Labouring without water

[peaceloveandbiscuits]

I'm consultant-led because of high BMI. In my last pregnancy I was forbidden from using a birthing pool so the midwives wouldn't have to drag my immense bulk from the water were anything to happen to me. By a stroke of luck, a rogue midwife let me labour in the one pool on the labour ward (also luck that it was available), and it was a wonderful experience. It really helped me deal with the pain (also had G&A but didn't need anything else), and meant I could change position easily in the water so I was active and comfortable. I ended up getting out of the pool to deliver, but labouring in the water was very beneficial to me.

Now I'm pregnant again I'm obviously facing the same issues, but I'm terrified of labouring out of water. Can anyone who has done both advise me as to whether it was awful out of the water and much more painful? I'd rather avoid an epidural but I worry that G&A won't be enough on its own.

I'm hoping to demonstrate that I can safely use the pool given my past experience (I got in and out by myself a number of times), and hope they might see me as a whole person (a fit and active one) rather than just a BMI.
Of course this all relies on the one pool on the ward being available when I want it

And of course if I can't have the pool, I will have to just get on with it, but I do worry that it will lead to further intervention without the water as an aid.

Not bragging at all and I am who I say I am.

It's not about ignoring guidelines at all. It's about women being "allowed" to make an informed choice. Sometimes I might not even agree with those choices but as long as the woman has all the information then she should be supported in her decision.

"Allowing" such a labour against guidelines wouldn't just be a case of saying "ok". It would involve a meeting with her consultant, then a meeting with me where all pros and cons are discussed in detail and documented. A plan would be written accordingly.

Patients are free to ignore any medical advice they are given, whether that's my alcohol detox patients refusing pabrinex injections, because quite frankly they are awful, and increasing the risk of wernickes encephalopathy, or taking action that is not advised e.g. Water birth above a certain bmi. Healthcare is no longer paternalistic, and it shouldn't be, so your comments to cannibal are quite frankly ridiculous.

It's useful to all kinds of strategies for dealing with pain. An epidural might not available straight away, the birthing pool might be in use. It's navity to think you have a right to a birthing pool. Even with me opting for a home birth and buying a birthing pool I didn't get a water birth. Dd came too fast and there was no time to blow it up and fill it.

If you listen to a cd with lots of positive affirmations it's not going to cause you to have a crash section. A former neighbour of mine did listen to CDs I gave her and did have an emergency section. She is still glad she did as the cds helped sleep and reduced worry. Even so she did get to 9cm dilated with no pain relief. She had an exceptionally large baby.

Really I don't feel that I have a right to a pool at all, I mentioned numerous times in my OP that it was pure luck that I used it last time.

I'm sorry, I didn't mean to come across quite so harsh. What I meant was the access to a birthing pool involves luck, even if you are low risk and everything is perfect.

As a second time mother your chances of a good birth are high as you had a good birth last time.

I disagree. Rights around medical treatment are negative rights - I can refuse any procedure or medication or treatment that is recommended for me. I do not however have positive rights - I cannot insist a healthcare provider carry out a treatment on me that is not, in their medical opinion, recommended for me and my circumstance. If I have tonsillitis and removal of my tonsils is recommended, I can refuse for no reason at all. I cannot in the absence of any symptoms demand a doctor remove my tonsils because I don't want them any more.

Oh and both of these things cannot be true at the same time: "The consultant said no which I knew would happen as it's against guidelines. But as a supervisor I don't need permission from a consultant to sort it out, so I just bypass them and carry on." And later your post about care team meetings and agreeing a plan in collaboration and full agreement with the consultant.

