Bring back the bed bath?

Giving a bed bath to women as they recover from birth has not been a common feature of my practice as a home birth midwife. I know from hospital-based colleagues that, these days, bed baths aren’t the norm for women who have vaginal births in most units either, although they seem to be more common where women have had a caesarean section. If I am honest, I always tended to think of bed baths as things that were offered to bed-bound sick people rather than to well women who are recovering from normal birth. Like many of my colleagues, I aim to enable women to be able to wash themselves in the bathroom – perhaps with the help of their partner – after their birth.

But I changed my mind somewhat after I attended one particular woman – let’s call her Kim – who had a home birth with her first baby. (This was a good few years ago now, but i have re-posted this article because I think it is fascinating to consider how things change, and sometimes don’t change.) A combination of abysmal weather and a quick labour meant I did not have another midwife with me, although I did have the help of Kim’s partner, mum and auntie. Happily, everything went very well; Kim gave birth to a healthy baby boy after a fast and furious labour, she moved from her bedroom to birth his placenta on the toilet and then flopped back onto her bed, clearly feeling very tired from all her efforts!

Like most women, Kim wanted to get clean as soon as possible afterwards, yet I found myself feeling slightly uncomfortable with the idea of her getting in the bath. Her blood loss during the third stage had been towards the high end of normal and I wanted to keep a close eye on her for a bit longer. Kim is also both very tall and rubenesque, and I knew she had struggled to get in and out of the bath in late pregnancy. I realised that, although there was no single ‘problem’ as such, the combination of these factors and the lack of another midwife were leading to my slight unease about having Kim get in the bath.

After some thought, I asked Kim how she felt about the idea of having a bed bath instead. She was more concerned about the end point of being clean than about how she reached this state, and said that was fine with her. Kim’s mum, Maggie, asked if she could give Kim the bed bath while I got on with other things, and I gladly accepted her offer of help.

As I completed my paperwork nearby, it was lovely to hear the women together as Maggie washed her daughter in the bed where she had just birthed her baby. They talked to each other, and to the baby beside them, and they laughed as Maggie used phrases that she used when Kim was a child to get her to lift her arms, while talking about how Kim would soon be doing this with her own child. Later that evening, we left Kim and her family snuggled in the clean bed that Maggie and I had made and, to this day, she looks upon her experience with fondness.

When I got home, I called a midwife friend to tell her the birth story, and I confessed that I had felt a little guilty that I had effectively denied this woman the chance to have a soak in the bath, but also told her how lovely I felt it was that Kim, Maggie and the baby had connected in this way. My midwife friend laughed; she had (at the time) been a midwife for at least twice as long as I have, and remembers the days when bed baths were the norm. Her reminiscences about what used to happen on the community reminded me of a lovely community midwife I worked with as a student, who always gave women bed baths after their births at home or in the local GP unit. She would invite them to lay back, let her worry about where their arms and legs needed to go, and tell them that she would pamper them as their reward for giving birth to their baby. In fact, I found out later that this had been Maggie’s experience after her own births. Yet, perhaps in part because of the time pressures which many midwives are now under, it no longer seems to be a common occurrence.

I have since discovered other midwives who are revisiting the idea of the post-birth bed bath as a great way of caring for women and an opportunity to combine an act of nurturing with talking to the woman about what she can expect from her body in the first few postnatal days. Since this experience, I am also now thinking that perhaps it is important to offer women not only the choice of having a soak in the bath or a wash in the shower ‘under their own steam’, but also the option of lying back and being pampered?