recommended Temperature: 95-100.9F or 36-38C (body temp)
Temperature should be checked hourly
(Some recommend covering the pool with a shower curtain and quilt/blanket if you take a break from the pool to help keep the water warm. Some birth pools come with covers)
Emptying the Pool
Bucket Method
-Can take A LONG time
-Cheap, any pail/pot would work
Water pump
-Empties the pool very quickly!
-Expensive
Python fill and drain pump
-Fairly cheap
-Attaches faucet to hose and will drain the pool when the faucet is turned on.
(I have no clue how it actually accomplishes that!
)
Interesting Waterbirth Studies
Waterbirth & GBS
https://www.springerlink.com/content/313mv1n3m8610140/
Good Waterbirth Websites
????
FREQUENTLY ASKED QUESTIONS
Won't the baby drown?
Babies are born with the "diving reflex" which prevents them from trying to breath underwater. It's controlled by the primitive cerebral structures in the brain as well as nerve and chemoreceptors in the face and larynx. When they receptors are exposed to water the brain automatically responds by causing bardycardia (lowered heartrate, apnea (cessation of breathing) and peripheral vasoconstriction (which restricts the blood flow to the limbs and other non-essential body parts). This ensures that the vital organs continue to receive adequate amounts of oxygen. Once the facial receptors encounter air this reflex is inactivated and the baby takes a breath. This reflex is strongest at birth and gradually weakens overtime.
At what stage would you suggest OH start filling up the pool?
I got hubby to start filling the pool once my contractions were every 5 minutes (pimento1979)
How full should you fill the tub? All the way up to the marker or a little less to allow for top ups?Filling to the minimum line should allow adequate room for more hot water to be added later. If necessary, someone can take a few buckets of water out before putting new hot water in to avoid overflow. If your partner will be coming in with you, you'll need less water then if it will be just you.
When should I get into the pool?
It is recommended that you wait until you are in established active labour before getting in the pool because the comfort of it can slow down progress if labour is still in it's early stages. The exact recommendations vary, some midwives say 4cm, some say 5cm, some say 6cm and some say hold out for as long as possible and only get in when the contractions start becoming too intense to deal with on land in order to maximize the pain relief experienced by the water. It has been suggested that the first two hours of being in the water provides women with the greatest amount of pain relief and that the benefits gradually reduce after that making periodic breaks away from the pool beneficial. Some women stay in the water throughout their entire labour with no issues at all.
Can getting into water in early/prodromal/latent labour ever be a good thing?
YES! If you've been having lots and lots of early labour contractions and are having difficulties coping with the pain and are exhausted water therapy can be very beneficial. Not only can it help alleviate some of the pain caused by the contractions but it can cause those pre-labour contractions to space out enough that you can rest/sleep (make sure someone's there to watch you to ensure you don't drown!). Often, once a woman is rested her body will either take a rest from contracting for awhile until it is actually ready to go into labour or she will enter straight into active labour and feel energerized enough to sail through it.
How messy will I be when I get out of the tub? My supply list says to have old towels?
You'll likely be less messy/bloody then someone who was labouring/birthing on land but you will be wet and there is a definitly a chance you'll get some birth goo on whatever it is you use to dry yourself off with so old towels are definitly handy.
Same with baby? Should I have old towels or a nice soft cozy one?
It can be a good idea to have a few old towels or some receiving blankets your not too fond of on hand initially. Again, baby will likely be cleaner then a baby who was born on land but there is certainly still the potential of getting birth goo onto whatever it is that is used to initially dry the baby.
Can and should my partner get in the pool with me?
This is highly individual. If they want to get in with you and you want them to it's a perfectly reasonable for them to do so. Some birth pools are better suited to fit two people then others.
Can vaginal exams be done in the water?
Yes
Could I use a kiddie pool?
