Waterbirth - should midwife encourage it?

Blimey! I have read the paper in Mears link, and am now even MORE horrified about the risk of Strep b infection to which DS was exposed.....The position paper says that it is best not to be in a pool if waters have broken more than 24 hours in advance.My waters were leaking from Fri lunchtime, and I first went into the pool on Sun tea time, more than 48 hours later, And the MW didn't do a swab for Strep B until late Sun eve. The test came back positive Mon a.m, several hours after DS was born. He was put on IV antibiotics for 5 days, not what I wanted after doing everything I could towards a drug-free delivery for his benefit!. I am still a great advocate of a pool, it was brilliant, but I think people need to have all the information which is relevant. I would happily have opted for maximum intervention for a speedy delivery which reduces the Strep B risk.
Why do some MWs try to avoid pool use? What don't they like about it?

I had a waterbirth at my own request but this is just because I am an assertive person and had strong views about pregnancy and childbirth which I had researched. It is not fair that less well-informed women should miss out on the chance to have a waterbirth, just because no one told them it was an option. I was also told very clearly that there was only one pool and I could not use it if someone else was in it. I am so lucky that it was available for me, and if I have another one, I would want a home birth, because it would seem terrible to get to the hospital and be told I could not use the pool. I think our hospital is too stingy with money and space to consider building another pool which is why they do not promote waterbirths more actively.

When I had my waterbirth there were only 2 mw when the baby was actually being born, and I'm pretty sure that there ALWAYS have to be 2 mw when the baby is actually coming out...if this is right (does anyone know?) then how do hospitals use the 2 mw unavailable excuse when they would have to find them whether you're in the water or not.

I saw different midwives throughout my pregnancy and they all supported my desire for a water birth, and the hospital unit was very keen.
As it turned out, the only reason I didn't have a water birth was staff shortages. We'd rung in advance, the pool was free, they'd even started filling it, and then discovered they didn't have two qualified midwives free.
Fortunately I didn't have my heart set on a water birth as I was prepared mentally for the possibility of not having one, but even so.... I really want one next time!!

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I had a fantastic water birth, but I had the same midwife throughout pregnancy and birth. I wouldn't not have been keen to try it with a complete stranger or with a midwife that was less than totally enthusiastic about it. I didn't even think of it as a form of pain relief (though it undoubtedly was) I just thought spending a few hours in some nice warm water sounded like a pleasant way to spend an afternoon in labour. I wouldn't have thought to ask for it when I got to the hospital because I had read somewhere that you can't get in if your waters have broken . So its good that she offered.
In short - yes! Water births are a service that you offer and you should be allowed to promote your services. Is your manager going to tell you next that only women who ask to breastfeed should be shown how?

Yes, waterbirth should be listed as a pain relief option along with all the others from breathing, reflexology to general anaesthetic.

Is your manager hesitant because of a lack of resources? There could be a sudden increase in demand if wb is promoted more.

Have read some of the answers below.... Blu- MANY MW do not talk about water as an option (and many feel pool and bath are the same- I have heard it many times!) and some fundamentally dislike it so would not talk about it and certainly not encourage it when they are on their shift in the labour ward....

Mears - as you know I have been a doula to quite a few women who had water births.... IME some of them would not have asked for it - simple ignorance of what it can do for them and how it works"... I have letters to testify how happy they were when we suggested it !
As you say if they don't like it they cna get out.

My 2 water labours were my idea.
In the 6 water births that I have attended, 2 had requested it and 4 had it when it was suggested to them.

I have seen 1 MW suggest them (routinely in appropriate situations) and sometimes the parents went for it and other times they didn't.

I always planned to labour in water first time around but due to staff shortages I saw a different midwife every appointment and only got to do my birth plan very late on. My midwife told me that to use the pool I had to "book" I rang the hospital and left a message but went into labour before anyone got back in touch with me.

When I arrived in hospital I asked about using the pool and the midwife said she would ask, meanwhile would I like to use the bath. I did so but found it quite restricting (too small and couldn't get in the right position as dd was back to back). The midwife never got back to me about using the pool.

This time I am planning a homebirth and would like to hire a pool but the midwife has told me that no-one on my team is trained. I am seriously rhinking of writing to the SOM informing her of my intention to labour in water and that I expect a competent midwife to attend.

What do you think, is this too bolshy? I really like my midwife and it is a novelty to see the same person each time, so I don't really want to go nehind her back but if I wait until I see her again it will be December and I am due in February.

I had a home birth, and hired a pool. I didn't really have any fixed ideas about whether I was going to give birth in it or not. I laboured in the water for quite a long time, but when I started pushing I wanted to get out - it just felt that that was the right thing to do at the time.

