Active labour and birth in Obstetric Units

Hi-Lo active birth chair

The benefits of upright and active labour and birth to women, babies and a healthy labour are uncontroversial and well established – and yet women are still so often confined to the bed in obstetric units.

Women who are welcomed into a midwife led unit, on the other hand, tend to have rooms where the bed is not centre stage, and instead the standard birth support equipment lends itself to upright, kneeling, squatting or forward leaning positions for labour and birth. Access to a birth pool is common, as are slings, birth couches, mats and balls.

Walk into most obstetric units and the untrained eye would have a hard time recognising it from any other hospital room. Machines, cables, bleeps and flashing lights and of course, in the centre, the bed. We spend 1/3 of our lives lying down in bed. When we are admitted to hospital for any other reason than to give birth, we lie down in bed. There is every psychological reason to automatically go to the bed and lie down when we’re admitted in labour – and every physiological reason not to!

By taking away the focus of the room from the bed and towards ways to support active labour and birth we know that we can shorten labours, help with babies’ positioning, reduce the need for pain relief and have more positive births. It is therefore not only a real worry that women who are birthing in the obstetric unit so often don’t have the automatic access to the low cost, high value equipment which supports this, it actively causes harm by reducing and limiting the woman’s ability to move in labour.

We call upon the commissioners and managers of obstetric units to consider the ways that their birth units can have the best of both worlds – the low-tech, high impact equipment which helps women to remain active, and the high-tech, high impact equipment available if necessary, but ideally easily accessible but slightly hidden, eg behind a screen. While, clearly, hospital birth pools can’t be plumbed into every obstetric unit room, there’s no reason why each room can’t benefit from a HiLo Birth Chair, or something similar. This simple piece of equipment is perfect for supporting active birth in every room in the obstetric unit. Fast and easy to clean, small footprint for even the smallest obstetric room, the HiLo Birth Chair provides excellent support for multiple labour and birth positions including upright breech birth. It supports normal human birth physiology and biomechanics while permitting extremely easy access to the woman in order to offer monitoring of all kinds, and all other tests and checks which can be performed without the woman lying down (ie almost everything). The reduction in the use of anaesthesia, caesareans and other expensive interventions1 that are likely to come from using the HiLo Birth Chair in each obstetric room will mean that it will quickly pay for itself. Indeed, just one avoided caesarean covers its cost as well as stopping that woman from possible life-long complications from major surgery.

We need to move away from an either/or situation for women. It shouldn’t be that only women on the MLU can access evidence based equipment that can reduce costs for the Trust, reduce interventions for the mother and baby and increase the chance of each mother having a positive birth. Obstetric units can benefit from this equipment too – saving money and having better outcomes for women and babies.

Reference

  1. Cochrane Review, “Mothers position during the first stage of labour” https://www.cochrane.org/CD003934/PREG_mothers-position-during-the-first-stage-of-labour

 

Installing a Birthing Bath

professionally installed birthing pool

There is no mystery to installing a birthing bath.  In may ways they are simpler than domestic baths because our baths are one-piece Single -Surface baths.  Midwives designed the bath from the top down, and plumbers designed it from the bottom up!

Usually, the bath arrives into a near-finished room.  Plumbing should already been in place behind an IPS panel.  All that should be visible is a small piece of 40mm solvent weld pipe protruding from the very bottom of the IPS (or no more than 25mm from the floor).  Taps are in place by this stage too.

In terms of taps, we don’t recommend any, but have a short guide sheet (pdf).  We know taps from the Ideal Bluebook range are commonly used.  For example, one Trust repeatedly favoured using two of the following so that there was a double supply of mixed supply hot water.  The reason being that 22mm taps that are HTM compliant are very difficult to source and a 15mm tap would take too long to fill the bath.  http://www.idealspec.co.uk/catalogue/bluebook/brassware/contract/contour-21/contour-21-single-control-mixer-and-15-23cm-spout_p351.html

Rada Sensor taps are also very popular.

  Looking in through the hatch, the finished pipe work should look like this.  The valve should be as close to the hatch door as possible so that the midwives are not having to reach right in under the bath.  The valve is supplied with the bath.  The pipe either side of the valve must be clamped to support the valve and to stop the pipework being twisted by the constant use of the valve.

Anyway, first things first.  This is a 2-3 person job – you’ll see why.  When we install a bath, we put down lots of padding and tip the bath on its side onto the padding.  This way, we can, using a long level or straight edge, adjust the feet to match the base of the pool.  The bath is designed to sit both on the basal rim of the bath and on the feet.  This is why our baths are so good at spreading the load.  If you don’t think you can put the pool on its side without scratching it, don’t – the warranty doesn’t cover it.

It is also easier to silicone in place the waste and, if ordered, the LED lights. The latter are fitted in the same way as a waste – a backnut and a lot of silicone!  Once all that’s done, carefully turn the bath back onto its base.

Offer up the end of the bath to the IPS.  This way, you’ll see where the waste pipe will come through the end of the bath.  mark and drill it out.

First to go on the tail of the waste is an elbow and the waterless trap.  The Hepworth vO is a good choice but other versions are now available.  Do  not use a U-bend or shower trap.  They hold water which will just become a source of infection issues.

ideal pipe bends
Avoid sudden 90 degree corners in the pipe run.

 

 

Next comes the valve and the remaining piperun to join on to the piece of 40mm pipe protruding through the base of the IPS (and through the end of the bath you’ve just drilled!).  Don’t glue the pipework before you’ve tried it all in place.  You may want to mark where the clamps either side of the valve are to go.  It is easier to pull the bath back, drill and then put it in place.  Finish the pipework.

Screw the bath to the IPS and, through flanges on the base in the hatch area, to the floor.  Silicone round.