You can.... Birth pools are designed to be very strong and can withstand alot of weight being supported by the walls. They have inflatable soft floors which helps ensure the woman's comfort. They are also deep enough (generally up to the mothers breasts) to provide +++ pain relief plus the increased depth makes it easier to deliver the baby completely underwater. If the water is too shallow, there is a risk of bringing baby's head up out of the water and then having it drop back down under during the birth which increases the risk of the baby swallowing fluid. Once the baby is out it should stay out. There are definitly kiddie pools out there that do fit the above criteria though sometimes it can take some searching. The “fishy” (Intex Aquarium) pool has become a very popular choice. And if you do intend on purchasing a kiddie pool do try to get one during the summer as they are much much cheaper the end of August then they are mid March!
Can I use a regular bathtub?
Very large speciality tubs tend to be just find for waterbirths though most standard sized tubs are inadequate in comparison to birth pools. As mentioned above depth of the tub is an important consideration. Also, standard tubs tend to be fairly narrow which can limit a woman's ability to spread her legs and open her pelvis during the pushing stage which can impede the progress. This can also make pushing out the shoulders more difficult and should there be an issue with the shoulders after the birth of the head the midwife may require you to get out of the tub to open up your pelvis more so the rest of the baby can be born. However, if a birth pool is not an option for you labouring in your standard size tubs still holds many benefits and should definitly be utilized if it appeals to you.
Do you have to get out of the pool to deliver the placenta?
You don't necessarily have to though some midwives prefer if you do so they can better monitor the amount of blood lost.
Waterbirth Reviews
(I'd LOVE it if some of you girls who have already had a waterbirth or have laboured in water could write a review of your experience)
-Did you plan to birth in the water?
-Were you in home, hospital, or birth center?
-What type of pool did you use? (was it good, bad, how long did it take to fill up, did it keep the water warm? etc)
-What were you favorite things about being in water?
-What things did you not like?
-If you could do something different next time what would you do?
-Waterbirth pics or videos would be lovely as well
Benefits
* Pain management
-Increased buoyonacy (less pressure on muscles and joints)
-Weightlessness (easier to get comfortable)
-Vasodilation (decreased oxygen flow to muscles causes increased pain, vasodilation increases blood flow throughout the body)
-Hydrostatic pressure (reduces edema,swelling and the discomfort caused by those)
* Decreased incidence and severity of tearing
* Decreased incidence of neonatal infection, specifically GBS (due to dilution/washout effect)
* Decreased need for interventions (augmentation to speed up labour, episiotomies, pharmaceutical pain relief)
Risks
*Dehydration
-Can be avoided by ensuring adequate fluid intake
-It is VERY important to keep hydrated regardless of where you are labouring, but it ESPECIALLY important to drink lots while labouring in water.
*Water aspiration
-Hypoxia (oxygen deprivation) during labour can stimulate the baby's “gasping reflex” which can cause water aspiration at the time of birth. If oxygen deprivation is an issue for the baby heart rate abnromalities would be detected and the midwife would recommend that you leave the pool.
*Problems associated with temperature extremes
-Extremely hot water could result in maternal hyperthermia which could potentially result in fetal brain damage. The water would have to be very very very hot for this to be an issue.
-Very cold water could stimulate the baby to breathe underwater
-Both of these can be avoided by using common sense and checking the water's temperature.
*Estimating blood loss can be difficult (some practitioners may recommend that you deliver the placenta out of the pool for this reason).
*Anecdotal reports of increased “snapped cords” as a result of mothers/midwives rushing to bring baby out of the water. There has been no research to verify this and more often then not if a cord is "snapped" the process in which the cord in elongated and stretched will cause the blood vessels to constrict which alleviates the risks of extensive bleeding from the baby as is what often happens naturally in the wild during the birth of animals.
Contraindications for Waterbirth (may vary depending on care provider and location)
*Situations where continuous electronic fetal monitoring is indicated
(eg induction involving oxytocin, abnormal fetal heart rate)
*Suspected amnionitis or maternal infections
(eg maternal fever is present)
*Thick meconium stained amniotic fluid
*Excessive vaginal bleeding
*Epidural anesthesia
*Active genital herpes
*Hepatitis or HIV positive
*High BMI (certain places in the UK)
*GBS (certain places in the UK)
*Hospital birth (majority of the places in Canada
)NOTE: It is very common for the baseline fetal heartrate to increase up to 30bpm (which may make it appear tachycardic) after getting into the pool. This should go back to normal within 20 minutes and should not be deemed as a reason to get back out.
