DOI: 10.5176/2315-4330_WNC15.33

Authors: Kim Russell, Denis Walsh and Tania Macintosh


Providing care in birthing pools during normal labor and birth (water immersion) has been recognized in the United Kingdom as part of the midwife’s role since the 1990’s (UKCC, 1994). But recent research findings identified that limited institutional support for water immersion may prevent hospital practitioners from promoting pool use (Stark and Miller, 2009; Russell, 2011; Woodward, 2012). The research focused on a group of midwives working in an English maternity unit catering for 3,800 births per annum. The labor ward had one birthing pool and an annual water birth rate of forty-five. During the first research phase clinical midwives identified the barriers to pool use as: negative attitudes, high workloads and lack of institutional support (Russell, 2011). The aim of this paper is to share the findings from an action research study aimed at addressing organizational barriers to birthing pool use during normal labor and birth. Methods Three two-hour workshops with midwifery coordinators, the labor ward manager and consultant midwife (n= 10) took place over a twelve-month period. At each workshop, relevant data from the birth records and previously identified barriers to pool use were discussed before interventions were developed. Descriptive statistics were collected from birth records to evaluate the success of interventions. Results An average of six participants attended each workshop. Interventions included: setting a target of 100 waterbirths, keeping portable pools partially inflated, appointing a waterbirth champion and improving the auditing and dissemination of midwives birthing pool use. At twelve months 383 women were recorded as having used a birthing pool, of these 115 (43{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}) gave birth in water. The number of individual waterbirth practitioners increased from 25 to 49.Conclusion The introduction of problem solving workshops enabled those in a position of authority to develop practical interventions to influence the way midwifery care was organized. The findings suggest that problem solving workshops with authority figures has the potential to improve the delivery of alternative models of care within medically dominated birthing environments.

Keywords: Midwives, Problem-solving workshops and Birthing pools

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