Birth Tub Bloopers

A few months ago I brought you a story of the trials and tribulations of finding a birthtub for the birth center.  If you haven’t checked it out, you can read it here. I am happy to say that we have an Aquatica pre-ordered for the new birth suite. But what about home births?

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What could go wrong?

not much but…..



In Richmond, many folks have had babies at home with Adrianna or Nancy using the horse trough birth tub.

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One option

Horse Trough

The vast majority of folks planning home births in the US, however, use an inflatable tub.  At River City Midwifery we have one of these (big) and two of these (smaller) for our clients to use at home. Sometimes people will plan to use a garden tub they have at home or skip the water birth plan completely. But most of the time, one of these is part of the equation. Inflatable tubs have some advantages over other birthing tub options - they are super comfy, somewhat translucent (better pictures) and, because they deflate, they are portable.  Unlike built-in tubs they are harder to keep warm, sortof a pain to drain, but for the most part they work fine. We’ve been doing this a long time and have a system practically guaranteed for success.

But, over several hundred births there have been a few….. shall we say…. Bloopers.  And I am here today to share them with you.


Birth tub problems

A question on a lot of people’s minds, definitely a question on more Dad Minds than Mom Minds, is the safety and reliability of the old inflatable birth tub. I would call some people (men) Tub Skeptics.  And although Inflatable birth tubs are usually filled, used, drained and deflated with no issues whatsoever, there’s always a little element of truth feeding any skeptic mind.


Filling with Air

If something is inflatable, it will eventually leak.  Balloons, rafts, camping pads and birth tubs. We try to find and fix leaks before labor  - we are there to hold space, not whip out patch kits and kick you out of the tub so we can take over your birthing space with solvents and sandpaper. So, if you ever see a midwife clinging to the side of an inflated tub with a bucket of soapy water (leaks make bubbles) or a stethoscope, try not to laugh. She is just trying to locate a tiny leak.

If you didn’t know, soap is a great way to find a leak in something right before you decide to just throw it away.

If you didn’t know, soap is a great way to find a leak in something right before you decide to just throw it away.


Several years ago I had a run of birth tub problems. It seemed like they leaked air at Every. Single. Birth. I checked them in between births, patched what I could, suffered through slowly leaking tubs during labors and replaced tubs just to have the new ones leak. One tub failed spectacularly. This was baby number two for a lovely family in my neighborhood. Her first labor and birth had been pretty quick and straightforward, so we were surprised that her 2nd labor was harder, longer and more intense. After several hours she decided to get in to the tub. As she stepped in, I heard the familiar hiss of a patch not holding. I found the patch and attempted to re glue it, but the tub was losing air FAST. My client was only getting relief from the tub. So, I did what any reasonable person would do. I called a doula in the neighborhood and paid her to hold the patch on the pool for the duration of her labor. This meant snaking her arm in between the tub and the liner and leaning over the side, practically in the pool herself and applying not-insignificant amounts of pressure on the plastic patch. For 4 hours. Thanks doula!  (have I mentioned how much we love doulas?)

At other births we have had to refill tubs between every contraction.  The mom has her contraction, doing what all laboring people do (moaning, breathing, coping) and also what most don’t (sinking toward the floor).  Then, we turn on the air pump and up she goes, the sidewalls filling and raising her back to position, water sloshing out all the while. So yes, it is not unheard of for birth tubs to lose enough air so that some water sloshes over the side. You will be heartened to know, however, that never, not once, over hundreds of births, has a tub popped completely or lost air quickly enough for the water to flood out.  Has this ever happened to you? Let us know if it has!



Filling with water

When I was a student, 13 years ago, I arrived with my preceptor at a labor on a hot, swampy, July day.  The dad had already helpfully inflated the fishy pool (we used to use these fishy pools almost exclusively back in the old days) with air and as we arrived, he was starting to the run the water.  We busied ourselves with the usual tasks of setting up for a birth - unfolding chux (why? I don’t know), assembling birth supplies, listening to the baby’s heart rate. Eventually I went in to the bedroom to check on the birth tub. Y’all, I have a strong stomach.  Nothing makes me nauseous on sight except maggots and…. this tub. The tub appeared to be full of egg drop soup, which is not something you want or expect, birth tub wise.

