Water immersion policies and guidelines: How are they informed?

Cooper, Megan; McCutcheon, Helen; Warland, Jane

doi:10.1016/j.wombi.2018.08.169

Cited by 10 publications

(40 citation statements)

References 31 publications

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“…Women should have the ability to exercise choice and autonomy with respect to childbearing, particularly where a woman’s decision making appears to be limited to those options that are viewed as safe and appropriate 10 - 13 , 15 . Water immersion as an option, seems to fall outside of what is deemed safe and necessary 17 , 28 .…”

Section: Discussionmentioning

confidence: 99%

“…Women had to seek water immersion rather than it being offered as part of routine discussions about labor and birth. Some policies and guidelines explicitly stated that water immersion was not to be promoted or encouraged 13 . This was further compounded by the inaccessibility to an appropriately trained clinician and/or suitable bath or pool 14 .…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…Building on previous studies [ 36 – 38 ], the effect of the birth room environment on pool use could be investigated. In addition, while water immersion guidelines themselves have been extensively examined [ 21 , 22 , 44 , 45 ], further exploration of their implementation in practice is needed.…”

Section: Discussionmentioning

confidence: 99%

“…Insufficient knowledge and education is a key issue: for example, pool use for labour and birth is commonly not included in Australian midwifery training [ 21 ]; in a Swedish survey of healthcare professionals, 26% of midwives and 38% of obstetricians/gynaecologists reported no knowledge of how to assist a waterbirth [ 20 ]. Research examining Australian water immersion policies and guidelines has found them to be restrictive and unsupportive [ 22 ], often mandating that midwives meet accreditation requirements (such as additional training) before being allowed to facilitate pool use [ 23 ]. Further barriers to water immersion include inadequate staffing levels [ 18 , 19 ], poor information provision antenatally [ 24 ] and stigma from women’s family and friends (e.g.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing water immersion during labour: qualitative case studies of six maternity units in the United Kingdom

Milosevic

Channon

Hughes

et al. 2020

BMC Pregnancy Childbirth

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Background Water immersion during labour can provide benefits including reduced need for regional analgesia and a shorter labour. However, in the United Kingdom a minority of women use a pool for labour or birth, with pool use particularly uncommon in obstetric-led settings. Maternity unit culture has been identified as an important influence on pool use, but this and other possible factors have not been explored in-depth. Therefore, the aim of this study was to identify factors influencing pool use through qualitative case studies of three obstetric units and three midwifery units in the UK. Methods Case study units with a range of waterbirth rates and representing geographically diverse locations were selected. Data collection methods comprised semi-structured interviews, collation of service documentation and public-facing information, and observations of the unit environment. There were 111 interview participants, purposively sampled to include midwives, postnatal women, obstetricians, neonatologists, midwifery support workers and doulas. A framework approach was used to analyse all case study data. Results Obstetric unit culture was a key factor restricting pool use. We found substantial differences between obstetric and midwifery units in terms of equipment and resources, staff attitudes and confidence, senior staff support and women’s awareness of water immersion. Generic factors influencing use of pools across all units included limited access to waterbirth training, sociodemographic differences in desire for pool use and issues using waterproof fetal monitoring equipment. Conclusions Case study findings provide new insights into the influence of maternity unit culture on waterbirth rates. Access to pool use could be improved through midwives based in obstetric units having more experience of waterbirth, providing obstetricians and neonatologists with information on the practicalities of pool use and improving accessibility of antenatal information. In terms of resources, recommendations include increasing pool provision, ensuring birth room allocation maximises the use of unit resources, and providing pool room environments that are acceptable to midwives.

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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%

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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Water immersion policies and guidelines: How are they informed?

Cited by 10 publications

References 31 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

Factors influencing water immersion during labour: qualitative case studies of six maternity units in the United Kingdom

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

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