This bravado amongst British midwives is a sign of a serious problem of trends towards practice way beyond their scope and resulting in poor outcomes for mothers and babies. Guidelines are not there for no reason. High BMI is associated with certain increased risks, like soft tissue dystocia, and delivering in water reduces the availability of immediate attention to resolve it. Irresponsible to ignore this in the hope of currying favour with patients (and gaining an online fan club)

Your analogy is totally irrelevant. This isn't about requesting unnecessary surgery. If a woman with a raised bmi is pregnant she is going to give birth. There is plenty of research saying what a benefit it is and how it reduces the chances of intervention. There is some concern that a raised bmi women may be more likely to have a pph or a shoulder dystocia and if this happened could she get out the pool. Labour isn't risk free and the individual should be supported in weighing up the risks and making a decision. You could argue that not been allowed in the pool increase the chances of an epidural which in turn increases the risk of an instrumental delivery which increases the risk of a pph or a shoulder dystocia.

Oh dear, I'm sorry I asked now.

i had a tens machine for both my dds' births - for dd1 i had the pool inflated, but did not fill it as i did not want to lose the cumulative effect of the tens machine by having to take it off. i didn't bother inflating the birth pool for dd2's birth as i wanted the tens machine (both hbs btw).

I had a BMI of 30+ for both my pregnancies. DS1 used the pool no probs. DS2 pool in use so the best I could do was stand in the wet room and let the water run over my bump / back.

sycamore

I never said I got full agreement from the consultant. Nor did I say anything about team meetings. I said the woman met the consultant.

She did. The consultant said no. But I can then "tick the box" saying the woman has met with a consultant and been informed of the risks. I then met her and went over the risks again and wrote a birth plan with her.

I do not need a consultant's permission for this. It's not bravado, it's fact.

Although completely different reasons and birth storys i am the same in that fist baby i didnt expect to labour in water but got the oportunity and loved it, so now worried i might have to do without this time. I dont want to get stuck thinking it will be awful if no pool, so trying to think of pool as bonus and picturing labour without. By the way- if pool not avaliable i still found the shower good- that was a bit earlier but still after 5cm. Good luck!

Silver that's just how I feel. I feel I've been spoilt now because I know how nice it could be I am really frightened of being strapped down to a bed on my back.

Even if the pool is unavailable for any reason hopefully there's no reason to be on your back on a bed. I know you can't move about as much in a bath as in a pool but it's still water and would be beneficial.

My first birth was in a pool. Lovely experience and a very positive birth. I really wanted my second birth in a pool so booked a home birth and hired a pool. My second labour came too fast to get the pool ready so DD2 came out of water. It was fast and more of an urgent pain/pressure type sensation but not horrible. It was far better than I expected.

I found out today that all three off my local options (including MLU) have only one pool each. And no ensuite facilities. "Nearby" toilet and shower for all three. There are no "normal" baths available at all... and no shower that isn't in a bathroom others would need to use. So, chances of any water what so ever are very low. Is that pretty shit or pretty standard?!

I don't want a home birth, never have, but I also don't want to be in labour in a place where my only options for soothing hot water are a shower/toilet combination that by using would mean others can't access.

All three of these hospitals apparently have had refits in the last three years too!!!

That's pretty shit.

Oh good. I thought I was being a bit precious...

Have just read the blurb again more carefuly. Apparently the birthing pool rooms are all en suite. Which doesn't really help!

That's very shit four! Where are you supposed to hobble to with all your bits hanging out and no clothes on after you've given birth?! Fuck doing the first post-wee in public!

• post-birth wee

Oh God peace that hasn't even occurred to me. Doesn't look like I'm going to have much choice but it just seems so... unnecessaily awful! I've stayed in grotty back packers hostels for less than £10 a night that were ensuite!

I'm sure their delivery rooms must be en-suite. Most women need to use the toilet during labour. Surely they are!
Suddenly feel very grateful that my hospital definitely does have en-suite toilets on the labour ward post natal ward another matter.

Nope. Not ensuite!

"There are six rooms within the central delivery suite for you to give birth in... All of the delivery rooms have access to toilets and showers which are all close by."

Same description for all three (I removed the bit about electronic beds from the middle) PLUS they advertise the fact that the birthing pool rooms are ensuite. I texted a few women I know locally to have used them recently... they confirmed!