A systematic meta‐thematic synthesis to examine the views and experiences of women following water immersion during labour and waterbirth

Feeley, Claire; Cooper, Megan; Burns, Ethel

doi:10.1111/jan.14720

Cited by 15 publications

(16 citation statements)

References 34 publications

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“…The women in this research found that using water immersion in labour and for birth had a positive impact on their experience of birth. The findings of this research align with the existing literature regarding the effectiveness of water as a strategy for pain relief in labour (Carlsson & Ulfsdottir, 2020;Clews et al, 2019;Fair et al, 2020;Feeley et al, 2021;Gayiti et al, 2015;Maude & Foureur, 2007;Richmond, 2003;Ulfsdottir et al 2018). This research also supports the findings within the existing literature regarding the sanctuary and privacy which water immersion can provide for women during labour and birth (Clews et al, 2020;Fair et al, 2020;Maude & Foureur, 2007, Richmond, 2003Ulfsdottir et al, 2018, Ulfsdottir et al, 2019.…”

Section: Revision Of Research Aim and Findingssupporting

confidence: 86%

“…Women with low-risk pregnancies using water immersion in labour have reported that it provides significant pain relief both during and between contractions and supports feelings of relaxation and ease during labour and birth (Carlsson & Ulfsdottir, 2020;Fair et al, 2020;Feeley et al, 2021;Liu et al, 2014;Maude & Foureur, 2007;Richmond, 2003;Ulfsdottir et al, 2018). Further, water immersion in labour provides support and buoyancy which supports movement in labour (Fair et al, 2020;Feeley et al, 2021;Maude & Foureur, 2007, Richmond, 2003Ulfsdottir et al, 2018). In addition, the sense of privacy and protection provided by water immersion supported the women in feeling like they were not handing themselves over to the process of birth but rather remaining in a position to work with, control and manage their labour in the way they required (Clews et al, 2020;Fair et al, 2020;Feeley et al, 2021;Maude & Foureur, 2007, Richmond, 2003Ulfsdottir et al, 2018, Ulfsdottir et al, 2019.…”

Section: Experience Of Water Immersion For Women With a Low-risk Preg...mentioning

confidence: 97%

“…Water immersion has been associated with a positive birth experience and women have reported that it supports their feeling of being in control and in a position of power during their labour (Barry et al, 2020;Fair, et al, 2020;Feeley et al, 2021;Hall & Holloway, 1998;Lathrop et al, 2018;Nutter et al, 2014). Women with low-risk pregnancies using water immersion in labour have reported that it provides significant pain relief both during and between contractions and supports feelings of relaxation and ease during labour and birth (Carlsson & Ulfsdottir, 2020;Fair et al, 2020;Feeley et al, 2021;Liu et al, 2014;Maude & Foureur, 2007;Richmond, 2003;Ulfsdottir et al, 2018). Further, water immersion in labour provides support and buoyancy which supports movement in labour (Fair et al, 2020;Feeley et al, 2021;Maude & Foureur, 2007, Richmond, 2003Ulfsdottir et al, 2018).…”

Section: Experience Of Water Immersion For Women With a Low-risk Preg...mentioning

confidence: 99%

“…Further, water immersion in labour provides support and buoyancy which supports movement in labour (Fair et al, 2020;Feeley et al, 2021;Maude & Foureur, 2007, Richmond, 2003Ulfsdottir et al, 2018). In addition, the sense of privacy and protection provided by water immersion supported the women in feeling like they were not handing themselves over to the process of birth but rather remaining in a position to work with, control and manage their labour in the way they required (Clews et al, 2020;Fair et al, 2020;Feeley et al, 2021;Maude & Foureur, 2007, Richmond, 2003Ulfsdottir et al, 2018, Ulfsdottir et al, 2019. Women have also reported that water immersion helped them feel strong and able and that they were working with their body rather than against it during their labour and birth (Ulfsdottir, et al, 2018).…”

Section: Experience Of Water Immersion For Women With a Low-risk Preg...mentioning

confidence: 99%

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Seeking safe harbour: Water immersion for women with complex pregnancy

