Megan Cooper1, Helen McCutcheon2, Jane Warland3. 1. School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia. Electronic address: Megan.Cooper@unisa.edu.au. 2. Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia Campus, Brisbane, Queensland, Australia. 3. School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. AIM: The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth. METHOD: Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis. FINDINGS: Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners. CONCLUSION: Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines'. ETHICAL CONSIDERATIONS: The Human Research Ethics Committee of the University of South Australia approved the research.
BACKGROUND: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. AIM: The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth. METHOD: Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis. FINDINGS: Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners. CONCLUSION: Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines'. ETHICAL CONSIDERATIONS: The Human Research Ethics Committee of the University of South Australia approved the research.
Authors: Sarah Milosevic; Sue Channon; Billie Hunter; Mary Nolan; Jacqueline Hughes; Christian Barlow; Rebecca Milton; Julia Sanders Journal: Midwifery Date: 2019-10-05 Impact factor: 2.372