Why use water during your labour and birth?

Water and TENS machines are non drug-based methods of pain relief.

For some they are essential methods of avoiding pharmaceutical drugs during labour - because they don't cross the placenta and affect the baby. For others they are a stepping stone before moving on to other options.

Why use water in labour?

Movement

Water is physically supportive, allowing you to move around more freely and get into positions you would not be able to get into on dry land.

It supports your back, pelvis and hips, and is particularly useful for those with PGP, back problems or arthritis.

Relaxation

The warmth of the water is incredibly relaxing, which helps with physically feeling less pain (if you are tense, it hurts more).

It also means you produce more oxytocin, the hormone of labour, and more endorphins, the body's natural pain relieving chemicals.

Privacy

The walls of the birth pool are opaque, and so they act as a protective bubble, within which you feel secure, safe and unobserved.

This reduces your adrenaline and increases your oxytocin levels, allowing your body to labour more easily and effectively.

Are there any negatives to using water?

Sometimes water can slow the first stage of labour down. If you feel that may be happening, you can get out of the pool again. There is no rule saying you must stay in the pool once you are in it! In fact, it can be beneficial to get in and out of the pool to help the baby move down well into your pelvis, and to facilitate trying different positions.

Some women and birthing people find that the water makes them too hot during labour so they want to get back out again. There is debate about the best temperature for birth pool water to be at but generally, a comfortable temperature for you is best while you are labouring. It is important that you can easily raise your body up out of the water as that is how we lose heat while in water.

Using a pool may increase your chance of having a minor tear (or it may not), but it decreases your chance of having a severe tear or episiotomy. You can read more about the evidence around waterbirth on Evidence Based Birth.

Using TENS in labour

TENS stands for Transcutaneous Electrical Nerve Stimulation, and is an option for pain-relief that is easily portable, non-invasive and non-addictive. It is used in a wide range of medical scenarios. The idea behind a TENS machine is that it blocks some of the pain signals travelling up the spine as well as stimulating endorphins, which are the body's natural pain relieving chemicals (imagine the way your headache hurts less when you laugh at something funny). They take effect quickly, and their pain-relieving effects die off when they are no longer in use. The evidence around the usage of TENS machines is mixed.

Anecdotally, TENS machines work best if put on during the very early stages of labour, which makes it great for use before getting in a birth pool, which can sometimes slow labour down in the early stages. One of the advantages of a TENS machine is that it is very flexible and discrete - it can attach to your clothes via a clip or be worn around your neck on a lanyard. You can wear it in bed (although not while sleeping), or while going for a walk round your neighbourhood or even visiting town. You can wear it before labour starts if you have backache, or after your birth if you have afterpains.

A labour TENS machine differs from a regular TENS machine because it has 4 pads rather than 2, the pads are larger, and it also has a boost button for use during contractions. There are two different pulse patterns so you can choose the one you like best, and the strength of the pulses is fully adjustable. Some more high end models have contraction timers built in as well, but none of my models feature that option.

Are there any negatives to using a TENS?

Some people absolutely hate the feel of them on their skin.

Some people don't find them effective, and for those that do they really work best when put on early, which means if you forget to put it on until later, or your labour starts full on instead of building up slowly, then it doesn't have as much effect.

Sometimes you can forget to turn the pulse strength up as your labour progresses. It is useful to talk with your birth partners about checking in with you whether it needs turning up at regular points during your labour.

Some people feel that the boost setting is too intense. In this case I suggest turning the pulses up in strength during contractions, and then turning them down again between.

It's a lot of money, is it really worth it?

I think so! And I'm speaking both as a doula who has seen multiple clients use both, and also as a homebirther who used TENS and water during 2 of my 3 children's births.

If you are concerned about being overwhelmed by labour, choosing to birth in water is a really good option. A lot of homebirthers choose TENS and water as their pain relief and find them to be invaluable during their births. There are also people who choose to give birth at home specifically so that they can be guaranteed the use of a birth pool, as there are a limited number of pools at hospital, both on obstetric wards and birth centres.

I have done my utmost to make the hire process as streamlined and stress free as possible, and I am always on hand to answer any questions you may have, both about the use of water, and about homebirthing in general.

If you are unsure, remember that water and TENS are just two of a vast toolkit of things that can be use for relief and comfort during labour and birth.

Don't just take my word for it though, here are some photos and comments from people who have used water during their labours and births...

We had the perfect home birth where we welcomed a very healthy 10lb 2oz baby boy!

Rebecca

September 2021

Having the water birth helped with the pain of my osteoarthritis.

Amy

October 2015

Personally, the pool made my homebirth. I was starting to really struggle and as soon as I entered the pool I felt weightless and able to properly relax between contractions.