Birth Pools, Supplies and the Technical Aspects of Having a Waterbirth
Birth Pool Comparison link: https://www.yourwaterbirth.com/editorfiles/file/Pool Comparison Chart 2-11.pdf
Supplies (Many are nice to haves but not essentials)
*Fish net for floaties just in case
*Hose
-Drinking water quality is preferable
-Shortest length that gets from the sink to the pool is preferable.
-Aquarium hoses tend to be both short and of drinking water quality.
-They can be purchased at pet stores for $10-20.
*Faucet Adapter
-Allows the hose to hook up to the faucet
-Plastic ones are labelled “G” and metal ones are labelled “F”
-These tend to be cheap and are only a couple of dollars
*Waterproof thermometer
*Tarp for underneath the pool
*Comforter/blanket for underneath the pool to make the bottom softer. (Birth pools more often then not have inflatable bottoms which accomplish this)
*Underwater mirror
Air pump
-Electronic air pumps are definitly preferable and much faster then manual ones.
-Generally costs between $10-$15
Pool liner
-Makes clean up easier
-Is more hygienic if you are planning to share the pool
Test Run: It can be very beneficial to do a test run prior to the actual birth to see how long it takes to inflate the pool, fill the pool and to ensure there are no defects with your pump or holes in the pool, etc etc.
Inflating Pool: Time it takes varies. Many recommended inflating it at term 37 weeks and keeping it inflated and ready until the birth.
Filling the Pool: Time it takes varies. Can take 30 minutes to several hours. May be a good idea to turn up the hot water heater beforehand. Water can be heated on the stove if you do run out of hot water.
Recommended Temperature: 95-100.9F or 36-38C (body temp)
Temperature should be checked hourly
(Some recommend covering the pool with a shower curtain and quilt/blanket if you take a break from the pool to help keep the water warm. Some birth pools come with covers)
Emptying the Pool
Bucket Method
-Can take A LONG time
-Cheap, any pail/pot would work
Water pump
-Empties the pool very quickly!
-Expensive
Python fill and drain pump
-Fairly cheap
-Attaches faucet to hose and will drain the pool when the faucet is turned on.
(I have no clue how it actually accomplishes that!
)Interesting Waterbirth Studies
Waterbirth & GBS
https://www.springerlink.com/content/313mv1n3m8610140/
Good Waterbirth Websites
????
FREQUENTLY ASKED QUESTIONS
Won't the baby drown?
Babies are born with the "diving reflex" which prevents them from trying to breath underwater. It's controlled by the primitive cerebral structures in the brain as well as nerve and chemoreceptors in the face and larynx. When they receptors are exposed to water the brain automatically responds by causing bardycardia (lowered heartrate, apnea (cessation of breathing) and peripheral vasoconstriction (which restricts the blood flow to the limbs and other non-essential body parts). This ensures that the vital organs continue to receive adequate amounts of oxygen. Once the facial receptors encounter air this reflex is inactivated and the baby takes a breath. This reflex is strongest at birth and gradually weakens overtime.
At what stage would you suggest OH start filling up the pool?
I got hubby to start filling the pool once my contractions were every 5 minutes (pimento1979)
How full should you fill the tub? All the way up to the marker or a little less to allow for top ups?Filling to the minimum line should allow adequate room for more hot water to be added later. If necessary, someone can take a few buckets of water out before putting new hot water in to avoid overflow. If your partner will be coming in with you, you'll need less water then if it will be just you.
When should I get into the pool?
It is recommended that you wait until you are in established active labour before getting in the pool because the comfort of it can slow down progress if labour is still in it's early stages. The exact recommendations vary, some midwives say 4cm, some say 5cm, some say 6cm and some say hold out for as long as possible and only get in when the contractions start becoming too intense to deal with on land in order to maximize the pain relief experienced by the water. It has been suggested that the first two hours of being in the water provides women with the greatest amount of pain relief and that the benefits gradually reduce after that making periodic breaks away from the pool beneficial. Some women stay in the water throughout their entire labour with no issues at all.