Birth Baths in the Netherlands – Geboortebaden in Nederland

 

Aquabirths birthing baths have been installed in several hospitals across the Netherlands such as the Saint Lucas Andreas in Amsterdam.  Now we have an agent/distributor in the Netherlands.  We’ve partnered with the established Dutch company VAB so that customers in the Netherlands can discuss the baths and get support locally.  Their Mobypool range is here.  You can contact Maks and Hans here.

Also, we now price our baths in Euros and pounds so that customers in the rest of the EU can choose the currency that suits them.

Free Mini Birth Couch Kit with Birthing Pool

Birthing Couch Kit for Smaller Birth Rooms

The SoftBirth birthing couch kit has a new little sis!  A shorter version for smaller rooms at a smaller price.  A HoM asked us to design a smaller birth couch kit for smaller rooms, so we did and will even fit in the back of a small hatchback. Anyway, with all our birth couches we offer very large discounts when more than one of the same couch is bought. So, this is £600+VAT but 3 or more would be at £500 each.  As with the larger SoftBirth couch, this is a kit – the stool and kneeler are included.  The mini is also FREE with Aquabirths’ Canberra, Venus and Heart-shaped birth baths.

Mini birth couch kit

Free BirthSoft Birthing Couch Kit

Aquabirths will include a free SoftBirth birthing couch kit with the Canberra, Venus and Heartshaped  models of our birth baths.  The SoftBirth birthing couch kit is usually £950 but is on offer at the moment at £795.  More details can be found at http://softbirth.com/ You can also copy-of-softbirth-birth-couchdownload their information flyer and spec sheet there too.  We’ve tried one out – it is very comfortable and unlike other couches, is not cumbersome and heavy.  The inter-changeable cushions make this a very flexible help for birthing and labouring mothers.  So, even if you’re not buying one of our birthing baths, you can still get it at the offer price.  http://softbirth.com/
couch-stool_01

Corner Baths

We’ve had a bit of a flurry of requests for corner baths, mainly from export customers, so we thought we’d better write a short blog on them.

The short answer is, ‘yes, we do make them.’ They are an excellent option where space is a bit tight but the hospital still want to give a birthing mum the option of a water birth.  Sometimes, corner baths are avoided as the midwives want to be able to access the woman from as many parts of the bath as possible.

Our Dunoon model birthing bath is ideally suited to being used in a corner.  It is already designed specifically to be compact and fit in smaller rooms but to still give a labouring woman plenty of room to move and keep active during birth.  It does this by virtue of its rounded rectangular shape and by using space wisely so that it still has the capacity of a birth.

The Dunoon can be fitted in any position and doesn’t have to go in a corner but if you let us know when ordering, we can include an extra piece of trim (at no cost) so that you can have a neat finish against the corner walls.

Dunoon compact birth pool

Compact Birth Bath for Labour and Post-partum Bathing

Bathing for labour and post-partum bathingAnother of our compact birthing baths for labour and post-partum bathing, the York model, is ready to go off to the Isle of Man.  With its verycompact birth bath modern  look, the York gives birth centres that luxury spa feel.  As with all Aquabirths pools, it is a one-piece construction for maximum strength and infection control as well as for ease of installation.

Midwives and waterbirth mums had a direct hand in this bath’s design, hence the broad rims and curves.  An additional feature they designed in was the excellent lumbar support.

Contact us for drawings, photos and offers for this birthing bath.

The Softbirth Birth Couch Kit

Couch Complete

Softbirth©  have just launched their  range of soft furnishings for the birthing room.  The most exciting piece being their birthing couch kit.

With its simple yet innovative design, its segments can be moved around to suit the needs of the moment.  The stool segment pulls out to give a seat for the midwife or birth partner.  The recess can be used for the mother to kneel – a kneeling mat is included for comfort.  Other couches charge for other items, such as inserts, as an optional extra whereas they are included in the price of the Softbirth couch.

The foam used is very firm for safety’ s sake but it is topped off with memory foam to give a very comfortable feel. The comfort is enhanced as the design tries to get away from the ‘clinical look’ whilst still being suitable for the birth room.   Its approximate dimensions are 2m x 1m x 0.45m.  And whilst it is firm and stable, it is not heavy or cumbersome like other similar products.  It can be easily moved and deployed or put aside to clear space.

The cover is hospital grade and has welded seams and is fully cleanable.  The cover is zipped so that it can be replaced and to enable inspection (the inner of the cloth is white so that any ‘strike-through’ can be quickly spotted.  The zips are covered by hygiene flaps.  The couch can come in mid-lilac as shown or navy blue and replacement covers can be purchased either with the couch or later as a replacement.

SB-couch and cushions

IMG_0178

Another optional extra is the comfort cushions set consisting of a pillow, a square cushion and a cylinder-cushion.  Larger versions of these cushions are available.

For prices, click here.

Fantastic Looking Birthing Pool

 

We had an email that came via the midwives of the Morecambe Bay Trust in response to our installation of a Canberra birth bath at Barrow (Furness General)

To whom it may concern,

I have seen pictures of the new birth pool in Furness Hospital on your website it looks fantastic. We are looking at developing  a water birth service in our hospital in Limerick in the Republic of Ireland.

We would like to get some information and details of the birthing pool.

I would be delighted if you could supply some information in relation to the birthing pool company and specification that was used.

Regards

Best birth bath ever

Waterbirth Conference 2015

A packed-out conference on waterbirth and normality held in Shipley, with such speakers as Dianne Garland and consultant midwife Alison Brown.  A fuller report to follow but here are some of the tweets…

 

 

 

There was also the launch of BirthSoft for reasonably priced birth couches, mats, etc.