The Method of Birth in Water in Scotland - Essay Example

Introduction Birth in water has become a common method of child birth in today's modern age. Such method of giving birth has constantly been explored to determine its advantages and benefits as well as the risks associated with it. Various studies have been conducted on specific issues associated with water births. Some of such studies have indicated the potential advantages of giving birth in water while some have pointed out the need to review the process due to the risk and safety issues associated with labouring and giving birth in water. The method of giving birth in water is widely popular particularly in European countries. Moreover, the movement that supports such child birth method has picked up in the United States (Harper, 2000). However, debate still rages on with regards to its acceptance as a legitimate and safe method of child birth. This is the reason why not all hospitals have the equipment necessary for water births. Although there are certain hospitals that support water births, there are still those that do not agree with it. Giving birth in water traces its roots to the commonly used clinical practice of lying in warm water for relaxation and pain relief during early labour. However, water birth only gained in popularity in the 1980s when birth in water using specially designed pools were used for prolonged immersion in water through out labour (RCOG, 2001) The person many recognize as the man responsible for popularizing water births in today's time is Odent (RCOG, 2001). . Birth in water is an interesting topic to explore in the realm of midwifery because it has become a commonly used yet highly debatable practice in child birth. It has been said that many midwives use water births. However, there are still those that contend that the practice of giving birth in water is unsafe and should not be used. Since midwives are highly involved in child births, it would be highly significant to discuss what role midwives play in the issue of water births. This paper will explore the method of births in water, particularly in Scotland. The discussion will include the noted advantages and disadvantages of water births as remarked by various practitioners. The main focus of the paper would be the role that midwives play in the issue. This includes what midwives must do in order to clarify the issues concerning birth in water. The primary basis of this discussion will be past studies, researches, and literature that have been written regarding the topic at hand. Finally, this paper will attempt to explain the role that the supervisors of midwives play in the issue of water births. It must be noted that although studies from various groups in different countries will be used, the main focus of this discussion will be water births in relation to the practice of midwifery particularly in Scotland. Should Birth in Water be supported How Beneficial is Birth in Water Various studies have attempted to determine the benefits that may be derived from giving birth in water. Studies have focused on the benefits of such method for both the mother and the baby. More importantly, several proponents of the method have noted the different advantages that births in water provide. Most of the time, such assertions have been backed up by studies whose results support the use of water births. For instance, in a review of the available evidence and in an attempt to formulate guidelines to assist midwives and women in their decision making process about the use of water immersion for labour and birth, the Royal College of Midwives (2000) noted several potential advantages of water immersion in both labour and birth. Although the said group noted the small yet continuously growing body of evidence regarding water immersion, it named the said potential advantages based on experience as well as on certain theoretical considerations. According to the College of Midwives (2000), "In the absence of a substantial body of evidence on the use of warm water immersion for labour and birth, the potential advantages which follow are part derived from experience or theoretical considerations." Potential Advantages of Water Immersion The buoyancy of water enables the mother to move more easily; Blood pressure is lowered; Comfort and relaxation may be enhanced; Maternal sense of control may increase, which in turn enhances emotional well-being; Pain may be diminished; The need for pharmacological pain relief may be reduced; Length of labour may be reduced; Improved perennial stretching may reduce trauma; and Operative births may be reduced (Royal College of Midwives, 2000). The findings of the College of Midwives stated above are similar to those professed by another birth in water expert, Barbara Harper. In her article, Harper discussed the various issues that have been mentioned with regards to water births. Harper discussed the truth behind common misinterpretations regarding water birth. Moreover, she identified various benefits associated with water immersion. Among the benefits Harper named are the following: the increase in control that mothers have during labour and birth, the calming effect of water immersion particularly during early labour, the reduction in pain attributed to deep immersion, and zero episiotomy among mother who labour and give birth in water (Harper, 2000). Basically, water immersion eases the labour and birth process for mothers. The pain associated with labour is reduced and the mother is bale to go about giving birth less strenuously. These advantages are the most commonly named benefits of water immersion in labour and birth. How can Water Immersion be Disadvantageous or Harmful Despite the numerous benefits of water birth that have been cited by various practitioners, there are still probable disadvantages or risks that are associated with water immersion during labour and birth. The Royal College of Midwives noted the following potential disadvantages of water immersion: Decrease in uterine contraction strength and frequency, especially if used before active labour is established; Neonatal water aspiration; at least two cases have been recorded; Maternal hyperthermia may contribute to fetal hypoxemia; Neonatal hypothermia is possible if water temperature is too cool; Cord immersion in warm water may delay vasoconstriction, increasing red cell transfusion to the newborn and promoting jaundice; Blood loss estimation and assessment is difficult in water; Maternal and neonatal infection may be increased; not supported by evidence Theoretical risk of maternal water embolus; and Risk of acquiring blood born infection or sustaining back injury for caregivers (Royal College of Midwives, 2000). However, as indicated above, not all risks are supported by evidence. For on, the potential increase in maternal and neonatal infection has no basis for it has yet to be proven. Harper mentioned that the risk of infection for both the mother and the baby is wrongly assumed (Harper, 2000). Moreover, a British study of 541 water births over a three-year period revealed no serious infection for both mother and baby (Brown, 1998). These risks may seem serious. However, studies have shown that not all of