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Pain relief options

Having a water birth and using a birth pool

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Having a water birth and using a birth pool

Find out why using water can help you during labour and discover if having a water birth could be the right choice for you.

How can I use water in labour? 

Many women use water in different ways and at different points during their labour.

  • ‘Using water in labour’ is when you stay mobile and get pain relief throughout labour with the use of water (whether in a shower, regular bathtub or birth pool).
  • A water birth is when you give birth to your baby in a birth pool.

Around two in ten women giving birth in England use water to cope with pain during labour, according to a 2018 survey by the Care Quality Commission, and one in ten women have their babies in a birth pool.

Water birth: the benefits 

Being in a birth pool can be relaxing and a good way of reducing pain in labour. Research involving more than 3,000 women found that those using a birth pool during labour are less likely to need an epidural.

Midwife Pauline Cooke explains:

Because the water supports your weight, it can be easier to move around and get into comfortable positions. Being enclosed and surrounded by water in a birth pool can also give you a sense of privacy, which in itself may help labour to progress.

Some women report an increased feeling of birth satisfaction after giving birth in water. Water births might also be easier as the water provides support, allowing you to get into upright positions that are beneficial for labour.

Depending on your circumstances, such as the position of your baby, you might also be less likely to tear your perineum, the area between the opening to the birth canal and the back passage.

Some women feel that having a water birth provides their baby with a more gentle transition to the start of his or her life, although no one can be sure how babies feel during labour.

Water birth: the problems

Using water in labour is not always suitable for everyone. In some circumstances, women will need closer monitoring or interventions that are not necessarily possible in a birth pool.

For example, sometimes when women are induced, their baby needs to be monitored more closely using electric sensors, and these cannot be used in a birth pool.

Using pain relief in a birth pool

Being in a birth pool limits your other pain-relief options. Entonox, or gas and air, can be inhaled through a mouthpiece when you’re in a birth pool. Some women also turn to non-medical methods to cope with pain in labour, such as massage and breathing techniques; these can all be used in a pool.

You won’t be able to use the following forms of pain relief in water:

  • Tens machine
  • Epidural
  • Opioid drugs

Is it safe to have a water birth?

There’s no evidence to suggest that there are any adverse effects of using water in labour, and national guidelines from the National Institute for Health and Care Excellence (NICE) recommend it.

Giving birth to your baby in water also appears to be safe but it’s not actively encouraged or discouraged in national guidance because of the lack of robust statistical evidence available.

There can be a small risk of the baby overheating. This can be prevented by keeping the temperature of the water at around 37°C, so it’s the same as your body temperature. Your midwife will make sure the water is at a safe temperature for your baby.

Can I use a birth pool wherever I give birth?

Yes, you can use a water birth regardless of whether you give birth at home, in a birth centre or a labour ward.

Water is more often used by women who plan to give birth in a birth centre or at home than by women who plan to give birth in a labour ward, according to a 2011 BMJ Study.

As the image below displays, the percentage of women at low risk of complications who use water for pain relief varies according to their planned birth environment.

Using a birth pool in a birth centre or labour ward 

If you use a birth pool in a maternity unit, the midwives will take care of everything practical – such as filling and emptying the pool for you.

Will I be able to get a birth pool when I come to the maternity unit?

Although most maternity units offer birth pools, not all do. In general, birth centres are more likely to have a birth pool than the labour ward. Some maternity units allow you to bring your own, inflatable pool.

It’s also important to consider how often all birth pools at the unit are occupied. Some units may have a low pool to delivery rooms ratio (for example, one birth pool but five other delivery rooms without a pool).

If there is only one birth pool available at the maternity unit where you’re planning to give birth, it may already be in use by another woman when you go into labour.

If being able to use a birth pool is important to you, it’s worth asking your local maternity units about their facilities, so you can factor that into your decision when planning where to give birth.

You may find it helpful to use our checklist of questions for choosing a unit that suits your needs and preferences.

What should I wear during a water birth?

It’s completely up to you if you want to wear anything when you’re in the birth pool, the midwives won’t mind either way.

Some women feel most comfortable naked while others want to wear a bikini top, bra or T-shirt. If you’re not sure how you’ll feel, pack an extra top (that you don’t mind getting wet) in your birth bag so you can decide when it’s time to go in the pool.

If you want your birth partner to come into the pool with you at some point, they will need to wear swimwear, so make sure they have something suitable packed and ready to go as well.

Having a home water birth 

You can hire or buy a birth pool to use during labour if you’re planning a home birth and want to have a water birth. Many women plan to give birth at home partly so that they will definitely be guaranteed the use a birth pool during labour.

Make sure you’re prepared by running through the questions below as you plan the birth.

Is the floor strong enough?

If you’re planning to use your birth pool upstairs or you live in a flat, you have to make sure that your floor can take the weight of a pool full of water.

A filled birth pool with you in it can weigh almost 800kg. This is about the same as 11 people, and in addition there will probably be a couple of midwives and at least one birth partner in the room. So if your upstairs floor is strong enough to hold 15 people for a day, chances are it will also be fine with a birth pool.

If in doubt, contact the pool manufacturers for more guidance.

Is there enough room for a birth pool?

Birth pools come in different sizes, the smallest are around 170 x 135cm. If you think about it, it’s the same as having a small jacuzzi in your living room.

Before measuring up, bear in mind that the midwife needs to be able to sit next to the pool, and you have to be able to get in and out easily.

It’s worth shopping around if you don’t find a suitable pool straightaway – look for a company that makes compact pools, as these may be a better fit for your home.

Having a small birth pool doesn’t have to be a bad thing. A lot of women practising hypnobirthing deliberately choose a small pool, as it makes them feel more enclosed and secure.

Is there easy access to hot water to fill the pool?

Make sure there are no glitches on the big day and practise filling and draining the pool before you go into labour. You’ll need a long enough hose to go from the tap to the pool, and enough hot water to fill it.

Since you may be in the pool for quite a while, you also need to be able to add more hot water to keep the temperature comfortable throughout labour.

How will the pool be drained after the birth?

You can either use a pump to empty the birth pool or use a bucket to scoop out the water. If you’re using a pump, it’s better to have it go to the toilet, as the water may not go down fast enough in your kitchen sink.

If you gave birth in the pool, it’s a good idea for your birth partner to use a sieve to get any bits out before using the pump, so your hose doesn’t end up blocked.

Should I hire or buy a birth pool

Setting up a birth pool at home doesn’t have to be expensive.

Hiring a pool is a popular option and generally costs less than £100. If you want to buy a pool, it could cost up to £400.

When is the birth pool needed by?

Plan to have the pool delivered to your home by the 37th week of your pregnancy so you’re prepared in case your baby arrives before its due date. This will also give you time for a practice run of filling and emptying the pool.

If you go into labour before 37 weeks or after 42 full weeks of pregnancy, your midwife is likely to recommend that you don’t have a home birth, as there could be higher risks of complications for your baby.

Can I use a pre-heated birth pool?

Public Health England is advising people not to use heated birth pools that are filled before labour begins, and where the temperature is maintained by a heater and a pump. This is because the bug which can cause Legionnaires’ disease was found in some of these particular birth pools.

Most birthing pools rented or bought for use at home are filled from domestic hot water after you go into labour, and there is no health concern about using these pools. If you have any worries about the pool you were hoping to use, contact your midwife or the pool manufacturer.

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