The Use of Water During Labour and Birth
June 2005
The Australian College of Midwives supports immersion of women in water
during labour as a method of relaxation and pain management. There is no
evidence that remaining in the water for the birth of the baby leads to adverse
outcomes for the mother or baby where the pregnancy and labour have been within
normal parameters. Every maternity service should have evidence based policies
and guidelines on the use of water in labour and birth.
Water birth means
when the baby is born underwater.
Evidence articulates that water
immersion during the first stage of labour significantly reduces epidural/spinal
analgesia requirements and women’s perception of pain, without adversely
affecting duration of labour, operative birth rates, or neonatal wellbeing.
Additionally immersion in water during the second stage of labour increases
women's reported satisfaction with pushing. Evidence that immersion in water
during labour reduces the length of active labour or reduces the incidence of
perineal trauma is inconclusive.
Guidelines:
The assistance of women to labour and birth in water should be
considered a core midwifery skill. However some midwives will lack experience in
this area of practice. Managers and midwifery educators should ensure that
midwives and midwifery students receive appropriate education, support and
supervision to acquire and maintain the skills and confidence necessary to
assist women who choose to labour or birth in water.
All women should be offered information on the option of using
water in labour and birth. All women who express and interest in the use of
water should be given full verbal and written information, including where
appropriate a copy of the service’s policy. This information should include any
expectations of the woman, and what steps will be taken in the event of an
emergency.
Service guidelines should
detail what steps are expected in an emergency situation. All midwives, and all
women using water for labour and/or birth and their support people, should know
and understand these steps.
References:
Cluett E R, Nikodem VC,
McCandlish RE, Burns EE. Immersion in water in pregnancy, labour and birth. The
Cochrane Database of Systematic Reviews 2002, Issue 2.
New Zealand College of
Midwives Consensus Statement: The use of water in labour and birth, July
2002
The Royal College of Midwives.Position Paper No. 1a: The use of water in
labour and birth. http://www.rcm.org.uk