Thanks mears. Does your manager not want you to say anything about any pain relief or is it just water births? I mean, water labours are pain relief in many cases, right? They're easier to get out of than a shot of stadol (? don't know the UK equivalent -- demerol?) at any rate. Still, it wore off after a while. I do wish I had been offered a water birth my first pregnancy, but know it wasn't available at that hospital (small community hospital) nearly 6 years ago.

Anyway, you give me his entire argument and I'll rip it to shreds. And we should have a sign for nights we're up drinking wine.

Mears

I had a fantastic waterbirth with No 2, who was actually induced.

It NEVER occurred to me prior to the birth to have a WB. My wonderful midwife suggested it after my labour was well established, and all I kept saying was "I didn't think you could have a WB with an induction" - I think I said this many times LOL!

Anyway, got in the water, and once there really didn't want to get out. My midwife never told me to get out/stay in - just left it to me to decide. At one point, I did say I wanted to get out - stood up, had a very bad contraction - said "sod that, I'm staying put" LOL!

My son was born about 20 minutes later and the birth was fantastic. Desperately wanted a WB with my 3rd child, but she was too keen to get out and I was fully dilated on arrival at hospital!

I totally agree with you - and I am so grateful to Teresa, my midwife who suggested the WB (even though I was induced!) and allowed me to experience such a wonderful thing

Mears, I never did get to labour in water, but was keen to. Our newly built Women's Services Unit has an excellent large permanent pool in one of the suites and has published a leaflet encouraging its use. My community team were cautiously in favour (no-one seemed to have read Michel Odent on the benefits of water especially for would-be VBACs...). My consultant was initially OK about it until it became clear I'd need another c-section, but I felt everyone involved ought to have been promoting it to the hilt. A lot of people don't have access to Mumsnet, or NCT publications, or even baby magazines, and think a pool is the same as having a bath. Midwives are well-placed to inform women about this option. If a client didn't know about gas and air I bet your manager would go bananas if a midwife took that to mean it shouldn't be offered...
I think you are totally right to be suggesting it to anyone who might benefit and I wish more midwives were like you. But then again, with Mears in charge, most of us lot would happily give birth perched on a rooftop
Good luck with your campaign!

I didn't have a waterbirth or waterlabour (?), but think that midwives should make women aware of all available options. My first labour I would have gone for it, I'm sure. I would probably have given it a go the second time, too. Is it possible to be hooked up to an IV and do it? I needed the IV antibiotics for GBS. (I'm just curious. If you needed to keep it out of the water, you could put the line in the wrist maybe?) Truthfully, I couldn't have gotten through either labour without the suggestions and reminders from the nurses/midwives.

Mears - it was always my idea. I had babies 2 & 3 in the pool - labour and delivery. Last time round had to fight to get them to let me in the pool (they thought I wasn't far on - having had 2 quick labours I knew I had less than an hour! Fortunately had dh to fight for me.)

I loved the waterbirths - fantastic pain relief, and generally a wonderful feeling. But it was much better first time with a midwife who was clearly more positive about waterbirths, and more supportive of my decision.

IME lots of women think waterbirths are odd and a bit freaky, and would have no interest in them anyway. But I don't see any reason why a m/w should not mention it as an option to anyone, along with other possibilities.

This is an interesting thread. When I was pregnant with ds I always thought I might like to try the pool at the hospital, but in the end I had an unplanned homebirth (and so no pool was available). Tried the bath, didn't like it - I was interested to hear what you said about the pool being nothing like, motherinferior.

My first labour was 20 hours long, agonisingly painful and punctuated by largely ineffective drugs which didn't take the pain away but did make me talk a load of rubbish. My ds was eventually born by ventouse.

My second and third labours were 6 and 4 hours respectively, the pain was bearable with only gas and air (and I'm a coward)and I felt in control the whole time.

The difference? The first labour was with a midwife who made me lie down wired up to a monitor the whole time the second and third were in a different hospital and were water births.

I'd take the water option every time. Both my babies were born in the water (my decision). The second time the midwife told me to get out of the water to deliver because they didn't have the right number of qualified people present. Figuring that they couldn't make me I refused (and the midwife was really pleased afterwards).

So how are women who might not have realised a pool is available as an option supposed to know about it? Surely it is the MW's job to lay out all the options in a factual, non-directive sort of way?
I did spend time in a pool, and I'm very glad I did, but I would say that there were many points, throughout my ante and post natal experiences where I felt that I was not an individual, but a pawn in a campaign of one kind or another, (on both sides of the low/high-tech divide).

I can't see what could possibly be wrong with MWs suggesting things which may be of support: during labour my mdwives suggested all sorts of things, all of which had been discussed with me in advance, and when the time came, I rejected some and accepted others...but you need the professionals to give you the full range of options in advance, and you then need them to remind you of them in the heat of the moment.