Monday, November 12, 2012

Should waterbirth be offered to all women?

The Australian College of Midwives is asking for feedback on its draft Position Statement on the use of water immersion for labour and birth - click here for details of the Statement and how to submit your feedback.

I have to admit, there are two areas that I feel a tad uneasy about and am looking forward to seeing how others feel - these are my own opinions and I am not reflecting the Australian College of Midwives.

The first thing I have reservations about is the opening statement "The ACM supports the choice of all women at term to have the opportunity to access water immersion for labour and/or birth."

I think there are instances when women have risk factors that would preclude them from water immersion, so I am not sure "all women" should be in the statement. Having said that...if water immersion is restricted to just low risk women, we would be preventing women with conditions such as diabetes, who are labeled "at risk" but actually would be fine to labour in water.

I believe that every woman needs to be assessed individually at the time, and I am not sure this is reflected in the Position Statement. At the same time, we do have a lack of evidence about water immersion and the outcomes for so-called "high risk" women, so it is difficult to give an informed opinion.

The second issue that I am a little uncomfortable about is the point "All maternity services to be encouraged to provide women with access to water immersion in labour and/or birth including telemetry as required". Note: telemetry is the monitoring of the baby's heart beat using water proof equipment. Thus, women who require continuous baby heart rate monitoring can still have access to water immersion.

I just need to be's not telemetry I have a problem with...I think it's fabulous if it supports more "at risk" women to have access to water immersion. What I am concerned about is that the minute it is included into the ACM Position Statement, some midwives and doctors will take it as an opportunity to push continuous fetal monitoring for all women, including "low risk" women, which is not evidence based practice, but widely supported in areas.

What do you think?

If you have any comments about either these issues or any other aspects of this Position Statement, please make a submission as per these instructions.

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Maddy M O said...

Interesting post Sarah! I actually had a waterbirth with my eldest four years ago in the UK (they're very strong advocates for the waterbirth, so strong that I almost convinced myself to have a HOME water birth...the small confines of a tiny Cardiff apartment was a great reality check!) and was so surprised it wasn't offered here in Australia. I guess only having had the waterbirth experience (which I loved and found to be very positive not to mention a lifesaver for my back and sciatica problems which I suffered in both my pregnancies), I was hoping for a similar experience with my now almost 7 month old. Having had both a waterbirth and normal V delivery (and would prefer the waterbirth anyday). I do see your concerns, particularly in the ACM's choice of words to use "all women" but am just so glad this option of delivery is being more widely accepted and hopefully more widely practiced in the near future. Thankyou!

Sarah Stewart said...

Hi Maddy, sorry its taken so long to respond to you...still recovering from Christmas. There is definitely disagreement about the "all women" vs "low risk women", so it will be interesting to see what the ACM decides in the end. Have a lovely birth - get back to us and let us know how things went. cheers Sarah