Bringing a child into the world is forever a special experience. However, giving birth is not without stress for many expectant mothers. The licensed midwives of Tourmaline Birth and Wellness Collective in San Diego’s Pacific Beach community are medical providers trained in supporting women prenatally, during birth and postpartum. They are licensed by the Medical Board of California and carry all the tools and medications to keep birthing people safe, while treating the whole body to allow families to thrive.
In addition to the standard tools maternity providers have, midwives have one very unique tool: Lots and lots of water! Tourmaline midwives use warm water to fill their birth tubs and provide gentle relief during labor.
“We have two, 100-gallon birthing tubs in our center,” explains Allison Tartari LM, CPM, one of the founders of Tourmaline, along with Maral Shabak LM, CPM, and Josie Petrich LM, CPM.
“The moms are in and out of these tubs multiple times during the birth experience,” Petrich adds. “This is why one of our first construction concerns was finding a water heater that could provide this high volume of hot water continuously, and at a consistently correct and comfortable temperature.”
Serendipity worked its magic and connected Tartari and her partner-co-owners with Erik Arnett, owner of Arnett’s Water Systems, a San Diego plumbing contractor who has successfully specialized in tankless water heater conversions and installations for 20 years. Initial conversations with Tartari centered on large, storage-tank-type water heaters, which led Arnett to explain the limitations of that conventional technology, especially for Tourmaline’s specialized application:
- With a tank water heater, the center would likely run out of warm water in the middle of a birth, and Tourmaline would be helpless to do anything about it in the short term: “The recovery time on a storage-tank water heater like that is hours once they are emptied,” says Arnett. “The baby won’t wait for you to fill one of those tubs with hot water;”
- Storage-tank-type heaters are less efficient than tankless technology, especially a condensing unit. This was an important economic consideration, since Tourmaline is a 501(c)(3) non-profit;
- The size of a conventional tank water heater was also a problem, given its location on the second level of the center. There simply wasn’t room for the amount of hot-water storage that would be required — even if Tartari and colleagues could persuade themselves that a tank unit could meet their needs; and
- Finally, in another critical economic concern, a conventional storage-tank unit would simply cost more than a properly sized tankless water heater. Arnett estimates that Tourmaline would’ve had to purchase a 100-gallon, commercial-grade water heater.
Warm water equals critical difference
All these factors made the decision to switch gears to a tankless heater much easier. “We’re not like a hospital,” Tartari says. “We don’t use medicine for pain relief. Water is our biggest coping mechanism in the birth setting, and it really makes a critical difference. One mom was recently in the bathtub for hours, and I used a hand-held shower on her back the entire time to assist with providing relief and minimizing discomfort.”
This is why one of Tourmaline’s first construction concerns was finding a water heater that could provide this level of hot water continuously.
“Working with Thrive Wellness Collective [a non-profit that supports the goals of Tourmaline], we invested our time and our funds to create the perfect space for our clients,” Tatari explains. “Our requirements were unique and potentially expensive: Lots of clean water, an endless supply of hot water and good water pressure. All that doesn’t come cheap.”
Once convinced of the technological and performance benefits of a tankless heater from Arnett, the question came down to specifications and cost. Arnett recommended that Tartari contact his preferred brand for tankless water heaters, Noritz America. After a needs-based conversation with a technical expert, not only did Tourmaline get the right model recommendation from Arnett — an EZ111, a high-efficiency (0.96 UEF), condensing unit with a capacity range of up to 11 gallons of hot water per minute — but the product and components were fully donated by the manufacturer.
Noritz’s EZ Series, which offers a warranty of 25 years on the heat exchanger, is designed differently than most tankless water heaters. The hot- and cold- water connections are located on top of the unit, not the bottom. This positioning in a tank-to-tankless conversion allows the flexible water lines used by the previous storage tank heater to be quickly and easily reconnected to the new unit, saving time and money on the installation.
Consequently, in replacing the conventional, 50-gallon water heater at Tourmaline, Arnett was able to use the existing water supply lines, as well as the venting and gas-line connections, helping to speed the tank-to-tankless switch.
“Many years ago, when I first began working with tankless, I casually suggested to the local rep that Noritz consider redesigning their water heaters, so that the water connections are on the top just like tank heaters to help on retrofit applications,” recalls Arnett. “Lo and behold, that’s exactly what they did several years ago!”
Arnett says top-mounted connections look nicer from an aesthetic standpoint, and the unit is mechanically easier to install because there’s no need to build extra plumbing. The total installation time at Tourmaline was about three hours, half of which was devoted to the cumbersome task of removing the old tank unit.
“We have done so many conversions over the years, we can usually knock them out in a couple of hours,” Arnett notes.
Because of the coronavirus pandemic, Tourmaline Birth and Wellness had to delay its startup by several months. Now that it has opened, demand for its special support services has remained consistently strong.
“Due to the shelter-in-place orders, we didn’t get our big grand opening when we wanted it earlier this year,” Shabak reports. “But we’ve had no issues with our new tankless water heater — truly one of the only aspects of the opening I can say that about. It’s really a blessing for us and, even more so, for the moms in our care.”