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Actual picture of the birth tub

plus onions



The water was yellow and cloudy with long, thin, gelatinous strands of egg-white looking goop throughout. If you’ve ever wondered why I am so adamant about using a NEW hose for filling the birth tub, this is why. In this instance, they had used a very, very long hose that had been sitting in the heat, full of water.  What grew in it was like the SCOBYs (symbiotic culture of yeast and bacteria) you find in your kombucha bottle. Interesting, but not something you want to have a baby in. We sent the dad to the hardware store for a new hose, drained the tub, sanitized it and filled it again.

Sometimes there is not enough hot water to get an entire birth tub full of water warm enough for a birth.  This was always true in apartments in the city, so we started pots and tea kettles boiling when we began filling the tub. A little known fact about me is that while I am patient when it comes to big things - labor, long drives, listening to my kids talk about space, I am REALLY impatient with little things.  Like, it’s extremely annoying how long it takes to pour all the water out of a tea kettle! It takes forever! It is so boring! So, at a birth one chilly April morning, I decided to pour the water out the top of the tea kettle instead of the spout. And this happened.

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I know

It was gross


The birth was imminent, so I gloved up and finished my work, swallowing a handful of ibuprofen when I had the chance. All I remember about the rest of that day is red hot searing pain and an internal dialogue that went something like “you IDIOT!”



Draining the Water

Cats and kittens, this is where we have the real fun. A hundred gallons of bloody, sometimes poopy water. What could go wrong?


Back in the old days - the aughts -  we used to drain birth tubs via gravity siphon. I actually have no idea why we did this because sump pumps are not a new invention.

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not like this!


Nevertheless, this was the apprentice’s task and it went like this:  hook the hose up to an outdoor spigot and run water until it reaches the pool which, ideally, is quite a distance above the spigot. One you hear your helper shout “OKAY, ITS RUNNING” (very relaxing for the new parents, obviously) you rapidly turn off the water, unscrew the hose, and if all goes well, and gravity being a pretty solid theory, it usually did, the water will start to flow out in to the yard. The water runs slowly and it takes a very long time to drain a tub. But it will drain.  Even on a good day this was a ridiculous procedure, often cold, always wet, involving tromping through bushes and mud. A bad day involved poison ivy, rain or snow.

After one cozy winter birth, the kind where you arrive to christmas lights twinkling in the snow and leave as the sun peeks over the horizon, the neighbors got a siphon-related surprise. After tucking in mom and baby, after packing everything up, after pulling the hose back in through the window and winding it up in the bathroom, I got in my car and pulled down the long driveway. Only then did I notice the snow. I had drained the bloody tub on to a hill of snow.  A hill that now appeared to be the site of a massacre or mauling. Sorry neighbors!

 

There are a lot of bloody snow pictures out there….. here is one

There are a lot of bloody snow pictures out there….. here is one

Now, of course, we use sump pumps and with the aid of electricity we pump the dirty water straight in the bottom of the toilet. The sump pumps are powerful and drain the water fast. This is very effective, and also very fun for small people who enjoy hoses and water and don’t know about germs.  As a bloody pool was draining in to the toilet one morning, a wee toddler friend pulled it out and sprayed bloody water all over the bathroom. She did this for several minutes before anyone noticed. Another horror movie scene. We lock doors and supervise now, when there are curious toddlers around.

And here we are at, hopefully, the biggest birth tub bungle of my career (shared with permission). This was another birth in my neighborhood, a lovely first time mom on the second floor of a two family city building.

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Classic STL 2 family

Picture the birth on the 2nd floor there




She labored beautifully, and had her baby in the tub quickly and easily. In fact we had not finished filling it when she had the baby so the end of the hose was still in the tub, and we left it there, busy with other tasks, and maybe a little tired. Since the mom was small, we hadn’t used as much water as usual - it was a pretty concentrated mess as far as birth tub water goes. Baby poop, lots of blood. But normal stuff.

We got her and her sweet baby girl to bed and did the tasks of immediate postpartum: watching, waiting, cleaning. The hose had been screwed in to the kitchen sink faucet and I unscrewed it in order to wash my hands. You probably know where this is going and I am sorry to say you are right. Remember the siphon and the laws of physics?

At some point, the end of the hose was knocked out of the sink and on to the kitchen floor where it proceeded to drain the tub. By the time I made it back in to the kitchen there was two inches of bloody, poopy water on the floor.

This seemed bad. My apprentice and I frantically sopped and mopped, pushing water in to buckets with a broom and dumping it in the bath tub. The water has seeped in to the floor boards and under appliances. It was an endless, multiplying mess the way blood can be. Everywhere. We somehow got it cleaned up, disinfected the floor, and finished our midwifery work and went home. I went home thinking, well, that was bad but, LESSON LEARNED, to always take the hose out of the tub. That night I packed a roll of duct tape in the birth bag, vowing to also always tape the hose to the sink.

