Local Birth Support – Yorkshire and Manchester

UK Homebirth Support Group: Visit them on Facebook

Bradford Choices is the 2nd Tuesday of the month, beginning at 7.30pm.  Join the Facebook group for more information and the venue: https://www.facebook.com/bradfordbirthchoices

Wharfedale Birth Choices Group meets in Burley in Wharfdale, on the 3rd Saturday of the month at 10:30am. Would love to see you there, and please do help us get the word out by inviting friends and colleagues to join the group. Find them on Facebook HERE

Huddersfield and Calderdale Home Birth Support Group meet every six weeks. Find them on Facebook HERE

Ilkley Positive Birth Movement Group meets on the last Sunday of the month at Midwife Amanda’s house in Ilkley.  Please contact Amanda on 07828 315622 or visit them on Facebook.

Leeds and Bradford Caesarean and VBAC Support Group. A ‘peer’ support group for women and their partners who are considering caesarean, who have had a caesarean and want to discuss their emotions relating to their experience, for women planning another baby or already pregnant and wondering about their options and choices to birth normally next time around. Click HERE to go to their Facebook Page.

Harrogate Homebirth Support Group. The Harrogate and District  Home Birth Support Group meetings are held on the third Sunday of every month 10.30am – 12 noon at the Oatlands Community Centre, Gladstone Street, Harrogate. For further details contact: harrogate@nct.org.uk .

Leeds Choices – St. Andrews Church, Horsforth. Their Facebook page is HERE.

Manchester Homebirth Group. Visit their facebook page.

Wakefield Birth Choices is now only on Facebook.

York Home Birth Support Group meets on the first Sunday of the month from 3-5pm. See Facebook HERE

Sheffield Homebirth Group – https://www.facebook.com/sheffieldhomebirth/

Hull & East Yorkshire Home Birth group – meets third Monday of the month.

La Leche League Groups in Yorkshire:

Having a homebirth in Leeds – information and support from your midwives. Contact the Lotus Team on  0113 392219
There are home birth and water birth information evenings, speak to staff at the LGI for information.

Biofilms and Birth Pools


Are biofilms a health and safety risk in hospital birth pools? What can be done to minimise the risks of biofilms in hospital birth pools? Aquabirths answers these questions and more.

What is a biofilm?

Biofilms are a collection of bacteria which have clumped together in a supportive environment, which will include the regular flow or presence of water. Biofilms are everywhere, and are likely to be the reason that we have life on earth, as the ability for bacteria to join into larger groups, rather than simply floating around as planktonic lifeforms (individual bacteria cells) appears to have been vital as part of the stepping stones from single cell to complex life (1).

When bacteria clump together into biofilms, they produce chemicals which makes them harder to destroy with normal anti-bacterial chemicals, and a combination of cleaning agents and scrubbing is necessary to remove them.

Biofilms are present in most areas of our life, and are often beneficial to our bodies, including some which reside in our gut. An example of a bodily biofilm is dental plaque, which needs to be regularly removed to avoid harm, and this is an example which clearly shows how just using an anti-bacterial mouthwash isn’t enough. Scrubbing with a toothbrush is also necessary to properly remove the bio film of dental plaque.

So, while biofilms aren’t necessarily a human health hazard, some are, so understanding how to clean them is important in all hospital environments.

Biofilms in hospitals

Biofilms can be found in many areas of hospitals (and shops, and our homes), and are likely to be present everywhere there is water. They are a natural part of the planet’s environment. The time that they may become a problem is:

  • If the bacteria that is growing in the biofilm happens to be one that can cause harm to humans
  • If this harmful bacteria is able to access the human body, eg via an open wound

For this reason, hospitals have strict policies on cleanliness, and following these policies should be enough to keep everyone safe from harmful bacteria.

Biofilms and birth pools

There are three areas that biofilms can grow on birth pools:

  • Plumbing into the pool (taps and pipes to the taps)
  • The pool itself
  • The birth pool’s drainage system

Biofilms can grow in any pipe through which water runs, including if the water is clean and chlorinated. Of course, the chlorination is likely to significantly control any pathogen build up. There is nothing that needs to be considered in the birth pool that isn’t already considered in the use of fresh water elsewhere in the hospital. For instance, there is no additional risk from the birth pool water intake than there is for the water used in scrubbing up for obstetric or other surgical procedures.

Running the water for two minutes before starting to fill the pool (so with the drain open) will ensure that any loose bacteria that might be in the intake pipes or taps will be washed away. This will also safely wash away any loose bacteria around the drain.

The second area to consider is the birth pool itself. Clearly, the infection control policies which relate to the cleaning of the pool include both anti-bacterial cleaning agents, and scrubbing, which if done correctly are sufficient to ensure that the pool is clean and safe. ALWAYS ensure that any cleaning products are non-scratch. Abrasive cleaning agents must NEVER be used – including the cleaning cloth or pad, and the chemical used. Scratches on the pool caused by abrasive cleaning chemicals or cloths/pads can be harder to clean than a smooth surface, so in theory could make complete pool cleansing harder.

Finally, the drain needs to be kept clean. Birth pools should not have an overflow, as these are very hard to clean, and if the water level in the pool rises above the overflow it is theoretically possible that the water may be contaminated from this outlet.

The drainage area (plug hole) should be kept clean as per the guidelines provided by Aquabirths (2), or as defined by local hospital policies. There are a number of options to plug the waste outlet, and hospitals can choose what they feel happiest with.

