ABSTRACT
Routine care in labour plus:
One-to-one care is necessary – never leave a woman alone when she is using the pool.
Remember to have training in using the pool and dealing with any emergencies that may occur.
Remember manual handling issues and your personal health and safety.
Check the woman's temperature hourly.
Encourage the intake of fluids as dieresis increases when in water.
Test the water temperature every 30 minutes and adjust to between 35 and 37°C.
Abdominal and vaginal assessments can be carried out in the pool.
Fetal heart monitoring can be intermittent using a waterproof Doppler device or using telemetry continuous monitoring if available.
For the second stage the water temperature should be maintained at 37°C.
A mirror can be used to view progress.
Hands off the birth unless assistance is deemed necessary!
The woman can raise the baby to the surface herself or the midwife can do so.
Assess the baby's condition but remember that these babies don't often cry straight away.
Avoid putting the baby back under the water once the head is above the surface.
64The third stage can be conducted either in the pool or on dry land.
Allow approximately 1 hour, unless there is excessive bleeding, before any perineal repair to allow the tissues to become less waterlogged (Garland 2011).