Several days later the landlord of the building called me. In the only stroke of luck in this story, he was the client’s father in law.  So it was with sadness and not anger that he told me what had happened.

I googled “bloodbath” so you don’t have to.

I googled “bloodbath” so you don’t have to.


The people who lived downstairs had been on vacation during the birth.

When they came home, they were surprised to find their kitchen ceiling red, brown and crumbling wetly. They were also surprised to find all of their many things in the kitchen, soaked in, and in the cases of dishes and pans, containing, old bloody birth water.  The landlord told me that, not only was the ceiling ruined, but that the people were “sort of hoarders”. They had dozens and dozens of kitchen items that were now, according to any reasonable person, ruined. Also, they were so traumatized, they decided to move.  

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No, it really does not get much worse than this.

I did pay for their items. But, after a small investment in bleach, I also kept some of those items.

So, if you ever come to my house for cookies, know that they were made with love…. and a kitchenaid mixer that was once covered in bloody birth water.

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The end.












Birth Tub Odyssey

I considered writing this blog post in the form of an Epic Poem. This story has most of the classic Epic elements: A Hero (in this case Heroines) of Legendary Proportions, Adventures of Super Human Strength and Valor (hours staring at incredibly similar items online, hauling massive tubs up and down stairs), a vast setting (China to Richmond and back!), and multiple sites of action (whats up, Ferguson!).  But, alas, this tale does not involve supernatural forces and I’m not sure this poet can remain objective and omniscient, so this is just going to be a regular blog post.

Have you ever noticed, tooling around online, looking at birth centers, that an awful lot of them have the sort of garden tub your mom might have had in her bathroom in 1994?  

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Often built in to corners, sometimes with outdated tiling, occasionally involving steps, birth center tubs seemed to us to be a design problem in otherwise beautiful birthing spaces.  Every so often you see a freestanding tub, usually appearing, in our browsing, to be way too narrow. These birth center built-ins and narrow tubes are nothing at all like the deep, wide, poofy blow-up birth tubs most homebirth midwives are used to.  

Our favorite birth tub, the LA Basseine, is a dream of cozy, sturdy functionality.

Our favorite birth tub, the LA Basseine, is a dream of cozy, sturdy functionality.

When we set out on this Grand Birth Center Adventure, we naively and offensively assumed these tubs were a failure in taste among our midwife sisters.  Perhaps birth center midwives and designers had just not gotten the memo about Beautiful, Round Freestanding Tubs. Perhaps they had forgotten how nice it is during home water births that to be able to reach a client from all sides of the tub. Maybe they’d never watched HGTV?

The truth is that we had heard whispered tales about birth tub woes before. Through the grapevine we heard about a hospital labor-tub program where all of the expensive tubs were returned not once, but TWICE.  We heard from students who spent hours cleaning jetted tubs after messy water births because, their preceptors told them, they literally had no other tub options. We remembered hearing that tubs were delivered with jets when none were asked for and that plumbing was always, always an issue.  Another midwife had mentioned ominously, in passing, “good luck finding a freestanding tub, we tried”.


So we were smug then, when a quick search in google, lead us to Wayfair. On Wayfair, there seemed to be a plethora of tubs that appeared perfect for water birth. They looked fine, were strangely affordable, and about the right height and size. We wondered, “have midwives never been to Wayfair before?”  We felt worldly and wise, and in the middle of about 49 other renovations, a lake of paint, and the business of starting a new health care business, we didn’t look too carefully at the specs (actually we didn’t know there were specs) and clicked “proceed to checkout”.

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Our new tub began its journey to us from China.  


An Epic Adventure

some of the perils on the journey

some of the perils on the journey

While we waited, we added plumbing to a bedroom where no plumbing was before.  To be clear, the amazing and patient Matt at New Day Mechanical installed the plumbing.  He worked like a surgeon performing reverse laparoscopic surgery. One small incision in the wall here, another two there, and one to let out the gas over there (there was no actual gas involved). Look inside, thread the plumbing in and voila!  

Our ceiling, to this day

Our ceiling, to this day


The Tub arrived. Adrianna and Marinda muscled and rolled it up the stairs, all by themselves!  I was not there, but I imagine they felt very pleased with themselves (and possibly annoyed with me) as they set it in to place.  But…….it was not right. Bafflingly shallow. We texted each other pictures of ourselves in various labor positions and declared that “it had to work”.

