Is a water birth right for you?

Looking for an alternative to drugs and a bed during labour? The answer could be a water birth.

Floating around blissfully in a pool sounds like a lovely way to spend your labour, but how practical, safe and available are water births really? We answer all your questions (yes, even the one about pooing in the pool…)

Q What’s so great about water births?

A Advocates say that being in a pool can make labour quicker and less painful. “Studies show that in places water births are available, the number of women having epidurals is lower,” says Janet Balaskas, author of The Water Birth Book (HarperCollins £14.99) “It’s also noticeable that babies seem more relaxed.

It’s as if this is a gentler way to enter the world.” One study showed that 76 percent of first time mothers who laboured in water did not need pain relieving drugs. This could be because deep water makes it easier to move around and find comfortable positions, and to relax with your weight supported between contractions.

Research shows water also greatly reduces the chances of needing an episiotomy (a cut to the perineum), as water makes this area more elastic.

Q Are there any downsides?

A “Water can slow labour down if you get in the pool too soon,” says Oxford-based independent midwife Meg Miskin-Garside. “This is why waiting until you are at least five centimetres dilated is a general guideline. I advise women to get out and walk around for a bit so things don’t grind to a halt.”

Another worry can be the risk of infection if your waters broke a while ago, but this will be monitored by the midwife.

Q Is water birth safe?

A A recent study of 4,000 water births concluded that, in low-risk women, there was no additional danger to their baby if they had a water birth. But, naturally, many women still worry about potential hazards – particularly that their baby could inhale water and drown – but most experts now believe that babies don’t take a breath until they reach the surface.

Your baby is used to being in water while inside you, and won’t breathe until he reaches the air.

Q What if there’s no pool available at my hospital? Can I bring my own one in?

A You should consult your local hospital, but there’s a good chance they will say no, due to various ‘health and safety’ concerns. Even if they do have a pool, it might not be easy to get yourself in it.

The majority of maternity units have facilities for water births, but some are more “pooled-up” and enthusiastic than others. “Too many women are told they can use a pool in hospital but then there’s an endless train of reasons they can’t have one when it comes to it,” warns Beverley Lawrence Beech of the Association for Improvements in the Maternity Services (AIMS).

So you need to research local maternity services and discuss them with your midwife.

Q I’m planning on having my baby at home – can I still have a water birth?

A Yes, many people choose to have their water births at home and buy or hire a pool. They range from low-cost inflatable pools (try birthpoolinabox.com, from £65) to deluxe wooden home-spa stylee ones for around £350 for a month’s hire.

Debbie Summers of BirthWorks (see birthworks.co.uk), who is also a doula and had water births for her own daughters, says: “We see a lot of people having their first babies at home in a pool,” she says.

“We offer hexagonal pools that we will install, and fold-up ones to put up yourself if space is tight.”

Q What if we can’t fill it in time?

A Order the pool to arrive two to three weeks before your due date and have a practice run - when your partner is not in an “Ohmigod this is it!” flap. “The big pools take about half an hour to erect, then one to two hours to fill and smaller ones just have to be unfolded, then take under an hour to fill,” says Debbie Summers.

“We supply a hose and instruction booklet and it’s easier than an IKEA flatpack!” Other hire companies that offer support and advice include the Active Birth Centre (activebirthcentre.com, or 0207 2816760).

Q Can I use any other forms of pain relief in the pool?

A It’s not safe or practical to administer most forms of pain relief in the water. Epidurals and pethidine are out and you can’t use a TENS machine. Most women who opt for a water birth find they don’t need anything. But you may be able to have some gas and air or choose to get out of the water periodically to use your TENS, so discuss that in advance with your midwife.

Q Can my birth partner get in with me?

A Yes, if they want to and it’s okay with you. Some birth partners help deliver the baby - under the close eye of the midwife - and this can be a very moving and memorable experience. Others stay at the poolside, offering physical and emotional support.. and staying dry.

Q Does the midwife have to be specially trained?

A Yes, she must feel confident and competent to deal with a water birth following the appropriate training. “Training is straightforward and most of it is common sense,’ says Meg.

‘It’s a matter of observing and using normal delivery skills. It’s very hands-off, though your midwife is usually the one to guide the baby to the surface to take that first breath.”

