Water Birthing Pools and Legionnaire’s Risk

If you are planning on a water birth/using a pool during labour, and are looking to buy or hire a pool for the purpose to use at home, you might have noticed that there are lots of inflatable home spa pools available to buy, for little more than double the price of a standard birthing pool or pool hire.

I have to admit, the idea was tempting. We’d be able to use it after the birth too!

Lay-Z-Spa Miami

Lay-Z-Spa Miami – Amazon – £379.95

In the event, we borrowed a birthing pool from a friend, but we may well have purchased a Lay-Z-Spa or similar if this hadn’t been an option. A lot of hire companies also loan out these types of pool, where the pool is filled up well in advance of the big day, and the water is kept heated and circulated by means of a pump.

Public Health England now advise against filling up the pool in advance, due to the risk of legionnaire’s disease, a very serious lung infection caused by legionella bacteria, after a newborn found to have contracted legionnaire’s was taken into intensive care. The source of the legionella bacteria was traced back to the birth pool. The company was not named. Legionnaire’s disease in young children is thankfully incredibly rare, only one case was identified in England between 1990 and 2011.

Birth pools for hire are usually thoroughly cleaned/sterilised before use, but in this case, legionella was either still present or entered the pool somehow. If legionella is there, constantly heating and circulating the water provides perfect conditions for the bacteria to multiply.

Prof Nick Phin, from Public Health England said: “This is an extremely unusual situation, which we are taking very seriously… We advise that heated birthing pools, filled in advance of labour and where the temperature is then maintained by use of a heater and pump, are not used in the home setting while we investigate further and until definitive advice on disinfection and safety is available.”

So, if you are considering using/buying a spa-type pool, there is no reason why you can’t still do that, just don’t fill it in advance of your going into labour, and don’t use the pump to circulate/heat the water.

100m Expanding Hose – £19.99

Make sure you have the hoses and connectors ready. Lots of people choose to buy a new hose for the purpose, as you don’t know what nasties could be lurking in a garden hose you’ve had a while. I think I would be tempted to try one of these expanding ones next time. You need to either have an isolation valve on the end or use the spray gun as a valve and then the water pressure causes the hose to expand to its full length.

Perhaps do a trial run so you know how long it will take to fill from whichever hot tap you are using. Give the pool a good clean with Milton or Dettol beforehand. You don’t need to get too concerned with the sterilisation as you’re not looking for a sterile environment (after all, you’re not sterile!), just a good clean will do to remove any dirt left from manufacturing/packaging/shipping.

Enjoy! Being immersed in warm water during labour really is incredibly soothing – I was shocked by the intensity of the contractions whenever I had to get out of the pool for an examination or to go to the toilet, and could not jump back in quick enough!

Patient Safety Alert - Legionella and heated birthing pools filled in advance of labour in home settings
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