NOTE - Second babies come much faster than first babies. For second babies, you may want to start filling the tub at the first thought that baby may come within 48 hours!
Also, please keep all the empty plastic bags as you unpack the kit - you will need these bags when you repack the clean kit after the birth!
Sterilizing the Tub Kit
About sterilization: I pass these tub kits directly from family to family, so you are responsible for sterilization of tub kit parts that could introduce contamination into the tub before use. The purpose of sterilizing them is to prevent cross-contamination, i.e. to kill germs that come from another family. Once that is done, it is OK if the tub kit parts pick up your own household germs; the kit does not need to be kept sterile until the time of the birth. So it's best to do this sterilization as soon as possible after acquiring the tub kit, so it's all ready when needed. This task involves bleach, so it's not appropriate for the pregnant woman. (Each user gets a new disposable liner for the tub, so you don't need to worry about disinfecting the tub itself.)
Use regular household bleach, like Clorox; generic is fine; please use unscented since plastic can absorb the scent. Any time you're using bleach, you need to be very careful with it. Bleach whitens fabric (i.e. your clothes or bathroom carpets), even if you get just a drop of bleach on it. Also, it is nasty on your hands, so it's best to wear gloves, or limit the amount of time you're touching the bleach. I provide disposable gloves to wear while handling the contaminated pump or drain hose, and while using bleach. Please use only the number you need, make sure the glove box is returned in the kit with everything else, and please let me know if there seem to be very few left. Thank you!
Use the 18-gallon tote bin (or similar size) that the hoses come in. Fill the 18-gallon tote bin with cool water; add 2.5 cups of bleach. Carefully feed the fill hose into the tote bin filled with water. You want to remove all the air as you go, so the bleach will come in contact with the entire interior of the hose. Continue filling the hose until it's all submerged. Then add the other parts to the tote bin, making sure to wedge the floating thermometer under other parts so it's completely submerged. Leave everything soaking for 60 minutes, then rinse everything well and let dry. [NOTE - This will also sterilize the 18-gallon tote bin, and you could use it for a Leboyer bath for the baby after birth if you choose. If you have any laundry you need bleached, you can use the bleach before dumping it.]
[Some parts are a real pain to sterilize - in particular,
the long fill hoses and the penny sheet. These are generally kept quite
clean at a birth because they're usually removed from the scene before
anyone gets in the tub. I personally would feel comfortable with sterilizing
just the 3' clear anchor hose that goes into the tub, and making sure the
penny sheet is completely dry, which kills just about everything except
yeast. But you must be willing to take responsibility for this if you make
this same choice. If you do decide not to sterilize the long fill hose
and penny sheet, you can fit everything else in the foot tub filled with
just 1/2 cup Clorox-type bleach.]
Absolutely Necessary for Safety
Do not plug in the AquaDoula heater until the tub is filled to the specified level, and unplug the heater if the water level falls or before draining the tub.
Pregnant women should not allow their body temperatures to rise to a point where they might reduce the oxygen flow to the baby. The water temperature should remain between 32 - 37 degrees Celsius (90 - 99 degrees Fahrenheit) for comfort and safety during labor. Ideally, it should be between 36-37 degrees Celsius (97-99 degrees Fahrenheit) at the time of birth.
Use the clear hose for filling, and the green Roll-A-Hose hose for draining. It is impossible to sterilize the green Roll-A Hose used for draining the tub, so it is absolutely essential that this hose not be used to fill the tub. Only the clear hose (CLEAR = CLEAN) and the detachable three-foot clear hose with the wider foot-long anchor tube should be used to fill the tubs with clean water.
The long green Roll-A Hose drain hose, the short plastic green hose and the drain pump have been used at previous births for emptying the tub after the birth, so they should be assumed to be contaminated and used only for waste water; keep them in their containers until after the birth, and wear protective gloves when handling them. They must not be put into the water until you are all done with the tub and ready to empty it. If you want to fill and empty the tub a number of times while it's in your home, you may want to purchase a garden hose of your own that you can use to drain it by creating a siphon; if you start out with a clean hose and use it only to drain it after your own use, this won't cause cross-contamination problems. Alternatively, you can disinfect the short siphon hose (about 9' long and about 2" in diameter) and use it to siphon water into the accessories tote bin, where you can use the contaminated water pump and drain hoses to drain the tub much more quickly. (Note that water accumulates between the permanent aqua-colored vinyl liner and the clear disposable liner; this is from condensation, not from a leak in the disposable liner.) Anything that comes in contact with the water pump or the green Roll-A Hose drain hose should also be assumed to be contaminated and should be sterilized with bleach before re-use.
Other Important Tips
When filling the tubs, make sure that the water is not so hot that it could melt the plastic parts!
Setting Up - Remember - Keep all those empty plastic bags for re-packing!
Obviously, as with any tub, it is essential not to use any electrical equipment near the filled tub so as to prevent electrocution.
The small plastic pitcher with handle is very nice for pouring water over the mom's back and shoulders if she likes, and for rinsing off her feet before she gets in the tub. (The small rectangular basin is to be used as a foot tub for this.) The small pitcher hangs very nicely over the side of the AquaDoula and can be used to hold drinking glasses or the midwife's Doppler.
The five-gallon water container can be filled with water and sunk in the tub to serve as a cushy seat.
The green net scooper can be used to remove debris from the tub.
Emptying the Tub
When you're done with the hoses, drain each as well as you can by starting at one end (keeping the hose end pointed up to prevent dripping out that end) and holding it high as you coil the hose. This allows water to drain out the other end. Once drained, please connect the ends of the hoses to prevent dripping.
This web page belongs to Ronnie Falcao, LM MS, homebirth midwife and hospital doula