A Western Australian study published in the Australian and New Zealand Journal of Obstetrics and Gynaecology in January has reported that of the 502 women surveyed who were intending to have a water birth, 303 (59 per cent) were able to labour in water, and 179 (41 per cent) were able to birth in water.

The researchers at Curtin University and King Edward Memorial Hospital (KEMH) comment the data suggests midwives are selecting the appropriate women with low-risk pregnancies to labour and birth in water.

“This research found that women who were identified and approved to undertake labour in water were less likely than those who were not to be transferred to KEMH’s main birth suite, suggesting the labour had fewer or no complications, and they were more likely to have a normal or spontaneous vaginal birth,” lead author Dr Lucy Lewis said.

“The main reason women who used water for their labour did not end up having a water birth was the fact they experienced an obstetric complication. This suggests the midwives at KEMH are following water birth guidelines by responding appropriately in the event a complication arises during labour.”

The small study indicated an association between water birthing and a shorter first and second stage of labour, as well as women being three times more likely to have an intact perineum. Such results were also higher among women who had previously given birth (multiparous).

It is interesting to note that the caesarean birth rate at KEMH is 37% for women of all risk; compared to 34% in all of WA; whereas for the group of water-birthers it was only 6% - it must be noted however that only women with low-risk pregnancies were offered the water birth option.

As the midwifery continuity of care model becomes more popular with patients in its quality of maternity care and provision of midwifery services that are responsive to women’s needs and wants, so too has the demand for water immersion as a birth choice – and the medical community is taking notice, as examined in The Lancet’s Midwifery Series.

Dr Lewis is encouraging maternity units who offer water immersion for labour and/or birth to publish their data, to help women make the best-informed decision for their labour. Dr Lewis’s previous research has looked into the reasons why women plan water births, with many women believing such a procedure would help them avoid an epidural.

Additionally, through the suggestion of establishing a national body to collect and publish this data, the researcher team hopes this will lead to further collaboration between the birth team of obstetricians, neo-natologists and midwives through the development of standards of optimal care and outcomes for all involved.