Waterbirths: regional audit of infection control practices

Waterbirths are increasingly being offered as an option, although concerns about associated infection risks have been expressed. We undertook an audit of current practice in our region to help formulate an infection control policy. Questionnaires were sent to the Infection Control Nurses at 16 centres, with a request for completion in conjunction with the Infection Control Doctor. Fourteen (88%) centres responded, 11 of which carried out waterbirthing. Eight had permanent on-site pools, of which five were permanently plumbed in and provided with separate water inlets and outlets. All eight centres had infection control policies for waterbirthing. Six policies included care of the pool using detergent and disinfectant (chlorine-releasing compounds) and two using detergent alone. In none of the centres were the mothers tested for blood-borne viruses. Six centres collected data on infection in mother or child, and two carried out regular microbiological testing of pools. Infection control policies for waterbirths should include instructions for pool maintenance and decontamination, for prevention of legionella, for universal precautions and for use of personal protective equipment. Post-natal surveillance of mothers and babies is required in order to ascertain infection rates.