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Birth Pool Considerations

5/15/2025

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As you are looking at what you want for a home birth, using a birth pool for labor and birth is a great option.There are a few things you should be aware of when considering what’s involved in using a birth pool.

Is there enough space for a pool?
The birth pools I use take up a fair amount of space, 65 inches by 57 inches. That is about the size of a kitchen table with one leaf in place.

Is the floor strong enough?
Thinking through where you will put a birth pool is important. Birth pools can weigh a lot once they are filled with water and Mom gets in the pool. The birth pool I have available for my clients holds 127 gallons of water when it is filled to the appropriate level. That means when it is full, it weighs 1017 pounds before Mom gets in. 

How much access does the midwife need?
Another thing to consider is how much access to the pool does the midwife need? Does she need access from all sides or just two or three sides? You might need to move furniture, or  use a different location than originally planned.

What is needed to fill the pool?
You will need an unused length of hose that can go from the faucet you plan to use to fill the tub to wherever the pool is set up. You may need an adapter between your pool and the hose to connect it. Clients in my practice have used kitchen sink or bathroom sink faucets, as well as showers.

Once it's filled, how do we keep the water at the right temperature?
TThe most common way is to have large pots of hot water on the stove ready to use, bailing some water out of the pool and replacing it with the hot water. If you use this method, be mindful to mix the hot water in with the existing water and not to pour the water on Mom or helpers while adding it. There are submersible heaters, but these seem to be questionably effective, and you often have to be mindful not to let them come in contact with pool surfaces.

Does the water need to be sanitized?
If you are using tap water, there is no need to add anything to the water to sanitize it. If the pool is up for longer than 24 hours, or you want to be cautious, you can add two cups of regular salt to the water.

How does the pool get emptied?
You can create a siphon the old school way by sucking on the end of the hose until pool water reaches the end and then letting the water continue to flow by keeping the hose end lower than the water level (I don’t recommend that). You could use a siphon pumps to empty the pool. Don’t forget to make sure your hose is long enough to reach where you want the water to drain, whether that is a toilet, or outside in a flower bed etc.

What other considerations are there to be aware of?
  • Pets. Claws can quickly puncture the birth pool if your pet tries to jump on the sides of the pool, or get into the pool
  • Children. Birth pools when filled are a drowning risk, so you need to be mindful of that when using a birth pool with little ones in the home.

Hopefully this helps you think through what is involved in using a birth pool.  With a little planning, portable birth pools are very easy to add to your birth plan.

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Back Labor

12/1/2024

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During labor, it's normal to feel some discomfort in your back, especially as baby descends low enough to shift your sacrum and coccyx as they pass through the pelvis. This is not the same as back labor. Back labor is when the back of baby's head is lined up with Mom's spine. It often feels like the contraction starts in the back and wraps around, or it can feel like the contraction is only happening in the back. It's intense and can make for a longer labor. Here are  some suggestions for back labor. 

The first thing is to try to convince baby to shift from a posterior position. Things you can try are:
  • Do 3 rounds of the Miles circuit.
  • Use a Rebozo to encourage baby to turn.

If trying those things don't encourage baby to shift, here are ideas to manage back labor:
  • Run the shower on your lower back
  • Use the birth pool.  If you don't have a birth pool and your tub is large, you can use that instead.
  • Roll tennis balls on either side of the lower spine during contractions
  • Do the double hip squeeze
  • Apply gentle pressure to the sacral area. Be mindful that pressure on the sacrum will limit the sacrum's ability to move which may slow baby's descent.
  • Use a TENS unit on the lower back
  • Try a heating pad on the lower back.
  • Sit backwards on the toilet. You can use pillows on the tank to have a soft place to rest your head and upper body between contractions.
  • Try sitting and gently bouncing on a birth ball.

Back labor is intense, but staying relaxed and trying the ideas I've shared can help you navigate labor with a baby in the posterior position.
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Prodromal Labor

8/15/2024

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Prodomal (meaning precursor) labor, also known as false labor is something that many Moms experience. Prodromal labor contractions are stronger than Braxton-Hicks contractions. They can be quite strong, similar to active labor, however prodromal contractions do not increase in intensity or frequency. While it is considered more common for third and subsequent births, it does happen with first and second births.

