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PHE confirms birthing pool advice

Heated birthing pools filled in advance of labour should no longer used in the home setting, Public Health England (PHE) has confirmed.

The advice follows a case of Legionnaires' disease diagnosed in a baby still in hospital after being born in a birthing pool at home.

PHE issued temporary advice as a precautionary measure last month (June 17) after the case - the first in England - came to light pending an investigation.

A PHE statement said: "Further investigations have been carried out and based on an assessment of the available evidence, PHE has now confirmed the provisional advice that heated birthing pools (incorporating both a recirculation pump and heater), filled in advance of labour, should no longer used for labour or birth, in the home setting.

The statement added that the majority of birthing pools used at home are filled from domestic hot water systems at the time of labour. "These birthing pools do not pose the same risk and are excluded from this alert, as long as pumps are used solely to empty the pool and not for recirculation of warm water," it said.

Professor Nick Phin, PHE's head of Legionnaires' disease, said: “Further investigation into this incident has confirmed that the type of legionella bacteria found in the birthing pool is the same strain which caused the baby to become ill with Legionnaires' disease.

“This final recommendation is based on the difficulty, in the home setting, of preventing legionella growth in re-circulated warm water over a period of days or weeks.” 

Louise Silverton director for midwifery at the Royal College of Midwives, said: “Women planning birth at home using a traditional pool that is filled when the woman is in labour or using a fixed pool in an NHS unit are not affected by this alert and should not be concerned. 

"Birthing pools in hospitals are subject to stringent infection control procedures and monitoring. Home birthing pools filled during labour come with disposable liners and are only in place for a relatively short time period, reducing opportunity for bacterial growth. 

“Any women with concerns about using home birthing pools should contact their midwife or local maternity unit.”