Birthing Tub Manual

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!

  1. You should already have sterilized the parts that need sterilization, according to directions.
  2. Select the area where you want to set up the tub. Some things to consider are privacy, temperature, sturdiness of the floor, and the floor covering (carpet vs. non-carpet, such as tile or linoleum - non-carpet is usually colder, but waterproof, although that's not usually an issue if you use the tarp). If you're planning to give birth in the tub, it is important for the tub to be accessible from all sides - ideally, leave a space of 2-3 feet all around the tub. If you're planning to use the tub for labor only, it can be placed somewhere with more limited access.
  3. If you have selected an area that does not have a waterproof surface, lay down the large blue tarp. It's important to flatten it as much as possible so it doesn't make an annoying crinkly noise when walked upon. (You can skip the tarp on waterproof surfaces.)
  4. Lay down the 6' x 6' quilted underpad in the tub area.
  5. Lay down the large cloth sheet to absorb drips, dry off feet and prevent slipping.
  6. Assemble the tub according to directions specific to that kind of tub. Set the tub in place, centered on top of the underpad and sheet. Make sure you like the location before filling it.
  7. When the time comes to fill the tub, first make sure it hasn't accumulated any dirt or debris. If it has, you can wipe it clean; even if you're using a disposable liner, you don't want any gritty debris to wear a hole through the liner.
  8. The plumbing setup for filling the tub is relatively simple. Connect the small white adapter to the kitchen or bath faucet you'll be using; you probably need to remove the end part of the faucet first. (Alternatively, you may use the large, black rubber Y-connector at the washing machine plumbing to create a single faucet with the right size connectors.)
  9. Connect the small yellow or grey hard plastic Y-connector to the adapter on the faucet (or the Y-connector on the washing machine); this will allow you to flush cold water out of the plumbing system at the sink, easily test the water temperature and still have access to the water at that sink. Note that each branch of the Y-connector has its own valve, which can be opened or closed.
  10. Connect the clear fill hose to one side of the Y-connector. While both ends of the hose are still at the sink, run the water through to rinse any accumulated dust out of the hose and attachments and so you're not filling the tub with cold water.
  11. Adjust the water temperature to nicely WARM, about 100 degrees. Please do not let the temperature in the tub go above 110 degrees as this may damage the plastics.
  12. As the hot water starts to run out, you may need to turn down the cold water to drain the hot water out of the hot water heater. Once this water runs cooler than you want, turn it off and wait for the water heater to do its job. The AquaDoula's heating system is designed only to maintain the water temperature after the AquaDoula is filled to the desired temperature, although some temperature rise will occur with the cover on.
  13. If you fill the tub before you want to use it, you can use the clear plastic sheet w/pennies at the corners to cover the tub and retain the heat. Even though there is no heater for the inflated tub, the inflated sides and bottom and the trapped air pocket on top act as insulation so the water in the tub will stay quite hot for several hours as long as the tub is covered. You can also use this to cover the tub if you get out for a while.

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

  1. Turn off and unplug the AquaDoula Heater.
  2. Use the green fishnet scooper to remove large clumps that won't flow easily through the pump.
  3. a) Connect the short (10-foot) green plastic hose to the yellow Jacuzzi pump, and then connect the short green plastic hose to the long Roll-A-Hose. Put the submersible Jacuzzi pump into the water. Draining will go better if you don't completely block the bottom of the pump; you can just tilt it a little by resting it on its own cord.

  4. b) If you're using an inflatable tub kit without a pump, you can easily drain the tub by creating a siphon, as directed in the separate instructions.
  5. Plug in the Jacuzzi pump to start it or get a siphon going, and drain the tub into the toilet. (It usually works well just to anchor the end of the hose under the toilet seat.)
  6. As the tub is nearly completely drained, have an assistant hold the end of the hose under water while you lift the liner so all the water runs towards the pump or the end of the drain hose. You should be able to get almost all of the water out this way. There may be a few gallons left in the tub; it's relatively easy to sop this up with towels or haul the liner to a drain.
Coiling the Hoses

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