The most common labor position in water tubs

The most common labor position in water tubs

At some point, most people do this too

At some point, most people do this too

Then we went back to painting a second or third coat on some trim. We had it plumbed in, and it looked beautiful. I posted a picture of the tub (in black and white because the walls were still the color of baby amoxicillin) on Instagram and it was a VERY popular post (for us, I don’t really understand IG). Okay, we thought, the tub is good.  It has to work.

A moment in the spotlight, Instagram Fame

A moment in the spotlight, Instagram Fame


Paint trim, rip out flooring, imagine that all future clients will be 4’11”.  

That night, I took a bath in it.

You guys. It was AWFUL, and I wasn’t even remotely in labor.  Hard, slippery, so, so shallow. The combination of shallowness and largeness made it feel like I was just sitting naked on the floor in a vast puddle, which, well, I was.  The hard and narrow sides hit a strange part of my back and leaning over the edge in hands and knees - the most common water labor position - was a comedy of errors and bruising.  


Another time, my toddler had a great bath in it.  He declared it a “Great BIG BIG pool-bath!”. So there you have it. Thumbs-up from the under 3 set.

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It was with great sadness that the three of us convened the next morning and admitted to ourselves and each other that it had to go.  We had thirty days to return it.

And thus began The Great Tub Search.  We wanted a tub that was:

  1. Freestanding

  2. Water depth of at least 19 inches

  3. Circular or at least roundish

  4. Interior width of at least 36 inches

  5. Can fit in the building

This seemed like a reasonable list.  We learned more about bathtubs than we ever imagined was possible to know.  We learned that the Standard Depth of a tub in the USA is 14-17 inches. This, of course, is too shallow for anyone who is not a baby.  We learned that a “European depth” is 18 inches and that “Japanese or Greek depth” was 22 or more inches. We studied websites and we learned the listed measurements were often wrong.  So, we downloaded and studied the specs.

Now, we understand that people not concerned about humans emerging from bodies might not have the same sense of urgency over these few inches, but it was frustrating how difficult it was to determine “how deep is the tub”.  


You guys, there are thousands of freestanding tubs on the market. Who knew? They are mostly variations on the theme of “Banana Split Boat”.

Exactly like this

Exactly like this


Or sometimes they are shaped like shoes or horse troughs. We kept searching.  

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Japanese soaking tubs, we learned, were deep and round, but far too narrow for baby having. Like big buckets. We learned that those Friends-era built in garden tubs, usually jetted, offered the best depth, but we couldn’t and didn’t want to tile a tub in to the simple little 1930s bedroom that we loved. And NO JETS EWWW.  So we looked, and looked.

Late at night, loopy, I even tossed hilarious hospital birth tubs like this in to the ring.

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Some of them are actually pretty cool, but mostly not available in the US (of course) or hospital-budget friendly not low-debt birth center budget friendly.

I mean, this could be cool.

I mean, this could be cool.


And, no post about waterbirth tubs would be complete without this:

I’ve always wanted to be a spaceship pilot!

I’ve always wanted to be a spaceship pilot!

or this

Someone actually made this.

Someone actually made this.

At this point, we considered scratching the whole birth center idea and opening a birth tub manufacturing company instead…

At this point, we considered scratching the whole birth center idea and opening a birth tub manufacturing company instead…

We did find one tub that was kind of perfect.  I present to you: The Aquatica Pamela.

Yes,  Aquatica , this tub is perfect for our next birth suite! Construction starts soon!  hint, hint

Yes, Aquatica, this tub is perfect for our next birth suite! Construction starts soon! hint, hint

She wasn’t the prettiest tub at the prom, but she fit every single criteria. Except one. She wouldn’t fit in the birth center, up the stairs or in the room.  We contemplated removing doors, windows, trim, hiring a crane, and/or changing the entire layout of the birth center. She was also way out of budget. So we got special tub financing.

However, before clicking “buy now”, this time, like a pack of geniuses who learn from their mistakes, we made a template from an old sheet and laid it in the room.  No. No way. Way too big. Would be like a cereal bowl in a dollhouse.


We vowed to get Pamela for our next birth suite, because in all other ways, she is kind of perfect. At least we won’t have to go through this again in a few months.  

Finally, in an act of desperation we did what countless people before 2017 have done.  We went to a store.

These still exist!

These still exist!