these have seen realizations in actual water births. For one, a study of water births in the United Kingdom revealed that water births have a lower risk factor than conventional births (Alderdice et al, 1995). Moreover, water birth has a comparable perinatal mortality rate with that of other low risk primiparous methods as well as with conventional births (Gilbert & Tookey, 1999). What these studies suggest is that birth in water is not as risky as first conceived. In fact, it has a lower risk factor than conventional births which only attest to its advantageous use. Role of Midwives in Water Births Midwives play a crucial role in water births. In fact, according to the UKCC (1994), "water birth is preferred by some women as their chosen method for delivery of babies. Water birth should therefore be viewed as an alternate method of care and management in labour and one which falls within the midwife's sphere of practice." The midwife is given such a responsibility primarily due to the various important roles it plays in water births. Such roles are deemed critical to the success of the procedure. For one, midwives play a significant role in helping women make a decision on whether to use water births or not. This is the reason why the College of Midwives released a set of guidelines aimed at assisting midwives and women in deciding whether to go about birth in water or not. Furthermore, midwives serve as facilitators in the process. Since birth in water gives women more control over the birth of their babies. Midwives tale up a new role and serve as facilitators or observers in the process (Harper, 2000) As Harper (2000) stated, "Midwives have a great deal of influence over the outcome of a birth." Their suggestions are vital especially with regards to how a labouring mother should handle potential complications. Although the decision to birth in water is should be the mother's own, such decision must be based on sound advice and assessment of fetal well-being by the midwife (Harper, 2000). Possibly the most important role of midwives in the issue of water births is to serve as its main proponents and researchers. Midwives should conduct further research on the issue especially since there is a lack of a substantial body of evidence regarding the said topic. Also, midwives should help develop protocols that hospitals may adapt with regards to using birth in water as a common clinical practice. According to Harper, In almost all cases where there are successful water birth programs going, they have been started by Certified Nurse Midwives. Midwives are more open to exploring the issue with their clients and doing the research necessary to get protocols accepted in hospitals. Such a role is especially critical in the Scotland setting. There has been very little research conducted on water births in Scotland. If such a practice is to be accepted on a larger scale, midwives in Scotland must take the initiative to conduct researches and studies to help establish births in water as an accepted clinical practice. This is the only way by which people in Scotland, particularly women, will get to understand the beauty of giving birth in water. What Role must the Supervisor of Midwives Take Having explored the general role of midwives in the issue of birth in water, it would also be vital to explore the role that the supervisors of midwives take in the said issue. The supervisor may easily be assumed as the midwife who has the greatest amount of experience and knowledge regarding the various practices in midwifery. Therefore, her primary role would be to serve as an educator and trainer in the whole process. Furthermore, the supervisor must serve as the leader especially with regards to initiating researches to push for the acceptance of water in births as a clinical practice. Such role of the supervisor is supported by Harper's statements. According to her, one of the three critical components in initiating policy changes within the hospital setting with regards to births in water is, "a compassionate nurse manager or perinatal coordinator who is willing to take on the training of the staff and the creation of new policy" (Harper, 2000). Basically, the supervisor of midwives is responsible for training midwives in the proper techniques and practices in the water births. Having the greatest amount of experience, the supervisor can impart unto her staff what she has learned in using water immersion in both labour and birth. Also, the supervisor serves as the leader in proposing policy changes within the hospital setting in order to make births in water acceptable as a clinical practice. Finally, the supervisor should take charge in implementing policy changes and in laying out plans for the use of water immersion in both labour and birth. Conclusion Birth in water continues to become a highly debatable issue owing to the lack of a substantial body of evidence to support it. The said practice falls within the realm of midwifery. Midwives play significant roles in the process of giving birth in water itself as well as in the move to make such a method acceptable. There is an absence of research conducted on water births especially in Scotland. Therefore, the moves to create more understanding and to widen the scope of evidence fall in the hands of the midwives in Scotland. This paper has found that water immersion in labour and birth is a practice greatly considered especially in midwifery. However, there is a significant lack of evidence to support it. Since such practice is considered as part of the realm of midwifery, the responsibility of making further research on the issue is given to midwives. Midwives not only help women decide on whether to go about water births, they are likewise the facilitators and assessors in the process. However, their most important roles, as seen in this paper, are to conduct further research to support water births as well as to create protocols to make water immersion in labour as well as in birth acceptable not just in Scotland but in other countries as well. Bibliography Alderdice, R, Renfrew, M. & Marchant, S (1995) "Labour and birth in water in England and Wales: Survey Report", British Journal of Midwifery, 3, pp 375-382. Brown, L (1998) "The tide of water birth has turned: Audit of water birth" British Journal of Midwifery, April, Vol 6, No 4, pp 236-243. Garland, D (2000) Waterbirth: An attitude to care, Books for Midwives Press, London. Garland, D & Jones, K (1997) "Waterbirth: Updating the evidence" British Journal of Midwifery, June, Vol 5, No 6, pp 368-373. Gilbert, RE & Tookey, PA (1999) "Perinatal mortality and morbidity among babies delivered in water: Surveillance study and postal survey", British Medical Journal, 319(7208), pp 483-487. Harper, B (2000) "Water birth basics: From newborn to hospital protocols" Midwifery Today, Issue No 54, Summer. Royal College of Midwives (2000) The use of water in labour and birth, Position Paper 1a RCM, London. Royal College of Obstetrician and Gynecologists (2001) Birth in water, RCOG Statement No 1. [online], 3 March 2006, available at: . UKCC (1994) Registrar's Letter Position Statement on Waterbirth. Read More

 

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