More training key to water births

Mandatory training for midwives in facilitating water births could help banish a stigma that is attached to the birthing practice, according to a Perth midwife.

A study of WA midwives and their confidence in facilitating women giving birth in water found those working in a hospital setting were not confident with the process as they had little opportunity to practice.

The fact that water birth wasn't a widely accessible option for women in WA surprised Women's and Newborns' Health Network WA community midwife Sarah Nicholls when she moved to Perth in 2009 from the UK.

"It became very apparent that a lot of the midwives in WA thought that it was wacky and weird and they didn't understand why people would choose to have a baby in water," Ms Nicholls says.

She interviewed 16 midwives from the only institutions offering water birth in WA, which are King Edward Hospital, Kaleeya Hospital, Armadale Hospital and the Community Midwifery Program.

Midwives who had worked in low risk settings and were comfortable with natural physiological birth found it significantly easier to facilitate water birth because many of its philosophies were similar.

Physiological birth means labour starts spontaneously between the 38th and 42nd week of pregnancy, progressing to full cervical dilatation and birth without any form of intervention being required.

However, Ms Nicholls says midwives who had worked in medicalised settings where it was common for them to facilitate epidurals, cesarean sections and use machines to monitor the baby struggled with the concept of water birth.

"The midwives' role in all physiological births, including water birth, is to monitor the mother and the baby during the labour and birth to ensure that all in progressing safely," she says.

"If all is well the midwife will offer encouragement, support and leave well alone to allow the woman's natural hormones to work and labour to progress naturally, without intervention.

"So when a women is having a physiological birth that is progressing well, midwives that are used to medicalised birth find it challenging to sit back and watch and not interfere."

The study found midwives' initiation into the occupation significantly impacted their ability to be confident with water births.

"There should be mandatory training for midwives focusing mainly on normal physiological birth, including options such as water birth that will assist them," she says.

Ms Nicholls says she would like to see water birth be a more accessible option for women.

This article first appeared on ScienceNetwork Western Australia a science news website based at Scitech.