A very useful paper according to none other than Beverley Beech. More evidence (as if more were needed!) for the need for caseloading community midwifery. The link below is to the article of the same name as the title of this blog post.
BMJ Qual Saf-2013-Rance-bmjqs-2012-001295
It can also be found on the blog Bornstroppy.
One firm touts their bath as having low profile (sic) fast flow plumbing.
Fast flow, low profile plumbing etc. This is just unhelpful jargon. Speed of drainage is a function of the diameter of the plumbing beneath the bath and the distance to the foul drain. As our plumbers put it, gravity works the same and the only plumbing that counts is good, compliant plumbing. In the past we were called out by hospitals as they had ‘other’ baths that had started leaking – all were around the plumbing area. The low profile pipe inserted at an angle to the bath was the point of failure. It is evident from their brochure (and the exclusions to their guarantees) that this weakness has been recognized if not addressed.
We designed our baths from the plumbing up. We use only standard, purpose made plumbing fittings because these alone give the best fit, the longest life and are easily replaced by Estates and Maintenance in years to come. We also introduced the use of the quarter turn ball valve as they are far superior to the gate valves used previously. We are glad to see that this innovation has been taken up!
We also use waterless traps which still prevent odours and backflow but do not provide a reservoir for the build up of stagnant water.
Also, as our baths are designed to incorporate all the plumbing beneath the bath. This keeps it all concealed but also the trap can be fitted very close to the bath waste as required by water regulations (BS5572), which reduces the length of ‘uncleanable’ pipework. We note from ‘tother’ company’s brochure that their standard requirement is still only for trapping in the floor below. The baths should be trapped in the room as close to the bath as possible without the customer having to order the special adapted higher steel subframe (another expensive fix and design ‘cul-de-sac!). The ‘tother’ company’s website used to advise that it was not necessary to put a trap on the bath, it was sufficient to just close the sluice gate valve. I know from site visits that there were hospitals that fitted in this way. Thankfully, we have been imitated in terms of improved (if not ideal) trapping arrangements and better valves.
These so-called ‘fast flow / low profile’ drains are not only inferior in terms of durability, we have had comments from an NHS infection control department that
“This form of design has infection prevention and control implications with the potential for biofilm development”.
The sooner the ‘fast flow / low profile’ plumbing is seen for the jargon it is, the better. It is trying to put a positive spin on inferior design and plumbing.
Its about Department of Health encouraging normal birth and the birth environment by giving generous grants. Initially, the condition of the funding was that it had to be spent before 31st March, which made for a mad dash with midwives / midwifes and Estates Departments running around trying to get things in place.
Another interesting thing came to light. Active Birth Baths, which has trumpeted itself as the UK’s leading provider of birth pools had hit a snag. They didn’t have the capacity to meet the demand. He had to send an email round to get the date shifted.
Dear Midwives,
I’m writing with the hope of enlisting your support to obtain an extension to the March 31st deadline for the supply of water birth pools under the Dept of Health’s capital fund programme for the improvement of birthing environments.
I feel that though the offer was well received and appreciated by the hospitals it was misguided and not thoroughly researched as to the feasibility of achieving the desired result within the time frame.
As the main supplier of birthing pools I am uniquely placed to assess and comment on the situation.
I’m in touch with midwives, architects, estates departments, infection control, health and safety, contractors, capital planning officers etc.
They are all saying the same thing – that it is physically impossible to achieve the goals of the programme by March 31 due to the demand it has created, the complexities of NHS bureaucracy and the realities of building works needed.
This is not working for anyone and will not achieve the best possible results as stressed midwives, contractors and suppliers attempt to do the impossible.
To meet the demand created by the offer we started manufacturing pools after the new year even though there were no orders in place. We’ve temporarily taken on new employees and space in an effort to optimise our output.
At this point with just over 6 weeks to go to the deadline there are hospitals asking for new quotes, waiting for tenders to be completed, experiencing problems getting purchase orders through their systems, deciding which pool to go for and in some cases waiting for architects to finalise plans so they can proceed.
As you know the Dept of Health was meant to inform the hospitals if their bids were successful on Jan. 14th but in fact did not do so until the 25th. This delay has not helped!
I spoke to Karen Dodd at the Dept of Health to try and obtain an extension to the deadline. She said that as a supplier its not my place to ask and that they would have to here from the midwives.
I am writing to you in the hope that you can use your influence to exert a bit of pressure on the DOH so that they make it possible for the hospitals to achieve their plans within a realistic time frame.
I’ve informed Cathy Warwick from the RCM of the situation and she is discussing it with the DOH today.
Please help by contacting Karen Todd (020 7210 5413 karen.todd@dh.gsi.gov.uk) today to tell her of your situation and the need to have the deadline extended by at least 3 months to achieve your goals.
Best wishes,
Keith Brainin
Active Birth Pools
The World’s Leading Designers and Suppliers of Water Birth Pools est. 1987
Now, the Government announced that they were giving funding for ‘nearly 40 birth baths’ in this scheme. Assuming this to be 40 baths, we at Aquabirths are making well over half of this number and growing, which suggests the (sic) main supplier of birth pools, isn’t.
The deadline of the 31st March has been relaxed and we’re still being contacted by hospitals saying the delivery date from Active Birth is June. They also described his prices as “extortionate”. Aquabirths differs in that we manufacture (in the north of England) and we have large manufacturing capacity. We can and will be supplying out baths to the original deadline. Our baths for two hospitals (7 baths between them) were ready a week ago. For one hospital we are designing a new model of bath and aiming to have it there by 31st! If you order a Canberra model, you could have it in a week!
I don’t think it’s on to claim to be ‘the world’s leading’ if you haven’t the capacity. At Aquabirths, we couldn’t care less who is the ‘premier’ or ‘leading’, we want to change the culture of birth within the UK and beyond. We design baths, make baths, understand baths, understand plumbing. We are here to get water birth available in every birth room. We make very high quality baths designed and redesigned with input from mums, midwives and hospital specialists (such as infection control). We make a profit and we are still cheaper by far: those who don’t manufacture have to put on their cut.

A couple more pictures from the opening of the new Birth Centre and Bradford Royal Infirmary.
The new Canberra model birth bath is available on short lead times or from stock. The Canberra is £4100 and we discount for 2 or more baths.
The photos came from Lorne Campbell / Guzelian.
Hi Ruth & David,
I’ve finally got the green light to order!
After lots of careful measuring we have realised that the Canberra bath is our preferred option. We are going to order 3 Canberra baths, each with a light, steps and poles.
I have my order book at the ready to complete the process then realised after reading your website we have to attach the quote. Obviously we haven’t got a quote. Can you possibly send me something I can attach so that we can start our journey!
I must say that your heart felt support was overwhelming and gave me the determination to challenge my estates when they said “it couldn’t be done”. I truly cannot thank you enough and look forward to the day when I email you some beautiful pictures! (or you could come and see for your selves!)
Many thanks
Jules
We have been inundated with orders for new pools by hospitals using the Government grants for water births. Not only are our high quality baths already sold at a reasonable price, we also offer discounts when you buy two or more. And we can install or support you through your Estates Department in installing. We also make birthing stools and can supply stainless steel goods such as floor-to-ceiling poles or bespoke grab rails.
Bradford Birthcentre’s successful launch


It was the launch of the Bradford Birth Centre on 1st February 2013 – already over 280 babies had been born there. Feedback from Mums is fantastic, the birth pools (which Aquabirths supplied) are in constant use, and the rooms are beautiful.