Midwives’ perspectives on water immersion during labour and birth in Malta

Abstract

Background: The National Institute for Health and Care Excellence (NICE) (2014) states that women with low-risk pregnancies should be offered the opportunity to labour in water. There is a dearth of research investigating the link between the availability of water immersion (WI) in facilities and midwives’ knowledge, perceived benefits and concerns, and overall attitudes towards WI. Aim: To explore the local midwives’ perspectives on the practice of WI during labour and birth. Methods: A quantitative study with data collected via a self-administered questionnaire. Fifty midwives working at the local hospital’s Central Delivery Suite (CDS) were recruited through convenience sampling. A response rate of 80 per cent was attained with the return of 40 completed questionnaires (n=40). Manual analysis of the data collected was performed and results were presented in the form of absolute numbers, percentages, bar charts and tables. Findings: Midwives are supportive of WI in the first stage of labour but hesitant in facilitating WI during the second and third stages of labour, mainly due to lack of experience, available facilities and equipment. Lack of equipment and facilities, as well as lack of institutional and staff support, were the most common identified challenges. Education and training for staff as well as the acquisition of the necessary equipment were the most mentioned strategies for the facilitation of WI. Conclusion: Midwives’ perspectives of WI are affected by the training received, equipment available and the demand for WI during labour and birth by expectant parents. Therefore, the implementation of educational and practice interventions, coupled with adequate guidelines, are being recommended based on the findings of this study.