‘They follow the wants and needs of an institution’: Midwives’ views of water immersion

Cooper, Megan; McCutcheon, Helen; Warland, Jane

doi:10.1016/j.wombi.2020.02.019

Cited by 9 publications

(43 citation statements)

References 17 publications

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“…While this may be due to the clinician determining that the woman is ineligible for water immersion, these results suggest that over 40% of those who were unaware of the option, would have considered using it if was offered to them. This aligns with previous research that suggests that women must actively seek the option rather than wait for it to be offered 15 , 25 . They also rated the benefits of water immersion relatively high, and concerns relatively low against all Likert scales.…”

Section: Discussionsupporting

confidence: 89%

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The views and perceptions of water immersion for labor and birth from women who had birthed in Australia but had not used the option

Cooper¹,

Warland²

2022

Eur J Midwifery

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INTRODUCTION Recent research highlights that women experience great benefits from immersing in warm water during labor and birth. While there has been an increase in research examining women’s experiences of using water, there has been little investigation of the views and perceptions of women who have not. The objective of this study was to examine the views and perceptions of water immersion from women who had birthed in Australia but had not used the option. METHODS An e-survey was distributed to women using purposive and snowball sampling methods between November 2016 and October 2017. Email, text, social media, and parenting forums maximized recruitment. A total of 395 women who had not used water immersion for labor or birth participated. RESULTS Three quarters of all women surveyed suggested that they would have considered using the option of water immersion if it was offered to them. Nearly 20% of all women did not know it was an option and, therefore, were only made aware of it as a result of completing this survey. Women indicated that they most often learned about water immersion from a midwife. When asked to rate the benefits and concerns, the majority held very little concern and generally agreed that water immersion would probably provide the associated benefits that are commonly cited in the literature. CONCLUSIONS Water immersion offers women many benefits although may not always be discussed antenatally. In light of these results, water immersion could be included in the discussions about labor and birth options antenatally and better supported during labor and birth.

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Section: Discussionsupporting

confidence: 89%

“…The finding that women were not always made aware of or offered the option supports anecdotal evidence that midwives and other healthcare providers are actively discouraged from offering the option of water immersion. This is now supported by research 25,26 . In Australia, women generally must actively seek out and request the option.…”

Section: Discussionmentioning

confidence: 73%

The views and perceptions of water immersion for labor and birth from women who had birthed in Australia but had not used the option

Cooper¹,

Warland²

2022

Eur J Midwifery

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“…Overall, 3898 records were obtained from the seven electronic databases and relevant citation searching. After the exclusion of 1288 duplicates and 2523 irrelevant titles/abstracts, 88 full texts were examined and 22 papers such as unpublished dissertations (n = 4) (Mercredi, 2020;Russell, 2016;Way, 2015;Woodward, 2012) and peer-reviewed journal articles (n = 18) (Al Moghrabi, 2023;Bolsoy et al, 2022;Cooper et al, 2018Cooper et al, , 2019Cooper et al, , 2021Kaur & Singh, 2019;Lewis, Hauck, Butt, et al, 2018;Meyer et al, 2010;Milosevic et al, 2019Milosevic et al, , 2020Newnham et al, 2015Newnham et al, , 2017Nicholls et al, 2016;Orrantia & Petrick, 2021;Plint & Davis, 2016;Russell et al, 2014;Stark & Miller, 2009;Ulfsdottir et al, 2020) were included in this review. Search outcomes are displayed using the PRISMA flow diagram (Figure 1).…”

Section: Search Outcomementioning

confidence: 99%

“…Most midwives, some nurses and a few physicians believed that waterbirths and water immersion practices were safe based on the currently available evidence (Cooper et al, 2019(Cooper et al, , 2021Milosevic et al, 2019;Orrantia & Petrick, 2021;Plint & Davis, 2016;Ulfsdottir et al, 2020;Woodward, 2012). Water immersion during labour was more accepted compared to waterbirths (Cooper et al, 2018(Cooper et al, , 2021Way, 2015). Midwives generally reported significantly greater support for waterbirths compared to physicians and nurses (Mercredi, 2020;Orrantia & Petrick, 2021;Plint & Davis, 2016;Ulfsdottir et al, 2020;Way, 2015).…”

Section: Identifying the Supportersmentioning

confidence: 99%

Insights of healthcare professionals regarding waterbirths and water immersion during labour: A mixed studies review

Chua,

Choolani,

Lalor

et al. 2023

Journal of Advanced Nursing

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AimTo consolidate healthcare professionals' insights about waterbirths and water immersion during labour.DesignMixed studies review.Data SourcesSeven electronic databases were searched from their inception dates till June 2023: PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest Dissertations and Theses Global.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines and Pluye and Hong's mixed studies review framework guided this review. The quality of included studies was evaluated using the Mixed Methods Appraisal Tool. Findings were synthesized using the convergent qualitative synthesis method, and results were thematically analysed using Braun and Clarke's framework.ResultsThree main themes were identified from the 22 included studies: (1) believing in waterbirths, (2) opposing forces and (3) plotting the course ahead.ConclusionHealthcare professionals reported different views about waterbirths and water immersion practices; midwives were most likely to support these practices, followed by nurses and lastly, few physicians supported them. Reasons for opposing waterbirths include insufficient training and support from colleagues as well as concerns about work efficiency, waterbirth safety and litigation issues.ImpactThe available evidence suggests the need to provide waterbirth training for healthcare professionals, equip healthcare facilities with necessary waterbirth‐related infrastructure and develop appropriate waterbirth policies/guidelines. Healthcare professionals could also consider providing antenatal waterbirth education to women and obtain women's feedback to improve current policies/guidelines. Future research should explore the views of different types of healthcare professionals from more diverse cultures.Reporting MethodThe PRISMA guidelines.No Patient or Public ContributionSystematic review.

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“…Midwives recognise that their midwifery practice and decision making is influenced within this setting by the dominant obstetric discourse and the surveillance of their practice (Davis & Homer, 2016). The obstetric dominance and scrutiny within the hospital setting limits midwives' ability to practice autonomously or to support women in their informed decision making (Aanensen et al, 2018;Cooper et al, 2020;Keating & Fleming, 2009). This is influenced, for midwives working within high tech birth settings, through the process of socialisation to the institutional birth culture of fear and risk management (Seibold et al, 2010).…”

Section: Risk and Pregnancymentioning

confidence: 99%

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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‘They follow the wants and needs of an institution’: Midwives’ views of water immersion

Cited by 9 publications

References 17 publications

The views and perceptions of water immersion for labor and birth from women who had birthed in Australia but had not used the option

The views and perceptions of water immersion for labor and birth from women who had birthed in Australia but had not used the option

Insights of healthcare professionals regarding waterbirths and water immersion during labour: A mixed studies review

Seeking safe harbour: Water immersion for women with complex pregnancy

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