Now, I had been to another Ferguson the previous week and found a tub that would more or less work, but it wasn’t perfect.  Let’s call this tub “Barnabus”. Here, my husband and child demonstrate “how to make showroom workers uncomfortable”.

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At the time, convinced there was a perfect option, we dismissed Barnabus out of hand.

Back at Ferguson, this time, we scoured not just the internet but the dark web of shopping: industry catalogs.  We learned about the world of Very Expensive Tubs which included copper (the metal) and Solid Surface (the rock) and other rare elements.  We added “must not weigh more than 300 pounds” to our list. Armed with The List and a mountain of catalogs, Marinda and our wonderful sales worker Teresa McClellan, found us a short list of acceptable, or nearly acceptable, candidates.  With names like “Olivia”, “Elise” and “Adriann”, they were fancy versions of the banana split boat. Mostly they were too narrow, too heavy, and had a several week wait time. And were over five thousand dollars.  


Back to the Aquatica Pamela?  We did some more measuring and contemplated our life choices. Maybe we could make it work. MAYBE IF WE GAVE UP AND STARTED FROM SCRATCH.  Did we all cry? I’m not saying.


Enter, stage left. Barnabus. In a sea of almost-right Olivias and Pamelas, we had looked right past the almost-right Barnabus. There he was on my photo roll, comfortably accommodating a giant adult human and a small 10yo. His edges were wide enough to lean over, he was deep enough. He looked alright.

See, looks almost right!

See, looks almost right!


We ordered him.


When he arrived from across town, we visited him at the Fergeson showroom.  He was good. A little underwhelming among all the shiny copper pennies and cold, hard rocks, but we took him home. (I mean, some strong workers brought him to the birth center).  

And here he is!  

He fits in very nicely, we think, even without IG filters

He fits in very nicely, we think, even without IG filters




I have to say, he looks great!  So deep and cozy, lovely, freestanding.  We can get to all sides, he fit in the door.  

Toddler contemplates life as a tub model

Toddler contemplates life as a tub model

Now, we just have to get Matt here to move the drain over three inches….

Stay tuned for reports on Barnabas in action!

(but seriously, we think this will be a wonderful place to labor and have a baby. It is deep and wider than it seems. One end is sloped for comfortable learning back or side-lying, and the other is straight, making hands and knees easier. The bottom is textured and not slippery and the sides are wide and easy to drape over without armpit bruises. We especially love how deep it is, so everyone, even tall people, can give birth in any position that makes sense for them.)

Birth Center Week 2 Update

Week 2

Baby Ephraim helping!

Baby Ephraim helping!

I want to start this week 2 update by sharing that we have been humbled by and are so appreciative of the outpouring of support from the community. Your words of encouragement and support mean so much to us. Starting a new business is perhaps a little bit like having a baby, and small words of encouragement help get us through that last coat of paint, the last coding error on the website or hiccup with legal paperwork. Thank you! We want this birth center to be centered in community and connection, and look forward to giving back and serving the community for years to come.

So, we are 12 days in to the lease on our new space, and things are moving right along. We open for clinic in 10 days! So far, Marinda, Adrianna and I plus family and community members have been here every day working very hard. We have been painting. Did you all know that Adrianna used to work on a painting crew? She is an amazing painter! What do you think of these colors? Imagine art on the walls and colorful but simple mid century furniture.

New paint colors, obligatory accent wall 

New paint colors, obligatory accent wall 

We have pulled up three rooms of carpet, carpet padding and approximately 30575038 staples. Currently we are getting bids for floor refinishing. We hoped a buff and coat would do the job but it looks like a full sanding is necessary.

Marinda pulling staples

Marinda pulling staples

And then we need furniture. We are hoping to eventually transition to fully mid-century antiques, but the market is so high for them right now. If you happen to have any mid century beauties laying around that you'd like to sell to us, please let me know! We are in the market for shelves, a credenza (or nice low dresser), a couple couches and 4 chairs. For pieces we can't afford used (haha!) we are waiting for a sweet baby girl to come earthside, and then plan to drive to DC for some IKEA furniture.

Business updates: we have several clients in care already, and have tours planned for early September. I built the website in record speed, but our SEO is terrible. We know that takes time. If you have a website, you know link-backs are so helpful. We would definitely appreciate and reciprocate links.

We have a few very exciting projects and community partnerships in the works. We can't wait to tell you about them! Stay tuned!

Do you have any questions for us? Email us or post in the comments <3

-Linsey

Random vintage find in our building

Random vintage find in our building