A plug with a chain should never be used as the chain is very hard to thoroughly clean. Some pools have a traditional plug (without a chain) which can be removed by hand, but this means putting an arm through the water after it has been used for a birth, so long gauntlets would be recommended. Plugs do provide a seal between the birth pool and the drain, creating a strong physical barrier between the birth pool water and the drains, so some units choose this option and provide gauntlets for removal.

However, other plug options are available. The most commonly used waste option has a valve below a grated plug hole which can be opened and closed from a system that is outside of the birth pool (no gauntlets required!). To clean the waste area, close the valve and pour sanitising solution into the waste until it comes up above the plug hole, and leave it to stand per cleansing regime guidelines. Below this waste system is a waterless trap which can be removed for cleaning if required, and being waterless it is far less likely to develop biofilm matter (remember that biofilm needs water to thrive). Some other brands of birth pools use traditional U-bend traps which are a breeding ground for bacteria. These should be removed where possible. It is possible to use a traditional plug together with the valve if a physical barrier above the entire drain is preferred – but remember that a well-cleaned waste area, together with the good practice of running water for two minutes with the waste open before filling the pool – is already an excellent way to ensure that possible bacteria build up does not contaminate the pool.

Pop-up wastes are not recommended because they slow drainage in an emergency (although in the case of maternal collapse it is recommended to ADD water to the birth pool, as the buoyancy of the water helps when lifting her out). They also inhibit the flow of pool contaminants, and a prone to collect ‘debris’.

Should we be concerned about birth pools and biofilms?

Properly cleaning birth pools is vital to ensure the safety of the pool, which is exactly the same as any other area of the hospital, including “land birth” equipment, beds, etc. While biofilms require water to form and thrive, and therefore it might be incorrectly assumed that birth pools are a higher risk than other equipment, the amount of liquid required to form a biofilm is microscopic. Therefore, any spray of body fluid (from a sneeze, for instance, or a drop of blood) can support the growth of biofilm, including on stainless steel surfaces such as bed rails. And of course, all of us are walking biofilm hosts!

Therefore, birth pools do not lead to any greater risk of biofilm formation, provided that infection control procedures are undertaken – which of course is absolutely essential in all areas of the hospital, not just birth pools! And, in reality, evidence looking at the safety of birth pools versus land birth repeatedly shows that there is no increased risk of infection from using the pool. This means that birth pools can confidently be offered as an excellent form of pain relief and comfort in labour, and as with any other area of the hospital, we simply need to follow proper infection control procedures.



  • Is biofilm formation intrinsic to the origin of life?


  • Aquabirths’ Baths for Labour and Birth Cleaning Guidance (link)

High BMI & Guidelines for Hospital Birth Pools

First posted 25TH AUGUST 2019

How can Trusts ensure that their guidelines for hospital birth pools support women with a high BMI?

The benefits of using a birth pool for labour and birth are well documented, and yet there is a group of women who are regularly denied the chance to use this powerful form of pain relief and comfort when giving birth to their babies: women with a high BMI.

The most common reason given by Trusts for the denial of access to a birth pool for women with a high BMI is that if she were to collapse, she’d be harder to get out of the pool. Another reason is that women of high BMI might be less flexible, and less able to step out of the pool themselves. A recent article by AIMS clearly debunks both of these considerations. (See here: https://www.aims.org.uk/journal/item/waterbirth-high-bmi)

But what if women with a high BMI collapse in the birth pool?
The term “BMI” does not mean “weight”. A short women who is overweight might weigh less than a tall, slim woman, and yet the short woman may be classed as “high BMI”, and the tall woman “normal BMI”. The heavier woman would be permitted access to the hospital birth pool, whereas the shorter, lighter woman might not. This is clearly illogical as the taller woman would be heavier, and harder to lift out of the pool, despite her lower BMI.

Any woman may need to be lifted out of the birth pool, irrespective of her weight or BMI, and so appropriate equipment and guidelines should be available at all times for every person using the pool.  This should not need to be weight limited. For instance, slings which support people of all weights are commonly available through hospital suppliers.

Methods to help women out of the blow-up birth pools used at home which do NOT include slashing the pool are well known. Slashing the pool will flood the floor, and nearby electrical items, with water, and the women will “flow” out with the water in an uncontrolled way. Instead, supporting the woman to remain above the water (birth partners are always going to help with this!) while a managed removal happens is much safer. A fast deflation of the centre ring will lower the sides while containing the water and retaining the structure of the birth pool.

Women with a high BMI and mobility issues
Another reason commonly given to deny women with a high BMI access to a hospital birth pool is that these women may be less likely to be able to leave the pool without assistance. In other words, the assumption is made that larger women will have reduced mobility. Any woman may have mobility issues, so this should be a separate consideration, no matter her BMI. That said, women who may find moving on land harder, for any reason, may find that the supportive effect of water in a birth pool can help them to remain more mobile in labour, thus leading to a higher chance of a positive, straightforward birth. It therefore makes sense to do what we can to support women to access the water, even if they are limited in their ability to jump out of the pool themselves – and this has nothing to do with BMI.

There are many different considerations for Trusts when they are writing their guidelines for women who wish to labour and/or birth in water. Using BMI as a barrier to access, however, needs urgent reconsideration, in order to ensure that all women are given the opportunity to birth in the way that is right for them – and which has many benefits for the Trust as well, as a low-cost way to support normal birth and better birth outcomes.

For a full and detailed report on the issue of access to a birth pool and BMI, please read the AIMS Journal article here: https://www.aims.org.uk/journal/item/waterbirth-high-bmi