Exploring midwives’ perception of confidence around facilitating water birth in Western Australia: A qualitative descriptive study

Nicholls, Sarah; Hauck, Yvonne; Bayes, Sara; Butt, Janice

doi:10.1016/j.midw.2015.10.010

Cited by 28 publications

(53 citation statements)

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“…Although tools have been developed to help improve midwives' abilities to estimate blood loss following childbirth on land, an increasing number of women in several countries are now choosing to give birth in water (Burns et al, 2012, Henderson et al, 2014, Kavosi et al, 2015, Menakaya et al, 2013, Mollamahmutoğlu et al, 2012, Nicholls et al, 2015, Ministry of Health. New Zealand, 2018.…”

Section: Introductionmentioning

confidence: 99%

Developing and evaluating an online learning tool to improve midwives’ accuracy of visual estimation of blood loss during waterbirth: An experimental study

et al. 2019

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Objective: the principal objective was to test the effectiveness of an online learning tool to improve midwives' accuracy of blood loss estimations in a birthing pool environment. The secondary objective was to assess the acceptability of the online learning tool to the midwives using it. Design: a one group pre-test post-test experiment with immediate and six weeks follow-up to test ability together with an online questionnaire to assess perceived usefulness of an online learning tool. Setting: a large NHS maternity hospital comprising an acute care obstetric unit, a small district unit labour ward, one alongside midwifery-led unit and three freestanding midwifery-led units. Participants: volunteer NHS employed midwives who had experience in caring for women labouring and giving birth in water (n=24). Intervention: an online learning tool comprising six randomly ordered short video simulations of blood loss in a birthing pool in real time, and a tutorial giving verbal and pictorial guidance on making accurate blood loss estimations in water was developed then piloted. Midwives' accuracy scores for estimating blood loss in each of the videos were calculated at three timepoints; pre and immediately post the learning component, and six weeks later. The estimated blood loss volume was subtracted from the actual blood loss volume, to give the difference between estimated and real blood loss in millilitres(ml) which was then converted to percentage difference to standardise comparison across the six volumes. The differences between pre-and post-learning for each of the six blood volumes was analysed using a repeated measures ANOVA. Statistical significance was set at p<0.05. An online questionnaire incorporated questions using Likert scales to gauge confidence and competence and free text. Free text responses were analysed using a modified form of inductive content analysis. Findings: 22 midwives completed the online learning and immediate post-test, 14 completed a post-test after six weeks, and 15 responded to the online questionnaire. Pre-test results showed underestimation of all blood loss volumes and particularly for the two largest volumes (1,000 and 1,100 ml). Across all volumes, accuracy of estimation was significantly improved at posttest 1. Accuracy diminished slightly, but overall improvement remained, at post-test 2. Participants rated the online tool positively and made suggestions for refining it. Key conclusions and implications for practice: This is the first study measuring the accuracy of midwives' blood loss estimations in a birthing pool using real-time simulations and testing the effectiveness of an online learning tool to improve this important skill. Our findings indicate a need to develop interventions to improve midwives' accuracy at visually estimating blood loss in water, and the potential of an online approach. Most women who labour and/or give birth in water do so in midwifery-led settings without immediate access to medical support. Accuracy in blood loss estimations is an essential core ...

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Section: Introductionmentioning

confidence: 99%

Developing and evaluating an online learning tool to improve midwives’ accuracy of visual estimation of blood loss during waterbirth: An experimental study

et al. 2019

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“…Actualmente este método tiene su máxima expansión y adhesión en el Reino Unido, país pionero en emplear esta técnica, dónde más del 95% de los servicios de maternidad poseen una bañera a disposición de las gestantes que lo deseen (Burns et al, 2012). No obstante, la situación en los demás países desarrollados está en continuo crecimiento desde las últimas décadas, debido a la creciente demanda de las gestantes para tener un parto lo más fisiológico posible (Nicholls S et al 2016).…”

Section: Royal College Of Midwifes Y El United Kingdom Central Counciunclassified

Beneficios de la hidroterapia en el trabajo de parto. Estudio de revisión.

Benavides-Navarro¹

2020

Musas

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Introduction The growing demand of pregnant women to achieve a delivery as physiological as possible has led to a decrease in interventional techniques and consequently a rise in the search for alternative techniques for the relief of pain during labor, among which we can highlight hydrotherapy. Objectives To describe the effectiveness of the use of hydrotherapy in relation to the perception of pain during labor. Methodology Bibliographic review using the databases PubMed, Cuiden, Cuidatge, Cochrane Library and CINHAL. Results A total of 17 articles have been included: 13 original articles and 4 bibliographic reviews. In addition to this, the Clinical Practice Guideline on Normal Birth Care has been used. The articles refer to the maternal and perinatal results of the use of hydrotherapy in the dilatation phase and the expulsive phase, as well as the perceptions of midwives, nurses and pregnant women of its use. Conclusions The use of the hydrotherapy during the dilation phase of labor decreases the perception of pain and the use of pharmacological measures. However, the safety and efficacy of immersion in water in the expulsive phase have not been established and no benefits have been associated for the mother or the foetus.

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“…The concept of competence is often aligned with confidence [ 3 ], but distinguishing between these two concepts is important as they are not always synonymous. A midwife may be a competent waterbirth practitioner having met all the professional competency requirements, but becoming confident is an individual journey that is dependent upon trust in clinical guidelines, presence of peer support and the challenge of achieving consistent exposure to waterbirth [ 4 ]. Additionally, midwives with extensive experience of conventional birth on land may be challenged to unlearn old skills and develop new practices required for water immersion in labour and birth.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, midwives with extensive experience of conventional birth on land may be challenged to unlearn old skills and develop new practices required for water immersion in labour and birth. Whilst midwives working within low risk continuity of care models where physiological birth was the norm, researchers concluded that a supportive culture assisted in the development of their confidence, irrespective of clinical experience [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In this situation, mentors may not always be the most senior midwives who have extensive experience with conventional birth on land. Caution is recommended to recognise and consider ways to minimise the possible hierarchical tensions that may occur when experienced midwives are mentored by junior midwives who have achieved waterbirth competency [ 4 ]. Indeed, promoting and sustaining change in midwives’ waterbirth practice can be challenging.…”

Section: Introductionmentioning

confidence: 99%

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Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth

Lewis

Hauck

Butt

et al. 2018

BMC Pregnancy Childbirth

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BackgroundThere is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic.MethodsThis mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia. Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire. Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth. Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts.ResultsThe majority (85%; 29 of 34) of midwives surveyed returned a questionnaire. Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven. Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth. Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance.Phase two included two focus groups of seven and five midwives. Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth.ConclusionsThis research contributes to the growing knowledge base examining midwives' education, knowledge and practice around immersion in water for labour or birth. It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are integral to sustaining waterbirth as an option for low risk women.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1823-0) contains supplementary material, which is available to authorized users.

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Exploring midwives’ perception of confidence around facilitating water birth in Western Australia: A qualitative descriptive study

Cited by 28 publications

References 12 publications

Developing and evaluating an online learning tool to improve midwives’ accuracy of visual estimation of blood loss during waterbirth: An experimental study

Developing and evaluating an online learning tool to improve midwives’ accuracy of visual estimation of blood loss during waterbirth: An experimental study

Beneficios de la hidroterapia en el trabajo de parto. Estudio de revisión.

Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth

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