Can getting into water in early/prodromal/latent labour ever be a good thing?
YES! If you've been having lots and lots of early labour contractions and are having difficulties coping with the pain and are exhausted water therapy can be very beneficial. Not only can it help alleviate some of the pain caused by the contractions but it can cause those pre-labour contractions to space out enough that you can rest/sleep (make sure someone's there to watch you to ensure you don't drown!). Often, once a woman is rested her body will either take a rest from contracting for awhile until it is actually ready to go into labour or she will enter straight into active labour and feel energerized enough to sail through it.
How messy will I be when I get out of the tub? My supply list says to have old towels?
You'll likely be less messy/bloody then someone who was labouring/birthing on land but you will be wet and there is a definitly a chance you'll get some birth goo on whatever it is you use to dry yourself off with so old towels are definitly handy.
Same with baby? Should I have old towels or a nice soft cozy one?
It can be a good idea to have a few old towels or some receiving blankets your not too fond of on hand initially. Again, baby will likely be cleaner then a baby who was born on land but there is certainly still the potential of getting birth goo onto whatever it is that is used to initially dry the baby.
Can and should my partner get in the pool with me?
This is highly individual. If they want to get in with you and you want them to it's a perfectly reasonable for them to do so. Some birth pools are better suited to fit two people then others.
Can vaginal exams be done in the water?
Yes
Could I use a kiddie pool?
You can.... Birth pools are designed to be very strong and can withstand alot of weight being supported by the walls. They have inflatable soft floors which helps ensure the woman's comfort. They are also deep enough (generally up to the mothers breasts) to provide +++ pain relief plus the increased depth makes it easier to deliver the baby completely underwater. If the water is too shallow, there is a risk of bringing baby's head up out of the water and then having it drop back down under during the birth which increases the risk of the baby swallowing fluid. Once the baby is out it should stay out. There are definitly kiddie pools out there that do fit the above criteria though sometimes it can take some searching. The “fishy” (Intex Aquarium) pool has become a very popular choice. And if you do intend on purchasing a kiddie pool do try to get one during the summer as they are much much cheaper the end of August then they are mid March!
Can I use a regular bathtub?
Very large speciality tubs tend to be just find for waterbirths though most standard sized tubs are inadequate in comparison to birth pools. As mentioned above depth of the tub is an important consideration. Also, standard tubs tend to be fairly narrow which can limit a woman's ability to spread her legs and open her pelvis during the pushing stage which can impede the progress. This can also make pushing out the shoulders more difficult and should there be an issue with the shoulders after the birth of the head the midwife may require you to get out of the tub to open up your pelvis more so the rest of the baby can be born. However, if a birth pool is not an option for you labouring in your standard size tubs still holds many benefits and should definitly be utilized if it appeals to you.
Do you have to get out of the pool to deliver the placenta?
You don't necessarily have to though some midwives prefer if you do so they can better monitor the amount of blood lost.
Waterbirth Reviews
(I'd LOVE it if some of you girls who have already had a waterbirth or have laboured in water could write a review of your experience)
-Did you plan to birth in the water?
-Were you in home, hospital, or birth center?
-What type of pool did you use? (was it good, bad, how long did it take to fill up, did it keep the water warm? etc)
-What were you favorite things about being in water?
-What things did you not like?
-If you could do something different next time what would you do?
-Waterbirth pics or videos would be lovely as well
at you ladies afraid of the water pump, the electrics are protected and naturally it will need to be in the water to drain the water! Kandy I can tell you how the tap attachments works: basically the running water from the tap creates a suction on the adjacent tube as it flows past which draws water up it (ie from the pool) and out. I would've thought it must be possible to use a short hose to drain through simple capillary action - suck on one end until the water starts to come (might need to be brave! 
). 
