This is probably the toughest part for most families. If you hire a doula, she will likely be able to run the show on this part – yay for doulas! They are awesome – I can’t stress that enough. But if you do decide to do it yourself then here are some great tips on deciding when to inflate the pool, when to fill the pool, what temperature the water should be at, and finally when to enter the pool. These are actually quite variable and will differ for each birthing woman. Unless space is a major concern, I recommend that the pool be inflated during early labour when mom starts feeling rhythmic contractions. Getting this task completed early on lets you “check something off the list” and removes the distraction of operating a pump later, when mom needs to be focusing and relaxing. Put a tarp down in the spot you want to have the pool and blow it up in place. Once inflated, leave it until labour picks up a bit more. If labour starts in the middle of the night you can wait until morning unless contractions pick up enough that mom can’t stay in bed any longer.
Choosing the right time to fill up the pool can be a tough decision, as you don’t want the water to be too hot or too cold for when the birthing mother actually needs to get in the pool, and things can change quickly in labour. I usually begin by filling the pool with straight hot water until the tank runs out of hot water or the pool is halfway to the 80% mark. I would do this when contractions are very strong and lasting at least a minute and have been doing this for some time. When filling, be sure to periodically check that the water coming through the hose is still hot. Once the hot water runs out the transition can be quite abrupt, and you don’t want to accidentally add lots of cold water to the pool at this point. Purpose-built pools usually have a cover which will dramatically reduce convective heat loss and keep the water warm for at least a couple of hours. When mom is getting closer to entering the pool, you will add more water to control both the level and temperature. You need at least 18” of water in the pool for the buoyancy benefits to take effect. You also need to keep the baby’s head completely underwater until the baby is fully born so that the breathing reflex won’t be stimulated.
Once mom is feeling a lot of pressure or is feeling ‘pushy’, fill the pool up to the 80% mark and to a bath-like temperature – approximately 32°-38° Celsius (90°-100° Fahrenheit). Be careful about your hot water usage; most hot water tanks aren’t large enough to fill a birth pool in one go. For reference, a standard household water tank is 150-230 litres (40-60 gallons), whereas a large birth pool is over 600 litres (160 gallons). To conserve hot water, avoid running the dishwasher or washing clothes during a home birth. If you have access to the tank you can usually increase the tank’s water temperature by turning a dial. Use caution and inform everyone that you have done so, because the water could become hot enough to scald someone while washing their hands. You’ll want to make a note of the dial’s previous location so you can return the tank to its regular setting after the birth is complete.
It’s much easier to cool a pool than it is to warm it, for two reasons. First, the temperature difference between bathwater and the water in your hot water tank is fairly small, whereas the temperature difference between bathwater and cold water from the faucet is fairly large. A few litres of hot water will raise the temperature a little bit, but a few litres of cold water can cool the pool dramatically. Secondly, unlimited amounts of cold water are available from the water main, but hot water can be in short supply, and unless you have a high-end tankless hot water system it may take a long time to produce more hot water. As they say, a “watched pot never boils”. If you don’t have enough hot water or need to warm the water in the pool then boil some water on the stove and/or in electric kettles and add it to the tub. If the pool is too full, you may need to first take out some water with the pots or siphon out some water with the hose and replace it with hot water. Use caution: be careful while carrying heavy pots of boiling water through the house; avoid pouring boiling water directly onto the pool itself, lest you melt it; and certainly don’t pour boiling water onto anyone who is in the pool – or, for that matter, onto anyone at all. Once the pool is at the correct temperature mom, and optionally her partner, can get into the pool. I usually save this for when she really, really needs some support, which is usually near the end of the dilating phase and as she is coming into transition. She is having very intense contractions all the time, every time. She is very internal and vocal. She may have a lot of pressure or feel slightly ‘pushy’. This is a great time to get in the pool because things are feeling very intense and powerful and the warm water is very soothing. Most women will love the pool and not want to get out once they’ve gotten in and felt the relief the warm water gives them.
“I stood near the pool, I could hear the water dripping into it and filling it with warm delicious water. The sound was comforting like when you are getting ready to step into a bath and have that relaxing feeling wash over you. I have a sensation at the pool side, it is intense, there is pressure, I am moaning –ohhhhhhhhhhh. I am breathing in deeply and exhaling long ohhh sounds. My hips are rocking. My mind is elsewhere, I am internal and far from my home and those around me. The sensation ends and I come back to my space and the people around me. I see them looking at me, and I find my doula’s eyes. Can I get in? She tells me it’s ready. Ohhhh I have been waiting to hear that. I slip my leg over the edge of the pool into the warm water, then the other follows. I kneel into the water and all the water rushes over my protruding belly and body. It is bliss! The deep warm hug of water envelops me and I escape for a moment to a place of rest and relaxation. Ohhh it is amazing. I announce to the room – I am never getting out….”
-The power of water in labour, by a mom
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