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Discussion

Water Birth

I am looking for policies and procedures regarding water births...anyone have any they would like to share? Any suggestions for evidence based practice to support P&P's? We have 1 (new) physician that is willing to do them and I would like to do some education and preparation. Thank you in advance:nurse:

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    We do them very infrequently, but I do recall reading our policy on them not too long ago. Can't remember the whole thing, but here's what I do remember:

    1) Birth partner is responsible for setup and cleanup afterward if they're using their own pool

    2) If mom gets febrile/baby gets tachy or shows any other signs of distress, mom has to get out

    3) Mom has to get out for placenta delivery

    4) FHR still has to be auscultated as per policy (kind of a given)

    5) IIRC, ROM isn't a contraindication unless it's prolonged

    6) Baby has to be out of the water within about 10-15sec after delivery

    7) Water temp has to stay at a certain temp (can't remember the exact number right now but it's somewhere close to normal body temp, I think)

    The policy is a couple pages long and this is just what I remember reading one night at 0300ish. :) Hope it helps.

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    I am not fond of waterbirth's I think they are great for laboring in the pool but I haven't experienced/witnessed a lot of successful one's!

    Put it this way I wouldn't want my daughter to have one

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    I just found it funny that your thread is called "water birth" and your name is "ducknurse".

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    We do waterbirths quite frequently at our facility.

    There is one CNM practice who will actually provide a blow-up birthing tub. The CNMs are responsible for set-up and take-down (as it belongs to them, they wouldn't want to just leave it there anyway). They bring a new disposable fish-catcher to each birth, for cleaning the water out when necessary (stool, globs of mucous, etc).

    Women can also, if they choose, birth in the hospital tubs (a standard bathtub). I've had a few OB residents be absolutely cool with that, but generally it's the midwife pts who want to do that.

    Policies:

    Water must be between 98-102 degrees. Maternal temperature needs to be checked hourly. Cannot labor or birth in the tub if there is meconium in the fluid. Mom has to get out of the tub to deliver placenta.

    We DO allow the baby to stay in the tub with the mother, as long as it's stable, and the baby's body stays submerged in the water for warmth.

    We still have to auscultate heart sounds per policy. THe hospital provides shoulder-length "baggy" type gloves for doing that, although I don't even bother, and just stick my bare hand in there to doppler the baby, then wash well immediately after. When I attend a waterbirth, I remove all my jewelry for the duration of the labor/birth. One night I was the nurse for TWO water births, and I felt incredibly grimy afterwards. I wouldn't let my husband touch me until after I had showered.

    Expect to get wet.

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    There is a free-standing birthing clinic staffed by CNMidwives in the Woodlands, Tx, and they do water birth in large tubs routinely. They have been in business for many years, and have great success with them. That is one of the reasons that the women come there.

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