Midwifery and Women’s Health

Biography

Biography: Elizabeth Nutter

Abstract

Modern United States obstetrics is characterized by many routine interventions, some without supportive data, despite research demonstrating that unnecessary intervention can impede women’s ability to achieve physiologic birth. Research demonstrates that intrapartum hydrotherapy is a potential antidote which can facilitate physiological childbirth since women who labor and or birth in water are unlikely to experience medical interventions that can disrupt physiologic birth. Intrapartum immersion reduced the use of pharmacological pain relief methods, labor augmentation with synthetic oxytocin and episiotomies. Research demonstrates no increase in infection or other adverse effects on the fetus, newborn or mother and in women who utilized intrapartum immersion during labor and or birth. A growing body of evidence supports the safety of intrapartum immersion; however a myriad of political and cultural issues result in limited use of intrapartum hydrotherapy in United States hospitals compared to other developed nations. Available literature on immersion hydrotherapy provides a considerable amount of information about how to limit risk of harm and incorporate the best available data. Research demonstrates that when trained professionals utilize evidence-based practice guidelines including infection control, adherence to eligibility criteria, waterbirth delivery procedures and management of any cord rupture, outcomes are excellent and risks to healthy women and newborns are rare. The midwifery model of care facilitates shared decision-making and respect for women’s autonomy to make informed choices. Through this lens the choice of intrapartum immersion, including waterbirth, can be supported among women who understand the limited state of science and choose hydrotherapy for pain control in labor