According to the National Institute for Health and Clinical Excellence (NICE) guidelines, submersion in water provides the safest form of pain relief in labour and using water is more effective than anything other than an epidural. Feeling relaxed and comfortable is essential to oxytocin production and in turn a smoother, easier labour. Women using birth pools often describe an immense feeling of relaxation when they enter the pool in labour and this in turn leads to the release of endorphins with their powerful, natural pain relieving properties.
An advantage of giving birth at home is that you have the guaranteed option of a birth pool should you want one. Maternity Units often have birthing pools but these are obviously a shared resource and a popular one too. This may mean that the pool is being used or cleaned and unavailable when you arrive in labour. Hospitals and birth centres also have strict criteria on who can use a birth pool, often limiting them to ‘low risk’ women and stipulating when you can access the pool. As with any choice in your pregnancy, labour and birth, you have the right to decline advice including whether you should use a birth pool. In a hospital setting it is much more difficult to negotiate the use of a pool when ‘outside of guidelines’ (VBAC, raised BMI, GBS , twins, prolonged rupture of membranes etc) but at home you may find this much easier. Indeed, having guaranteed access to a birth pool is often the primary reason a woman first starts to investigate the idea of home birth.
Some areas impose limits on when they will ‘allow’ you to enter your birth pool – often this is about 5cm dilation as there is some evidence to suggest that the relaxing effect of the pool may slow down or lengthen the duration of labour.
It is important to understand that YOU DO NOT NEED PERMISSION TO USE YOUR POOL.
You may not want to have vaginal examinations which you are perfectly entitled to decline as they may lead to time limits being imposed on your progress. Do not feel that you must have one to be able to enter your pool. If you feel the pool would provide you with comfort you should feel free to access it. At home the pool is not a shared resource which needs utilising in a timely manner, so if entering the pool has a slowing effect on your labour and you feel this is not helpful….you can get out….
The recommended temperature for water during labour is 35ºC-37ºC and 37ºC-37.5ºC when birthing. During labour you may find you feel warmer as your body is engaged in a high energy process so it is fine to allow the pool to drop temperature to ‘maternal comfort’. When birth is imminent the pool can be brought back to optimal temperature quickly by adding some hot water.
Some areas may request that you birth your placenta out of the pool. This is due to a very small risk of water embolism and to help midwives assess blood loss more easily. If you feel comfortable and would like to remain in the pool with your baby for the third stage of labour, then you are perfectly entitled to do so. Blood loss can be assessed in the pool should you opt to stay in. If your midwife states in advance that they are unable to do that, you may like to remind them of their duty to keep up to date in all areas of their practice or ask that you are attended only by midwives who feel confident and competant in all aspects of water birth.
Choosing a pool
There are several birth pools available to buy or hire. Inflatable pools are easy to use, popular and come in various sizes to suit the space you would like to have your pool. Ridge sided pools can be hired and this type of pool can be filled in advance and used for relaxation during late pregnancy as well as for the birth. These types of pool have water heaters and filtration systems where inflatable pools will need the temperature maintaining and will need filling and emptying with each use. It’s a good idea to search around and ask for recommendations. Some homebirth groups have ‘community pool schemes’ where you can borrow a pool for free or a nominal fee. There is almost always a way to access a pool to suit any requirements or budget.