We have 7 pools in our midwifery stand alongside unit and pools in each of our 2 stand alone units. We had many "discussions" with risk management and manual handling prior to their build, all being new units < 4 years old. The midwifery team argued forcefully that these would be for women who could enter and exit pool easily. The water would be run daily even when not in use and pools would be cleaned as directed by infection control team. Our policies and procedures highlight that "low risk" women may use this facility and safety/risk issues came before "human rights" you could say we are discriminating against women with risk factors but common sense has to prevail. We did manage to talk the manual handling team out of overhead hoists for each pool by reluctantly agreeing to have a hoist on site. It's an ornament that has sat in the corner of a store room for 4 years and NEVER been used.
We now facilitate >800 women per year to labour in water and 50% to have their babies in the water. Our maternity user group were able to support our midwifery team in pushing the common sense element.
Elaine
Elaine Madden Dr
Head of Midwifery & Gynaecology
South Eastern Trust
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Stewart, Mary
Sent: 12 August 2011 10:29
To: [log in to unmask]
Subject: Re: waterbirth
Hi everyone
Thank you for raising this issue, Deb - unfortunately it can feel like a bit of an ongoing battle. I recently read the following comment from one of the manual handling advisors in our trust. Has anyone else been in a similar situation and, if so, were you able to achieve a sensible compromise? My own feeling is that it is reasonable to expect that women can get in and out of the pool independently, but I would hate to be seen as discriminatory.
There is a concern that the lack of accessibility of the pools to some women with certain reduced capabilities may mean that we are not in compliance with the Equality Act (2010) i.e. women with disabilities, such as MS. Women should not be restricted access to using the birthing pools solely on the grounds of their disability, consideration to ensuring as far as is reasonably practicable the pools are accessible to all patient groups must be paramount if to comply with the current legislation and is worth reviewing. Note other birthing units have chosen to provide hoist access to their pools.
Very many thanks
Mary
Mary Stewart
Consultant midwife
Room J334
Chelsea and Westminster Hospital NHS Foundation Trust
369 Fulham Road
London SW10 9NH
Tel: 07872 423085
________________________________
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Robyn Maude [CCDHB]
Sent: Friday, August 12, 2011 2:59 AM
To: [log in to unmask]
Subject: Re: waterbirth
Hi Deb
I do not think there is any 'evidence' around the perceived OSH issues.
Our argument when talking infection control ad H&S is around the fact that these women a re well and have uncomplicated pregnancies. Informed choice with good anatenatal discussion around risks and benefits and what constitutes an emergency situtation and the response required means that women are well informed and there are very few issues that arise that cannot be sorted by simply asking the woman to leave the pool (in an enmergency). In the 2nd edition Midwifery Preparation for Practice Pairman et al 2010 we have updated some references re: risk of infection -
Zanetti-Dallenbach R, Tschudin S, Zhong X, Holzgreve W, Lapaire O, Holsi I 2007 Maternal and neonatal infections and obstetrical outcome in water birth. European Journal of Obstetrics and Gynecology and Reproductive Biology 134:37-43
Zanetti-Dallenbach RA, Holzgreve W, Hosli I 2007 Neonatal group B streptococcus colonisation in waterbirths. International Journal of Gynaecology and Obstetrics 98(1):54-55
and talked about complications and response
Robyn Maude
Associate Director of Midwifery - Mondays, Tuesdays and alternate Wednesdays
Capital and Coast DHB, Private Bag 7902, Wellington South, New Zealand
Office - Level 4 - Clinical Services Block
(04) 3855999 ext. 5298
0274793826
Lecturer - Alternate Wednesdays, every Thursday and Friday
Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, P O Box 7625, Newtown, Wellington 6242
Office - Level 7, Clinical Services Block, Wellington Regional Hospital
04 463 6137; [log in to unmask] <mailto:[log in to unmask]>
________________________________
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Deborah Davis
Sent: Friday, 12 August 2011 13:32
To: [log in to unmask]
Subject: Re: waterbirth
I am afraid this is a very tedious request as I know it has been raised on this list previously; we are building a new maternity unit and have planned lovely deep baths (oval shaped) for the birthing rooms. Of course now we must wrangle with the Infection Control and Occupational Health and Safety obsessives. Can anyone point me in the direction of good evidence not on the safety of waterbirth itself but more on OHS issues, so that we can respond to the issues they will undoubtably raise. We are also developing our policy which will include criteria women, so if anyone has a good evidence based policy they would care to share it would be much appreciated
regards
Deborah Davis
University of Canberra and ACT Health
Adjunct Professor University of Technology, Sydney
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