Your NHS trust has a duty to provide a midwife, and if you are hoping for a water birth they have a responsibility to ensure she has the skills to cope. If you want to hire an independent midwife, go to independentmidwives.org.uk

Q Will I have to get out of the pool to actually give birth?

A Not unless you want to or any complications develop with you or the baby. You might feel you want to deliver in the pool and the midwife will guide you through that. Then again, you might feel you want a bit of help from gravity near the end.

Childbirth is a very personal thing and you won’t really know what you want until it happens. It’s up to you when, how and even if, you use the water.

Q We’re both a bit squeamish - will it get really messy if I give birth in the water?

A Well, childbirth is always a bit of a messy business. There will be blood and other fluids in there, but parents tend not to care when they are so focused on the labour and birth. “Actually, overall it’s less messy,” says Janet Balaskas. “Because after the birth you just throw away the water.”

Q But what if I poo in the pool?

A It’s easily dealt with. “It’s useful to have a little fishing net around,” says Meg. “Sometimes women move their bowels or lose a mucus plug. We simply remove such things from the water.”

Q What if my midwife or her bosses aren’t keen on the idea?

A If you meet opposition don’t get into discussions on the phone, advises AIMS. Put your request in writing to the chief executive of your hospital trust or health authority.

A standard letter and action plan - along with how to order booklet Choosing A Water Birth  - is available at aims.org.uk/choosewater.htm

Are we getting the births we want?

You should be able to choose where you give birth, according to NHS advisors the National Institute for Health and Clinical Excellence. And in April the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives gave a big thumbs up to labouring in water for healthy women with uncomplicated pregnancies.

But you might still have a fight on your hands to get a water birth. Many hospitals offer an excellent service, with midwives who love the whole idea. But if they don’t you can face endless excuses designed to put you off - from staff shortages to floorboards that can’t take the weight.

Although 64 percent of the UK’s 295 maternity units offer water births, they usually have only one pool. So it can be pot luck whether you’ll get to use it.
You shouldn’t give up, though, says Janet Balaskas. “More and more women want to have this option,” she says.

“Water birth is becoming more mainstream. Nearly two thirds of hospitals have birth pools installed, when 20 years ago they didn’t, so we have come a long way.”
So stick to your guns - and get ready to make a splash.

“I just climbed in the pool and thought, Bliss!”

Mandy Mullaney, 38, was so impressed with her water birth for Gina, three, she’s planning another for her second child [note: due October]. She is married to Des, 43, and lives in Whitstable, Kent.

I’d planned a home birth with an independent midwife, but only decided on water when my friend recommended it. We hired a fold-up rectangular pool and Des had a practice run at filling it up in the living room.

I went into labour at midnight and lay on the floor, then sat on a birthing ball, wondering whether this was really it. At 3am Des said: “I’m filling the pool!” and by 6am the contractions were 10 minutes apart so I rang the midwife. I hung on as long as possible before getting in.

The contractions were five minutes apart when I started to think I couldn’t cope. I was in the transition stage. That’s when I might have asked for pain relief because I had to do something.

So I stripped off and climbed into the pool. It was bliss! The relief was instant. The warmth and the buoyancy felt wonderful. The contractions were still intense and painful, but in between I could relax.

I alternated positions between squatting with my back to the poolside, then with my front, leaning onto my arms. Des was beside me, rubbing my shoulders, giving me sips of water and encouraging me, but he didn’t get into the water. After about an hour, the midwife told me to push.

I bore down and she said the baby was crowning and would be out with the next push. But she wasn’t. The waterproof doppler showed the baby’s heartbeat falling. The midwife said if the next push didn’t work I would have to get out of the water and have an episiotomy. So I gave a big push and Gina was born at 10.10am. I didn’t even tear.

The midwife reached into the water and took her out. She clamped the cord then handed her to me. She was quite small at 5lb 4oz, but healthy and beautiful. We were stunned by the sight of her and Des was really choked. She had a little nuzzle at my breast as we sat in the water for about half an hour.

Then I got out to deliver the placenta. I’m convinced being in the water helped me cope without pain relief. It felt warm and comfy and soothed my body. My second baby is due soon and I’ve already booked the pool!

Reader panellist Ann-Maree Campbell says: ‘’I am really interested in trying out the birthing pool at my local hospital and hope it’s available when I get there. I have been swimming throughout my pregnancy and feel that water would be relaxing and hopefully a good source of pain relief.’