There are many forms of pain relief open to you when you go into labour to have your baby. A great number of these are non-pharmacological and include staying mobile and active, the use of TENS machines, meditation and hypnotherapy, and the use of water. Many women request to have a water birth or some form of warm water immersion in their labour, whether this is by use of a shower, a bath at home, or getting into the birthing pool.

When you first start to have contractions, you will be encouraged to stay home until they are in a regular pattern. Often people come into hospital thinking they are in labour when contractions are spaced out, irregular, or not strong enough to be classed as labour. For midwives, labour is when you are having regular, strong contractions, every 2-3 minutes, lasting 45-60 seconds each, and you are between 4 and 6cm dilated. If your contractions are not regular, you are unlikely to be in established labour. That doesn’t mean that your cervix isn’t changing, it just means it’s too soon to be in labour and the contractions may stop and give you a break for half a day or so before starting again. One of the suggestions for pain relief during this early period may be to have a bath at home or a shower, as the water can be soothing, and staying in a warm, small private space will help your body to be relaxed and allow those contractions to do their job more effectively.
Once you are in labour, you may wish to get in the birthing pool. There are a few instances where this is contraindicated in the guidelines and not recommended. If you are having an oxytocin drip to make you have contractions, if you have a fever or any signs of infection, if the baby has passed meconium (their first poo) while inside, if there is any concern about baby’s heart rate, or if you are less than 37 weeks. You will also be encouraged not to get in the pool yet if you have only just got into established labour. This is because when you get in the pool the contractions can ease off, which is not what you want when you’re in established labour, as this can lead to increased intervention. The birthing pool can only be used with a midwife who has done some extra training to perform pool births (although most have). At GCUH there is a pool in every birthing room except 3 (these are the high-risk rooms for women with complex pregnancies), however, sometimes with acuity, we only have those rooms available, in which case there is no pool. This is rare, but something to be aware of.
When you are in the pool, there are several instances when you will be requested to exit the pool and it is very important to follow this for the safety of you and your baby. You will be asked to exit if you develop any of the contraindications listed above, and also to get out every 2-3 hours to pass urine, for vaginal exams, if when the baby’s shoulders get stuck while the body is being born, and after birth to deliver the placenta.
If you have any questions about waterbirth, speak to your midwife about your own personal circumstances and any questions you have. You can go in the pool for labour but get out for birth if you wish, and sometimes people think they will love the pool but get in and hate it and want to get out. Like with all things labour, it is best to have a broad idea of things you’d like to try, and then just see how you feel on the day.
Bree Lowing is a Registered Midwife and provides bulk-billed in-home antenatal and postnatal services through
The Mountain Midwife www.themountainmidwife.com.au and 0491 750 795