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Chua JYX, Choolani M, Lalor JG, Chong YS, Shorey S. Insights of healthcare professionals regarding waterbirths and water immersion during labour: A mixed studies review. J Adv Nurs 2024; 80:2156-2166. [PMID: 37994222 DOI: 10.1111/jan.15975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/07/2023] [Indexed: 11/24/2023]
Abstract
AIM To consolidate healthcare professionals' insights about waterbirths and water immersion during labour. DESIGN Mixed studies review. DATA SOURCES Seven electronic databases were searched from their inception dates till June 2023: PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest Dissertations and Theses Global. METHODS The 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. RESULTS Three main themes were identified from the 22 included studies: (1) believing in waterbirths, (2) opposing forces and (3) plotting the course ahead. CONCLUSION Healthcare 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. IMPACT The 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 METHOD The PRISMA guidelines. NO PATIENT OR PUBLIC CONTRIBUTION Systematic review.
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Affiliation(s)
- Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | | | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Nori W, Kassim MAK, Helmi ZR, Pantazi AC, Brezeanu D, Brezeanu AM, Penciu RC, Serbanescu L. Non-Pharmacological Pain Management in Labor: A Systematic Review. J Clin Med 2023; 12:7203. [PMID: 38068274 PMCID: PMC10707619 DOI: 10.3390/jcm12237203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 04/22/2024] Open
Abstract
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.
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Affiliation(s)
- Wassan Nori
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Mustafa Ali Kassim Kassim
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Zeena Raad Helmi
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Alexandru Cosmin Pantazi
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Dragos Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Ana Maria Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Roxana Cleopatra Penciu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Lucian Serbanescu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
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Cooper M, Madeley AM, Burns E, Feeley C. Understanding the barriers and facilitators related to birthing pool use from organisational and multi-professional perspectives: a mixed-methods systematic review. Reprod Health 2023; 20:147. [PMID: 37794365 PMCID: PMC10548665 DOI: 10.1186/s12978-023-01690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/13/2023] [Indexed: 10/06/2023] Open
Abstract
AIMS To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives. DESIGN A systematic integrated mixed methods review was conducted. DATA SOURCES MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches. REVIEW METHODS Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes. RESULTS Thirty seven articles (29 studies) were included-quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It's your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia. CONCLUSION The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the "swing" within these factors directly affected whether birthing pool use was facilitated or inhibited.
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da Costa Silveira de Camargo J, Dos Santos Oliveira Gama F, Ochiai AM, Araújo NM, Pinheiro LR, Néné M, Grande MCLR. Spiritual Experiences of Portuguese Women Who had a Water Birth. JOURNAL OF RELIGION AND HEALTH 2023; 62:3267-3284. [PMID: 37193939 DOI: 10.1007/s10943-023-01826-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 05/18/2023]
Abstract
This study aimed to understand the significance of spirituality to Portuguese women who had a water birth. In-depth interviews, using a semi-structured questionnaire, were conducted with 24 women who experienced water birth at the hospital or home. Results were analyzed from a narrative interpretation perspective. Three spirituality-related categories emerged: (1) Beliefs and connections with the body; (2) Spirituality: integration of being a woman and transformation during birth; and (3) Spirituality as wisdom, intuition, or the sixth sense. Spirituality was perceived in women's faith and beliefs in a superior being that helped them manage the unpredictability and uncontrollability of giving birth.
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Affiliation(s)
- Joyce da Costa Silveira de Camargo
- Abel Salazar Institute of Sciences, Biomedical of the University of Porto, Porto, Portugal.
