What's it like to labour in a birth pool?
The relaxing effect of water, with its support and warmth, can help you through your labour. The soothing sensation will help you to relax, which in turn will help your labour to progress. Being immersed in water can help you to simply go with your contractions, especially once you’re in active labour (Simkin and Ancheta 2011).
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Being relaxed also helps you to breathe calmly. It means you're less likely to take short, shallow breaths, which can make the pain of contractions worse.
In active labour, labouring in water may help your body to release less of the stress hormone adrenaline and more of the labour hormone oxytocin. This stimulates your labour contractions to be strong and regular (Simkin and Ancheta 2011).
Your body may also release more endorphins. These are the hormones that help you cope with contractions (Buckley 2011, Simkin and Ancheta 2011). A birth pool provides the perfect private nest for you to labour in (Cunningham 2016) and will work best if you are immersed up to your shoulders (Simkin and Ancheta 2011).
Once you're in the warm waters of the pool, you're in your own world and can labour undisturbed. If the lights are dimmed and the room is quiet, the effect can be heightened (Buckley 2011, Cunningham 2016), helping you to feel more in tune with your labour.
Being in water buoys you up and makes you feel lighter. It's easier for you to move about, so you can make yourself comfortable (Simkin and Ancheta 2011). The best position for you to take is the one you feel most comfortable in. Although when it comes to the pushing stage, your midwife may be able to help you get into a good position that will help your baby move more easily through your pelvis.
A useful rule of thumb is to keep your knees lower than your hips. But you can easily adopt lunge positions in the pool too (one knee down, one knee up), or kneel in the pool while you lean on the side. These positions can help your baby to descend as you push and make the pushing more comfortable for you (NCCWCH 2014).
Being in warm water can make it easier for you to cope with the pain of contractions (Cluett and Burns 2009). It's just the same as having a bath to soothe a tummy ache or back ache.
If you’re having your baby in a hospital or birth centre, you’ll have someone with you at all times, whether it’s your midwife or your birth partner.
Using a birth pool for labour is often such a positive experience, many mums want to use one again when they have their next baby (Cluett and Burns 2009).
What's it like to give birth in water?
Getting into a comfortable upright position may be easier if you’re using a birth pool (Cluett and Burns 2009). The buoyancy of the water and the feeling of being in a safe and private space can encourage your freedom of movement.
It may be quicker and easier to push your baby out in the water than in air (Torkamani et al 2010). You'll feel supported by the water and can use the sides of the pool for extra support.
You may feel uncomfortable about accidentally opening your bowels as your baby enters the world. There's no need to worry about this. Your midwife will scoop it up and get rid of it before you and your birth partner even realise.
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When your baby is born, he’ll be brought to the surface of the water to take his first breath. Your midwife will slowly bring him to the surface, or show you how to do it yourself.
The reason for this gentle approach, is because of the risk of the umbilical cord snapping or tearing. However, this is very unlikely, affecting just one in 300 to one in 400 water births (Burns et al 2012, Cunningham 2016). And there’s not enough research to say whether it’s more likely to happen during water birth than giving birth in air (Cunningham 2016, RCM 2012, 2014).
In any case, a snapped cord is not a life-threatening emergency for your baby. Your midwife will be trained for and alert to the possibility of it happening.
What's it like for my baby being born in water?
We can't know for sure what any baby's birth feels like to the baby! However, supporters of water birth believe that the transition to the outside world may be more peaceful for babies who are born in water (Harper 2012).
The idea is that the warm waters of the pool will feel similar to the amniotic fluid in your womb (uterus), which your baby has been floating in for nine months. As a result, babies born in water may be more alert, focused and quieter than babies born in air (Harper 2012).
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You may be worried that your baby will inhale water with his first breath if he’s born in a birth pool. When it comes to breathing, your baby won't take his first breath until his face, mouth and nose come into contact with air and a change in temperature (Harper 2012).
Babies born in water are protected by the "dive reflex". Your baby will instinctively close his airway, stopping him from breathing in water (Cunningham 2016, Harper 2012).
Your midwife will also be monitoring your baby during your labour to make sure he's getting enough oxygen. There’s no evidence that babies born in water suffer from breathing problems any more than babies born in air (Cluett and Burns 2009).
Experts believe that babies are only at risk of overriding their dive reflex and inhaling water if:
- Their oxygen supply via the placenta is affected in some way.
- They are stimulated by touch or a change in temperature, before the rest of their body is born.
(Cunningham 2016)
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Your midwife will guide you to make sure you don't bring your baby's head to the surface before the rest of his body is born. She will monitor your baby for any potential problems (Cunningham 2016). If she thinks that there is a problem with your baby's oxygen supply, she will ask you to stand up out of the water so that she can help your baby as quickly as possible.
Why would I need to get out of the pool?
You may find it too hot in the pool and want to get out for your own comfort, or you may need a loo break. Your midwife may also ask you to get out, to examine you or to break your waters.
You may find that being in a birth pool doesn’t make your contractions less painful. You can use gas and air, which is a mild pain reliever, while you’re in the water. But if you need stronger pain relief, such as pethidine or an epidural, you'll have to leave the pool (RCM 2012).
You may also have to get out of the pool if your midwife suspects a problem with you, or your baby, such as:
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- You feel faint or drowsy.
- Monitoring your baby's heartbeat shows that there is a problem (NCT nd).
- Your labour is progressing very slowly. Your midwife may suggest getting out and mobilising for a while until your contractions get going again (Simkin and Ancheta 2011).
- You start bleeding during labour (NCT nd).
- Your blood pressure goes up (NCT nd).
- Your temperature goes up (RCM 2012).
- Your baby's first poo (meconium) is detected in your waters (NCT nd). If you are in the second stage of labour and meconium is detected, you may be able to stay in the pool depending on how much there is. Your midwife will check your baby's heart rate for signs of distress.
Having to get out of the water and change the course of your labour may be upsetting for you. But your midwife will only ask you to leave the pool if she thinks it will be better for you or your baby’s health. You may be able to return to the pool, once your midwife is confident that all is well.
Most water births go smoothly, but if an emergency does arise, it may take time to get you out of the pool. Even so, your midwife is trained to deal with emergencies. She’ll be able to get you out of the pool quickly and safely, and get you the help you need.
Once your baby’s born, you may have to get out of the pool, depending on whether you are having a managed third stage or not. If you are having a physiological third stage, you may be able to stay in the water for a while cuddling or breastfeeding your baby while you wait for the placenta to come away naturally.
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If you’re hoping to use a birth pool in hospital, you may find there are restrictions on how you can use it. See our article on planning your water birth for more information.
How women give birth
UK stats on everything from caesareans to water births.
