A newborn baby has died from Legionnaires’ disease just a few weeks after being born in a heated birthing pool at his home.
The tragic death highlights the need for pregnant women to understand the risks of water births — and for standardisation of cleaning procedures in some midwife facilities.
The death, in Texas in the US, occurred when the baby was infected with Legionella bacteria found in the birthing pool where he was born, a new report by the Texas Department of State Health Services has found.
While the little boy appeared healthy immediately after his January 2014 birth, he’d developed diarrhoea, cyanosis and respiratory failure by the time he was admitted to hospital at six days old, according to a report in medical journal Emerging Infectious Diseases.
The little boy was placed on a machine to help him breathe, but died 19 days after his birth, CBS News reports.
Emerging Infectious Diseases reports that a midwifery centre had filled the jetted birthing pool with well water and added ‘purifying’ spa drops to the water — but they did not contain chlorine, and the water hadn’t been disinfected before use.
The tub also had internal tubing that hadn’t been approved for use as medical equipment, and can be difficult to disinfect.
The water was left to circulate in the pool for around 37°C until two days before the birth, when the tub was drained, filled with new well water, and left to circulate until the delivery.
Tests later found that the tiny boy’s death was caused by Legionnaires’ disease, a severe form of pneumonia caused by bacteria that can be commonly found in hot tubs and plumbing systems.
CBS News reports that giving birth in water is generally not recommended because there are no proven benefits, and there are potential risks to the baby.
“(Babies) are in a higher risk category because of their underdeveloped immune system, and their developing physiology,” co-author of the new report Elyse Fritschel, from the Texas Department of State Health Services, said.
While this death marks the first documented case of the disease’s link to water births in the US, there have been reported cases in the UK and France.
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Infection control risks associated with water birth pools and how to negate them
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13 December 2014 Keith Brainin Founder & Director – Active Birth Pools
There has been recent news from Texas of a fatality relating to use of a portable water birth pool that utlilised a recirculating water system
Earlier this year in the UK there was an outbreak of Legionella associated with similar equipment.
Having designed and supplied portable birth pools from 1987 and installed pools in hospitals since 1988 I probably have a greater knowledge and understanding of the issues relating to their design, engineering and manufacture then any one else.
I created the largest birth pool hire company in the UK hiring out 75-90 portable pools a month and never had an infection control issue.
It’s simple.
These are the rules that need to be followed.
NO recirculating systems of any sort!
This means no jets, no bubbles, no heating, no filtering systems of any sort – just a pool of fresh water, and by fresh I mean no more then 12 hours old.
You’d be amazed how quickly life takes root in a pool of warm water, you can actually feel that after 12 hours a pool of body temperature water feels differently to the way it did originally.
Fill the pool with a new hosepipe.
Hosepipes, piping, tubes of any sort and pumps are the No. 1 Risk!
You don’t know what is going on inside them and you can’t take the risk.
So, fill your birth pool with a NEW hosepipe once your in established labour and play it safe.
IF its a pool that has been used before USE a disposable liner to negate risk of cross infection.
Anything that has been in contact with water before must not be in contact with the water in your birth pool!
For water birth pools that are installed in hospital its even more straightforward:
The pool should not have:
• Overflow drains
• Water Inlets
• Hand held showers
• Systems with flexible hoses or pipes for filling and emptying
• Integral or secondary plumbing supply or outlet systems
• Any type of recirculating or pumped water systems such as whirlpool, Jacuzzi, spa, heating, bubbling, filtering etc.
To ensure that health & safety and infection control standards are met we strongly advise that you do not use a water birth pool that has any of these features.
Water Birth Pools should be filled from taps plumbed directly into the hospitals water supply as normal baths are and emptied as a normal bath would be.
Not only do secondary or integral plumbing systems of a proprietary nature present unacceptable risks, they are expensive to purchase, difficult to maintain and unnecessary.
The benefits of water for labour and birth are clear and understood.
The world is poised on a threshold in the proliferation of their use following successful models in the United Kingdom and other countries.
It must be safe!
www.activebirthpools.com
There has been legionnaires diseases discovered at The Royal Hobart Hospital too. I'm by now means a home-birth advocate but this is getting a little ridiculous.