- Research and Study Group in Clinical Simulation and Obstetric Practices (GPESPO), School of Arts, Sciences and Humanities of University of Sao Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP, 03828-000, Brazil.
| | - Flávia Dos Santos Oliveira Gama
- Management of Historical and Cultural Heritage, Federal University of Minas Gerais, Belo Horizonte, Brazil
- School of Arts, Sciences and Humanities at the University of Sao Paulo, Rua Arlindo Béttio, 1000, Jardim Keralux, São Paulo, SP, 03828-000, Brazil
| | - Angela Megumi Ochiai
- Research and Study Group in Clinical Simulation and Obstetric Practices (GPESPO), School of Arts, Sciences and Humanities of University of Sao Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP, 03828-000, Brazil
- Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP, 03828-000, Brazil
| | - Natalucia Matos Araújo
- Research and Study Group in Clinical Simulation and Obstetric Practices (GPESPO), School of Arts, Sciences and Humanities of University of Sao Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP, 03828-000, Brazil
- Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP, 03828-000, Brazil
| | - Leonor Ramos Pinheiro
- Faculty of Public Health, University of Sao Paulo, Midwife at Casa Angela - Humanized Childbirth Center, Sao Paulo, SP, Brazil
| | - Manuela Néné
- School of Health of Portuguese Red Cross, Lisbon, Portugal
- CINTESIS - NursID - Innovation and Development in Nursing, Porto, Portugal
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Garcia LM, Vanderlaan J, Kamanga FC, Graham-Wood BA. Content Analysis of Water Birth Policies With Implications for Practice and Research. Nurs Womens Health 2023:S1751-4851(23)00128-9. [PMID: 37353209 DOI: 10.1016/j.nwh.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/17/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To identify areas of agreement and variation in clinical guidance documents (protocols, policies, or guidelines) that direct water birth care. DESIGN Qualitative descriptive. SETTING The clinical guidance documents studied covered water birth in home and hospital settings. SAMPLE The sample included 22 water birth guidance documents in English from six countries. The documents were obtained by request and resulting snowball sampling. MEASUREMENTS The framework method was adapted as an analytic tool, and a structured matrix output was used to organize and support the method of qualitative content analysis using a general inductive approach. Areas of general agreement and variations in practice guidelines for water birth were identified. RESULTS Criteria for a term, singleton, and cephalic presentation with reassuring maternal and fetal status were the most consistent for inclusion. The reliance on "low-risk" status was strongly present but without a uniform definition. A history of previous cesarean birth, body mass index, use of opioid pain medication, adequate labor progress, and vaginal bleeding were found to vary in directed care, and scarce supporting evidence was offered. Meconium-stained fluid variably excluded water birth in most documents, but this was not supported by evidence. The inconsistent findings from this study are cohesive in the evidence they provide for needed research in areas that affect access to water birth. The findings also provide nurses and birth providers with evidence-based guidelines for water birth care. CONCLUSION There was variation across guidance documents, demonstrating that water immersion is a flexible intervention that can be implemented in different settings and locations while following individual facility protocols for processes for care. An identified area of concern comes from examples of overly restrictive policies for water birth based on opinion or perceived risk rather than evidence from research.
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Cooper M, Warland J. The views and perceptions of water immersion for labor and birth from women who had birthed in Australia but had not used the option. Eur J Midwifery 2022; 6:54. [PMID: 35974712 PMCID: PMC9348581 DOI: 10.18332/ejm/150355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/07/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Megan Cooper
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Jane Warland
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Australia
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Ingram MA, Brady S, Peacock AS. The barriers to offering non-pharmacological pain management as an initial option for laboring women: A review of the literature. Eur J Midwifery 2022; 6:37. [PMID: 35794877 PMCID: PMC9186088 DOI: 10.18332/ejm/149244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Many women use pharmacological or non-pharmacological pain management (NPPM) during childbirth, however, evidence shows the usage rates of pharmacological pain management are increasing. The shift towards a biomedical approach to birth care opposes the enduring midwifery philosophy of trusting the woman and her body. Identifying midwives’ beliefs and attitudes towards perceived and actual barriers to offering NPPM as an initial option will provide insight into the factors that affect this. METHODS This review of the literature sought to understand midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Peer-reviewed journals were searched for primary research that met the inclusion criteria and explored midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Included studies were evaluated for quality according to the Critical Appraisal Skills Programme (CASP) checklists. RESULTS Thirteen qualitative studies met the inclusion criteria and four main themes of barriers to midwives offering NPPM emerged: health system-related, health facility-related, health practitioner-related, and health consumer-related barriers. CONCLUSIONS The review of the literature highlighted there are barriers that prevent or delay the initial utilization of non-pharmacological methods of pain management in labor by midwives. These findings can be used as a platform to inform further research into this topic.