Take advantage of it! Prodromal labor is a great chance to practice:
  • relaxing through a contraction
  • ignoring contractions
  • coping techniques so you can learn which ones might be the most helpful
  • going about your day while your uterus does its thing
  • eating  and drinking during labor
  • the mindset you will need for labor
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Things to know about prodromal labor
  • you can't force prodromal labor to become active labor
  • it lets the uterus practice and strengthen for active labor
  • it can help the cervix to move into an anterior or more forward position
  • it can help the cervix to efface or thin
  • it doesn't tell us when labor will start or when baby will be born
  • it might help baby settle into a good position for birth

While it can be frustrating to have contractions that hang around for hours without turning into labor, it's not wasted work. It's a sign that the body is preparing for labor. It's one step closer to meeting your baby and that is a good thing. 





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Pushing

8/1/2024

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When labor has done its work and dilation is complete, pushing is the next phase to get baby born.

While you wouldn't think of pushing as a topic with differing opinions, it is. Do you start pushing as soon as dilation is complete? Do you wait until the fetal ejection reflex kicks in and your body is pushing? Is coached pushing the best? Do you hold your breath while pushing? Do you add effort to your body's pushing? How long should you push? These are just a few of the questions that have differing answers. Adding to the confusion is that there is no one correct answer that applies to every birth. 

I've been at births where Mom is told she's completed dilation so now she needs to push. I've been at births where Mom has completed dilation and takes a nap before pushing. I've been at births where Mom is complete, but needs a good snack before she has the energy to push. I've been at births where Mom has the urge to push, but is only at 5 or 6 cm dilation. I've also been at births where Mom has the urge to push but is told she has an anterior lip. The urge to push does not always mean it's time to push. 

In the home birth setting, I prefer for clients to wait for the fetal ejection reflex. I feel this leads to more effective pushing which means less time pushing. Sometimes this may mean there's a "rest and be thankful" phase where labor appears to slow down. I think this resting phase is beneficial to let Mom build up some energy for pushing. I also think it's a perfectly normal part of physiological birth.  

Sometimes in a home birth setting, a Mom will need some coaching to direct pushing where it needs to go.  I watch for this and will offer coaching if I think it is going to be beneficial. I am not a fan of asking a client to hold their breath while I slowly count to 10 . Sometimes holding breath for a few seconds while pushing can help with understanding of where to direct pushing efforts. I prefer Mom to breath as the body needs to make sure there is plenty of oxygen going to baby. If I coach a client with pushing, usually after a few pushes they need encouragement more than coaching. 

As baby starts to crown, I will remind clients not to add any effort to pushing in order to protect tissues. This also lets baby have time to adjust and do what they need to do tonavigate the pelvis. It can be perfectly normal for a pause between head being born and the rest of the birth. This pause lets baby turn his or her shoulders so they can come through the pelvis. 

I trust birth so I do not feel pushing has to be managed. I do not feel that pushing has to be rushed. I want to allow the time both Mom and baby need to work together in the pushing phase to have a safe, healthy birth. 


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Optimal Fetal Positioning

1/1/2024

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The modern lifestyle isn't always conducive to getting baby into a good position.  A lot of jobs involve sitting for long periods of time. Our cars, and seating arrangements at home often encourage a more laid back or reclined seating position. We may sit at home for extended periods of time watching TV or using the computer. We have labor saving devices to clean our floors such as a Roomba, eliminating the need to do much movement to clean, eliminating the need to get down on hands and knees to clean. These are all great things, but not so helpful in pregnancy to encourage baby to be in a good position for labor and birth.

Being up and moving, as well as sitting upright instead of reclined are just a few ways to encourage baby to settle into an optimal position when labor starts. 

​Other things you can do include:
  • Curb walking
  • Walking
  • Swimming
  • Sitting on a birth ball
  • Pelvic rocks for 10 minutes, 2 to 3 times a day
  • Taking the stairs
  • Scrubbing floors on your hands and knees
  • Bear walking
  • Sitting in a straight back chair instead of the recliner
  • Chiropractic adjustments using the Webster technique

Things to avoid include:
  • sitting with your knees higher than your hips
  • Recliners
  • Crossing your legs

Being up and moving is the best thing you can do to encourage baby to settle into a good position at the start of labor. Having baby in a good position will help labor to be efficient and might shorten the length of labor.


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    Author

    Gail Webster, CPM

    Gail is a Certified Professional Midwife serving Manhattan, Junction City, Fort Riley and other areas in Kansas.  


    When Gail is not occupied with birth work, she enjoys reading, quilting, baking, riding her motorcycle and spending time with family.
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