Will I be able to have a water birth?

It is now estimated that 60 per cent of NHS hospitals in the UK have facilities for women to labour or give birth in water, although it has been 10 years since a national survey has been done to assess the extent of the use of birthing pools.

In 1993, the Department of Health's Changing Childbirth Initiative looking into maternity services in the UK recommended that women should be given choice in childbirth including labouring and/or giving birth in water. If you want a water birth, there are some practical factors that need to be considered.

• There may not be any facilities at your chosen hospital
• The pool may be in use already when you go into labour
• There may be a shortage of midwives trained in water birth

However, in 2000 the Royal College of Midwives said "Women experiencing normal pregnancy, who choose to labour or deliver in water, should be given every opportunity and assistance to do so."

When water birth is not suitable

Practices in different hospitals vary, but if there are factors which complicate the birth in any way, midwives will probably advise caution in the use of the pool. In certain circumstances they might be happy to support a woman labouring in water, but then help her out of the pool for the delivery. This could be the case if:

• You are expecting more than one baby
• Your baby is in a breech position
• You are suffering from mild pre-eclampsia
• Foetal distress
• Your baby is at 37-38 weeks or 42-43 weeks gestation
• Prolonged second stage or poor progress
• If there is a risk of shoulder dystocia - baby large in proportion to mother
• If the water is unusually dirty
• If you have had a previous Caesarean section

It might be considered safer for you not to use a birth pool during labour at all if you or your baby may need treatments that may be difficult to administer in water. Some situations where it is thought unsafe to labour in water include:

• Signs of foetal distress
• Fresh meconium-stained liquor
• Intra-uterine growth retardation
• Bleeding before the onset of labour
• Previous post-partum haemorrhage
• If you have an intravenous infusion
• Severe pre-eclampsia or raised blood pressure
• If you suffer from some medical conditions including epilepsy. Skin conditions, hepatitis or HIV
• If you have received sedation
• If labour is progressing slowly
• If baby is in a breech position