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Affiliation(s)
- Matilda A. Ingram
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Susannah Brady
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ann S. Peacock
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
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The development of the W A + E R (water immersion agency plus expectations and relief) scale. Midwifery 2022; 109:103298. [DOI: 10.1016/j.midw.2022.103298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 02/08/2022] [Accepted: 02/27/2022] [Indexed: 11/18/2022]
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Milosevic S, Channon S, Hughes J, Hunter B, Nolan M, Milton R, Sanders J. Factors influencing water immersion during labour: qualitative case studies of six maternity units in the United Kingdom. BMC Pregnancy Childbirth 2020; 20:719. [PMID: 33228569 PMCID: PMC7682119 DOI: 10.1186/s12884-020-03416-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
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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Affiliation(s)
- Sarah Milosevic
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales, CF14 4YS.
| | - Susan Channon
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales, CF14 4YS
| | - Jacqueline Hughes
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales, CF14 4YS
| | - Billie Hunter
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House, 35-43 Newport Road, Cardiff, Wales, CF24 0AB
| | - Mary Nolan
- College of Health, Life and Environmental Sciences, University of Worcester, Henwick Grove, Worcester, England, WR2 6AJ
| | - Rebecca Milton
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales, CF14 4YS
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Heath Park Campus, Cardiff, Wales, CF14 4XN
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'They follow the wants and needs of an institution': Midwives' views of water immersion. Women Birth 2020; 34:e178-e187. [PMID: 32144024 DOI: 10.1016/j.wombi.2020.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND A midwife's ability to fully support women's autonomy and self-determination with respect to midwifery care is often challenging. This is particularly true of water immersion for labour and birth. However, the woman's agency over what happens to her body and that of her unborn baby should be key considerations for maternity care provision. OBJECTIVES A three phased mixed-methods study was undertaken to examine how water immersion policies and guidelines are informed. Phase three of this study captured the knowledge and experiences of Australian midwives, their support for water immersion and their experiences of using policies and guidelines to inform and facilitate the practice. METHODS Critical, post structural, interpretive interactionism was used to examine more than 300 responses to three open-ended questions included in a survey of 233 midwives. Comment data were analysed to provide further insight, context and meaning to previously reported results. FINDINGS Findings demonstrated a complex, multidimensional interplay of factors that impacted on both the midwife's ability to offer and the woman's decision to use water immersion under the themes 'the reality of the system', 'the authoritative 'others'' and 'the pseudo decision-makers'. Multiple scaffolded levels were identified, each influenced by the wider macro-socio-political landscape of Australian midwifery care. CONCLUSIONS The insight gained from examining midwives' views and opinions of water for labour and birth, has aided in contextualising previously reported results. Such insight highlights the importance of qualitative research in challenging the status quo and working towards woman-centred practice and policy.
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What are the benefits? Are they concerned? Women's experiences of water immersion for labor and birth. Midwifery 2019; 79:102541. [DOI: 10.1016/j.midw.2019.102541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/13/2019] [Accepted: 09/21/2019] [Indexed: 11/18/2022]
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Milosevic S, Channon S, Hunter B, Nolan M, Hughes J, Barlow C, Milton R, Sanders J. Factors influencing the use of birth pools in the United Kingdom: Perspectives of women, midwives and medical staff. Midwifery 2019; 79:102554. [PMID: 31610360 PMCID: PMC6894355 DOI: 10.1016/j.midw.2019.102554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 12/29/2022]
Abstract
Objective To identify factors influencing the use of birth pools. Design Online discussion groups and semi-structured interviews, analysed thematically. Setting United Kingdom. Participants 85 women and 21 midwives took part in online discussion groups; 14 medical staff participated in interviews. Findings Factors influencing the use of birth pools were grouped into three overarching categories: resources, unit culture and guidelines, and staff endorsement. Resources encompassed pool availability, efficiency of pool use and availability of waterproof cardiotocograph equipment. Unit culture and guidelines related to eligibility criteria for pool use, medicalisation of birth and differences between midwifery-led and obstetric-led care. Staff endorsement encompassed attitudes towards pool use. Key conclusions Accessibility of birth pools was often limited by eligibility criteria. While midwifery-led units were generally supportive of pool use, obstetric-led units were described as an over-medicalised environment in which pool use was restricted and relied on maternal request. Implications for practice Midwives can improve women's access to birth pools by providing information antenatally and proactively offering this as an option in labour. Maternity units should work to implement evidence-based guidelines on pool use, increase pool availability (even where there appears to be low demand), and enhance awareness amongst medical staff of the benefits of water immersion.
