Reflective Essay on Pool Births

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Labouring in Water
This essay is a reflection of the pool birth I witnessed whilst out on my practical placement. The elements of my experience in this area that I will be reflecting on are the advantages and disadvantages of birthing in the pool and the communication between the midwife and the expectant mother. I have chosen this area to reflect on because I would like to feel confident in promoting pool birthing and I would like to be able to support and provide correct advice for a woman considering to birth in the pool. The names of the people involved in my reflection, including the trust I experienced my practical placement have been changed to insure confidentiality is obtained. I will be using the Gibb’s Reflective Cycle (Gibbs, 1988) to help me to discuss, analyse and evaluate throughout my reflection. I began my first long night shift on delivery suit in ABC hospital and my mentor and I took over the care of a woman who was in early stages of labour. This lady had drawn up her birth plan which showed she wanted no pain relief and wanted to birth in the pool. We read through the notes and saw this lady was 41 weeks pregnant and a Multip. Reading this we knew labour might not be long so we saw the expectant mother to the pool birth room settled her in and did a full set of observations and checks on both mum and fetus. The observations and checks were all within the normal range my mentor also performed a V.E which found the woman was 4cm dilated. By this point in time the woman’s contractions were now quite strong and painful and seemed to be coming 3 in 10 and the woman asked to get in the pool as soon as she could, so we began to fill the pool with a water temperature of 37ºc. We stayed in the room once the woman was in the pool but the midwife did not touch the woman once she was in the pool she just encouraged, answered questions, listened in to the baby every 15 minutes and observed. Once the woman got in to the pool the labour seemed to progress quickly. The woman seemed very calm and relaxed and within 1 hour 30 minutes the woman began pushing and my mentor used a hand held mirror placed in the water to see the progress and began to listen in to the baby every 5 minutes and after a contraction. Within 30 minutes the head was born slowly with my mentor’s calm and low tone of voice guiding the woman and then the body followed on the next contraction and my mentor just helped guide baby up in to mums hands. The woman sustained two grazes which did not need suturing and both mother and baby were well. This was the first pool birth I had witnessed and I felt on edge and concerned throughout it. Because the woman seemed so calm and relaxed I kept expecting my mentor midwife to ask the woman to leave the pool for a vaginal examination to get an exact idea of progress. The baby’s heart rate was fine and showed no cause for concern throughout but I just could not help feel concerned. Once the baby’s head was born I felt relief, I was amazed and could not stop smiling. The woman clearly knew her pain tolerance level and what she wanted and how she wanted her labour and birth of her new baby to go.

According to Cluett and Burns (2009) water births have become more popular over the last 20 years and is now a popular option in the hospital, birth centre or at home (Coad & Dunstall, 2011). NICE (2007) states there is little evidence to guide and support a midwife in water birth management, so it is necessary for the midwife to determine the risks and benefits for each woman and baby by an assessment of each individual case (Macdonald & Magill-Cuerden, 2011). Birthing in water is becoming a popular choice for women and midwives because the water provides buoyancy and allows the woman to move freely and change positions freely. The birthing pool needs to be deep and water filled to immerse the woman when sitting down up to her breasts and according to NICE (2007) the water temperature needs to be no more than...
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