Kara¹

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Background: Water immersion is used by women, particularly within midwifery-led settings, as a strategy to manage the sensations of labour. Low-risk women who have used water immersion in labour express feelings of increased relaxation, support and control in their labour and birth experience. Being labelled ‘high risk’ can significantly impact both a woman’s experience of her pregnancy and her opportunity for experiencing a physiological birth. Women with complex pregnancies have reported an increase in anxiety and a feeling that their normal childbearing journey has been interrupted and subsumed by medical monitoring and risk management. Midwifery frameworks in Aotearoa New Zealand protect and promote the woman’s role as a decision maker within her experience and her right to make informed decisions about her care. Aims: The aim of this research was to develop an understanding of the influences, facilitators and barriers for women who chose to use water immersion for labour and birth, in a hospital setting, when they were labelled/identified as being clinically complex, as well as to explore their experience of using water immersion in labour. Methods: A qualitative descriptive inquiry, using semi-structured interviews was undertaken to explore seven women's experiences of using water immersion during their labour and/or birth after having a complex pregnancy. Inductive thematic analysis was used to analyse participant data. Findings: Thematic analysis identified four themes within the women’s experiences. Women use water immersion to resist the medicalisation of their birthing experience and protect themselves from the iatrogenic risks of birthing within a hospital setting. The desire to use water immersion is often driven by dissatisfaction with previous medicalised experiences of birth and the women’s desire to avoid repeating these experiences. Water provides a safe and protected space to labour which supports a sense of control and privacy. The LMC midwife is a vital ally and advocate in negotiating to use water immersion within the hospital setting. In this environment, staff can either facilitate or be barriers to using water immersion in labour with a complex pregnancy. Conclusions: Women use water immersion in labour to optimise their opportunity for physiological birthing, often in response to previous medicalised births. Water immersion is experienced positively as a strategy to manage labour. Individualised holistic midwifery care from a Lead Maternity Care midwife was valued by the women and viewed as a key support in negotiating for the choice of water immersion. Women needed to purposefully seek a midwife who was willing to support them in their choice to use water immersion.

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Section: Revision Of Research Aim and Findingssupporting

confidence: 86%

Section: Experience Of Water Immersion For Women With a Low-risk Preg...mentioning

confidence: 97%

Section: Experience Of Water Immersion For Women With a Low-risk Preg...mentioning

confidence: 99%

Section: Experience Of Water Immersion For Women With a Low-risk Preg...mentioning

confidence: 99%

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Seeking safe harbour: Water immersion for women with complex pregnancy

Kara¹

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“…The use of water immersion during labor and birth has been widely purported to support physiologic birth 6–11 . Laboring in water has been shown to provide a woman‐centered, low‐tech experience, 7–12 optimize physiology and relaxation, reduce pain, and increase maternal satisfaction with the birth experience 6,12–15 . Furthermore, studies demonstrate high levels of spontaneous vaginal birth, 10,12 and physiologic birth, 6,12 for healthy pregnant women, particularly in midwifery‐led settings.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Normal Physiologic Birth for Women Who Labor In Water: A Secondary Analysis of A Prospective Observational Study

Carpenter

Burns

Smith

2022

J Midwife Womens Health

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Introduction:Research to understand factors associated with normal physiologic birth (unassisted vaginal birth, spontaneous labor onset without epidural analgesia, spinal, or general anesthetic, without episiotomy) is required. Laboring and/or giving birth in water has been shown to be associated with a high proportion of physiologic birth but with little understanding of factors that may influence this outcome. This study explored factors associated with normal physiologic birth for women who labored in water. Methods:We conducted a secondary analysis of a UK-based prospective observational study of 8064 women at low risk of childbirth complications who labored in water. Consecutive women were recruited from birth settings in England, Scotland, and Northern Ireland. Planned place of birth, maternal characteristics, intrapartum events, and maternal and neonatal outcomes were measured. Univariable and multivariable logistic regression modelling explored factors associated with normal physiologic birth. Results:In total, 5758 (71.4%) of women who labored in water had a normal physiologic birth. Planned birth in the community (adjusted odds ratio [aOR], 2.58; 95% CI, 2.22-2.99) or at an alongside midwifery unit (aOR, 1.21; 95% CI, 1.04-1.41) was positively associated with normal physiologic birth compared with planned birth in an obstetric unit. Duration of second stage (aOR, 0.66; 95% CI, 0.62-0.70), duration in the pool [aOR, 0.93; 95% CI, 0.90-0.96), and birth weight of the neonate (aOR, 0.74; 95% CI, 0.65-0.85) were negatively associated with normal physiologic birth. Parity was not associated with normal physiologic birth in multivariate analyses.Discussion: Our findings largely reflected wider research, both in and out of water. We found midwifery-led birth settings may increase the likelihood of normal physiologic birth among healthy women who labor in water, irrespective of parity. This association supports growing evidence demonstrating the importance of planned place of birth on reducing intervention rates and adds to research on labor and birth in water.

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