Abstract:There is a paucity of high level evidence to guide practice in the area of waterbirth. It is unlikely that randomized controlled trials on waterbirth will be acceptable to childbearing women or maternity caregivers. Observational studies are a more appropriate choice for researchers in this field as they offer a more practical and ethical approach.
“…According to literature, waterbirth is safe for women with healthy pregnancies and low‐risk births (Davies et al, 2015; Nutter et al, 2014; Taylor et al, 2016; Ulfsdottir, Saltvedt, & Georgsson, 2018; Vanderlaan et al, 2018) and should thus be presented as an alternative for pregnant women who consider ways to give birth. Our findings illustrate that while women appreciate the opportunity to give birth in water, a positive birthing experience can be hampered if the equipment is unsuitable.…”
Section: Discussionmentioning
confidence: 99%
“…Our findings illustrate that waterbirth involves various benefits that women who choose this way to give birth highly appreciate and indicate that it is a suitable and a valued alternative for eligible women. According to literature, waterbirth is safe for women with healthy pregnancies and low-risk births (Davies et al, 2015;Nutter et al, 2014;Taylor et al, 2016;Vanderlaan et al, 2018) and should thus be presented as an alternative for pregnant women who consider ways to give birth. Our findings illustrate that while women appreciate the opportunity to give birth in water, a positive birthing experience can be hampered if the equipment is unsuitable.…”
Section: Discussionmentioning
confidence: 99%
“…Research has not identified any increase in maternal mortality or morbidity for women who give birth in water with healthy full‐term pregnancies and low‐risk births in cephalic presentation (Nutter, Meyer, Shaw‐Battista, & Marowitz, 2014; Ulfsdottir, Saltvedt, & Georgsson, 2018). No differences has been observed in low risk births between children born in and out of water with regard to neonatal outcomes, including Apgar scores, postnatal infections, umbilical cord samples, and admissions to neonatal intensive care (Davies, Davis, Pearce, & Wong, 2015; Taylor et al, 2016; Vanderlaan, Hall, & Lewitt, 2018), indicating that waterbirth is a safe alternative for many women.…”
Aims
To explore retrospective descriptions about benefits, negative experiences and preparatory information related to waterbirths.
Design
A qualitative study.
Methods
Women who gave birth in water with healthy pregnancies and low‐risk births were consecutively recruited between December 2015–October 2018 from two birthing units in Sweden. All who gave birth in water during the recruitment period were included (N = 155) and 111 responded to the survey. Women were emailed a web‐based survey six weeks postpartum. Open‐ended questions were analysed with qualitative content analysis.
Results
Two themes were identified related to benefits: (a) physical benefits: the water eases labour progression while offering buoyancy and pain relief; and (b) psychological benefits: improved relaxation and control in a demedicalized and safe setting. Two themes were identified related to negative experiences: (a) equipment‐related issues due to the construction of the tub and issues related to being immersed in water; and (b) fears and worries related to waterbirth. In regard to preparatory information, respondents reported a lack of general and specific information related to waterbirths, even after they contacted birthing units to ask questions. Supplemental web‐based information was sought, but the trustworthiness of these sources was questioned and a need for trustworthy web‐based information was articulated.
Conclusion
Women who give birth in water experience physical and psychological benefits, but need better equipment and sufficient information. There is room for improvement with regard to prenatal and intrapartum care of women who give birth in water.
Impact
Judging from women's recounts, midwives and nurses should continue advocating waterbirth in low‐risk pregnancies. The lack of adequate equipment in Swedish birthing units articulated by women challenge current routines and resources. The findings illustrate unfulfilled needs for preparatory information about waterbirth, further strengthening that midwives should discuss the possibility of waterbirth when meeting expectant parents in the antenatal setting.