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Affiliation(s)
- Sarah Milosevic
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales CF14 4YS, United Kingdom.
| | - Sue Channon
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales CF14 4YS, United Kingdom.
| | - Billie Hunter
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House, 35-43 Newport Road, Cardiff, Wales CF24 0AB, United Kingdom.
| | - Mary Nolan
- College of Health, Life and Environmental Sciences, University of Worcester, Henwick Grove, Worcester, England WR2 6AJ, United Kingdom.
| | - Jacqueline Hughes
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales CF14 4YS, United Kingdom.
| | - Christian Barlow
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales CF14 4YS, United Kingdom.
| | - Rebecca Milton
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, Wales CF14 4YS, United Kingdom.
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Heath Park Campus, Cardiff, Wales CF14 4XN, United Kingdom.
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Cooper M, Warland J, McCutcheon H. Practitioner accreditation for the practice of water immersion during labour and birth: Results from a mixed methods study. Women Birth 2018; 32:255-262. [PMID: 30196039 DOI: 10.1016/j.wombi.2018.08.165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Water immersion for labour and birth is an option that is increasingly favoured by women. Australian water immersion policies and guidelines commonly specify that practitioners, such as midwives, must undertake further education and training to become accredited. METHOD A three-phase mixed methods approach was used. Phase one used critical discourse analysis to determine who or what informs policies and guidelines related to water immersion for labour and/or birth. Phase two examined policy and guideline informants' experiences of the development of policies/guidelines, whilst phase three surveyed Australian midwives' views and experiences of water immersion and their use of and/or involvement in the development of policies and guidelines. FINDINGS Practitioner accreditation for the facilitation of water immersion was a common finding across all phases of the study. An examination of policies and guidelines found that practitioners, namely midwives, were required to meet additional training requirements to facilitate water immersion. Participants of phases two and three identified and discussed accreditation as a significant challenge to the option of water immersion, particularly where there were inconsistencies across documents and in the interpretation of their content. CONCLUSION The need for practitioners to be accredited to facilitate water immersion was identified as a major barrier to availability and therefore, women's ability to access the option. Given these findings, the need for accreditation should be challenged.
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Affiliation(s)
- Megan Cooper
- School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia.
| | - Jane Warland
- School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia
| | - Helen McCutcheon
- School of Nursing and Midwifery, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia Campus, Brisbane, Queensland, Australia
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Lewis L, Hauck YL, Butt J, Western C, Overing H, Poletti C, Priest J, Hudd D, Thomson B. Midwives' experience of their education, knowledge and practice around immersion in water for labour or birth. BMC Pregnancy Childbirth 2018; 18:249. [PMID: 29921233 PMCID: PMC6008918 DOI: 10.1186/s12884-018-1823-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 05/14/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND There 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. METHODS This 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. RESULTS The 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. CONCLUSIONS This 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.
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Affiliation(s)
- Lucy Lewis
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102 Australia
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Yvonne L. Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102 Australia
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Janice Butt
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Chloe Western
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Helen Overing
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Corrinne Poletti
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Jessica Priest
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6008 Australia
| | - Dawn Hudd
- Family Birth Centre, Midwifery Group Practice and Community Midwifery Program, King Edward Memorial Hospital, Subiaco, 6008 Western Australia Australia
| | - Brooke Thomson
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102 Australia
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