Planning to put a labor and birth pool into a birth center or hospital takes some upfront consideration. Careful planning initially will pay off in the long run. By getting it right first time, you will have facilities that support good and safe practice for women and their babies, as well as your team.
This post is part of a series addressing the major issues you need to consider: space; water supply; drainage; and electrical supply.
Here, we take a look at space.
When you’re considering your space requirements, the key elements you need to consider are:
Essentially, you need to be able to easily, quickly and effectively access the woman in the pool, so you must factor this into your space considerations. For every labor in water you will need to monitor heart rate and maternal temperature, and for water births you need to catch the baby as it emerges. You can perform all these tasks with any type of pool.
Do you want to ask a woman in labor to change positions? An important factor when you are considering how much space you’ll need. For example, you will need to ask women to move more often in a pool placed in the corner than one that is open on three sides. If you choose the latter, then factor in at least two feet (60cm) of space on each side.
There is an increasing trend to placing freestanding pools against a panel in the corner of a room. Not only does this look great, it also offers good, all-round access.
Unless you are using a lift (known as a hoist in the UK), then women need to be able to get in and out of the pool with limited assistance – specifically, without your team bearing a significant part other weight.
To do this, you will need:
Clearly, criteria for using the pool are important too. If you want to be able to safely offer the pool to a woman who is not able to get into it without assistance, then perhaps you do need to consider a lift.
With shoulder dystocia, you have limited time for action. Asking the woman to stand up and flex her pelvis with one foot on the step can remove it. But if this doesn’t work then the woman needs to get straight out the pool and onto a bed. In this instance, it’s critical to protect the baby’s head. You could try bringing a bed to the pool near the internal step, either length ways or sideways and approximately level with the pool deck (or rim). The woman can then step up onto the bed in a kneeling position, keeping the baby’s head well away from the hard surface of the pool.
This assumes that you have a mobile bed that can be brought next to the pool. You may want to consider keeping a mobile bed outside the room to preserve the “home-from-home” feel of your birth rooms.
While this is rare in labor, you must be prepared for it. Whether you plan to use a lift or a slide net – a net with handles designed for patient handling – it’s essential that your team is trained and confident in quickly getting a woman out of the water under these circumstances.
If the slide net option is not workable for you, then you will need a lift. If you have a permanent lift attached to the ceiling or on a gantry, then you won’t need to find space for a portable lift.
You also need to consider the necessary presence of able-bodied people: if your rota calls for two staff on site in the middle of the night, you will need at least one additional person to lift a woman out of the pool. One solution to this is to ask women to have a birth supporter present who is willing and able to be part of the lifting crew.
In this post, we’ve covered the main space considerations for rooms that include a birth pool. Any decisions should be made in close consultation with clinical managers, making sure that labor and birth pools support a safe, comfortable and practical birth environment for everyone involved. Note that that in the UK, electrical regulations require a pool to be 10 feet from a power socket – factor that into your plans. For many countries, a GFCI (Ground Fault Current Interrupter aka RCD) is sufficient protection.
Check out our previous blog here for more information on Shoulder Dystocia.
The Steps to Take When Planning a Water Birth Did you know that having a water birth can help you to feel more relaxed and in control while giving birth? Many women choose to have a water birth, whether that’s in a hospital, birth centre, or in the comfort of their own home. There are …
During these changing and challenging times I have spent the last few months sharing information about the use of water for labour and birth.
On 29th April, Oxford Brookes University in the UK published a piece titled “Coronavirus COVID-19: Supporting healthy pregnant women to safely give birth” that addresses the questions of birth setting and risks for water immersion in labor.