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Water births have become more and more popular since its UK inception in the mid-1980s. Portable pools have been in use since waterbirth started, and a need for high-quality, safe pools with a liner was required. Initially, birthing pools which were hired were fitted together with a tubular or light wood sectioned design with a heavy blue liner. These pools were often difficult or heavy to move, difficult to set up, and due to the coloured liner is was often difficult to establish blood loss. The pool liners were not shaped and often had creases which made them uncomfortable for the mother/ birth companion to relax on.
As an experienced waterbirth midwife, the options for birthing pool hire was initially limited, with families using children’s paddling pools or even homemade tubs with a variety of liners. Preventing a liner moving meant that midwives would try sticking the liner by using tape to the sides of the pool, or water pipe covers. My first two waterbirth deliveries were in a homemade wooden tub with a tent groundsheet to act as a liner. It worked but was not going to be suitable for multiple uses in the hospital, birth centre or at home.
Using water for labour and birth has become more popular in the last 30 years, and it is now estimated 20% women use water for labour, with 10% actually birthing in water (CQC 2018 statistics).
When birth pools are being discussed and written into birth plans (preferences), and indeed choosing not only where to have the pool (home, birth centre or birth centre), midwives can highlight the pool companies available for hiring or buying a birthing pool.
Birth Pool In a Box (company Edel Immersys) has become one of the world-leading companies. The design of their inflatable portable birthing pools has a liner explicitly designed for their shaped pools. On a practical level, BPIAB worked with health professionals and parents to ensure the shaped liner was easy to install and dispose of after use. The birth pool in a box liner is shaped so it fits directly into the seating area, with handles and cup holder so there is no way that water can seep onto the structure of the pool.
As this liner is designed for only Birth Pool In A Box, it has contact fit with their pools, which means it is robust and when fitted prevents possible water seepage onto the actual pool. Any water which spills over when the mother exits the pool should also be cleaned thoroughly on and beneath the pool. This is important for infection control and cleaning purposes, especially if the pool is used for other mothers (i.e. hospital or birth centre). Each type of pool (Mini and regular) have their own unique liner as one size does not fit all.
Once the liner is attached into place, using the cup and handles as a guide, the pool can then be inflated, ensuring a firm fit. The liner will not have creases, and thus when the mother moves, changes position or sits, there are no creases which would impinge on comfort, or cause pressure marks on the mother's skin.
The liner also has a separate slot to allow the hose pipe to be threaded through directly into the pool. This reduces any chance of water filling into wrong spaces, or dripping down the sides and underneath the pool.
Cleaning of the pool is easy once the water has been pumped out, the liner is easily folded upon itself and disposed of in the waste bin. As there will have been no water seepage inside the pool, no contamination will have occurred and therefore owner, whether NHS or mother will just need to wipe the external and internal surface with antiseptic wipes. If any water has splashed onto outer surfaces, then this should be cleaned with a chlorine solution as per BPIAB guidelines. Once completely wiped down the inside and external parts of the pool need to be wiped dry. This cleaning information complies with the UK and European guidelines.
Finally, it would be essential to remember that if the individual BPIAB liner ( which supports the use of each pool 40 times) is substituted for another liner the company warranty for the number of pool usage and infection/leakage would not be covered.
Dianne Garland FRCM SRN RM ADM PGCEA MSc
Freelance Midwife. Email Diannne