“…According to literature, waterbirth is safe for women with healthy pregnancies and low‐risk births (Davies et al, 2015; Nutter et al, 2014; Taylor et al, 2016; Ulfsdottir, Saltvedt, & Georgsson, 2018; Vanderlaan et al, 2018) and should thus be presented as an alternative for pregnant women who consider ways to give birth. Our findings illustrate that while women appreciate the opportunity to give birth in water, a positive birthing experience can be hampered if the equipment is unsuitable.…”
Section: Discussionmentioning
confidence: 99%
“…Our findings illustrate that waterbirth involves various benefits that women who choose this way to give birth highly appreciate and indicate that it is a suitable and a valued alternative for eligible women. According to literature, waterbirth is safe for women with healthy pregnancies and low-risk births (Davies et al, 2015;Nutter et al, 2014;Taylor et al, 2016;Vanderlaan et al, 2018) and should thus be presented as an alternative for pregnant women who consider ways to give birth. Our findings illustrate that while women appreciate the opportunity to give birth in water, a positive birthing experience can be hampered if the equipment is unsuitable.…”
Section: Discussionmentioning
confidence: 99%
“…Research has not identified any increase in maternal mortality or morbidity for women who give birth in water with healthy full‐term pregnancies and low‐risk births in cephalic presentation (Nutter, Meyer, Shaw‐Battista, & Marowitz, 2014; Ulfsdottir, Saltvedt, & Georgsson, 2018). No differences has been observed in low risk births between children born in and out of water with regard to neonatal outcomes, including Apgar scores, postnatal infections, umbilical cord samples, and admissions to neonatal intensive care (Davies, Davis, Pearce, & Wong, 2015; Taylor et al, 2016; Vanderlaan, Hall, & Lewitt, 2018), indicating that waterbirth is a safe alternative for many women.…”
Aims
To explore retrospective descriptions about benefits, negative experiences and preparatory information related to waterbirths.
Design
A qualitative study.
Methods
Women who gave birth in water with healthy pregnancies and low‐risk births were consecutively recruited between December 2015–October 2018 from two birthing units in Sweden. All who gave birth in water during the recruitment period were included (N = 155) and 111 responded to the survey. Women were emailed a web‐based survey six weeks postpartum. Open‐ended questions were analysed with qualitative content analysis.
Results
Two themes were identified related to benefits: (a) physical benefits: the water eases labour progression while offering buoyancy and pain relief; and (b) psychological benefits: improved relaxation and control in a demedicalized and safe setting. Two themes were identified related to negative experiences: (a) equipment‐related issues due to the construction of the tub and issues related to being immersed in water; and (b) fears and worries related to waterbirth. In regard to preparatory information, respondents reported a lack of general and specific information related to waterbirths, even after they contacted birthing units to ask questions. Supplemental web‐based information was sought, but the trustworthiness of these sources was questioned and a need for trustworthy web‐based information was articulated.
Conclusion
Women who give birth in water experience physical and psychological benefits, but need better equipment and sufficient information. There is room for improvement with regard to prenatal and intrapartum care of women who give birth in water.
Impact
Judging from women's recounts, midwives and nurses should continue advocating waterbirth in low‐risk pregnancies. The lack of adequate equipment in Swedish birthing units articulated by women challenge current routines and resources. The findings illustrate unfulfilled needs for preparatory information about waterbirth, further strengthening that midwives should discuss the possibility of waterbirth when meeting expectant parents in the antenatal setting.
“…Only one recent systematic review specifically addressed neonatal outcomes 51. The present study covers a longer time interval and contains a larger number of studies.…”
This systematic review and meta-analysis did not identify definitive evidence that waterbirth causes harm to neonates compared with land birth. However, there is currently insufficient evidence to conclude that there are no additional risks or benefits for neonates when comparing waterbirth and conventional delivery on land.
“…The safety of the newborn is disputed , although differences in Apgar scores, infections or other neonatal complications have not been reported in studies comparing waterbirths with other low‐risk births . However, case reports with an adverse outcome for the newborn following waterbirth have been presented .…”
In this low-risk population, waterbirth is associated with positive effects on perineal tears, the frequency of interventions, the duration of labor and women's birth experience. Midwives handling waterbirth should be aware of the risk of umbilical cord avulsion.
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