Practitioner accreditation for the practice of water immersion during labour and birth: Results from a mixed methods study

Background: Water immersion for labour and birth is an option that is increasingly favoured by women. Australian water immersion policies and guidelines commonly specify that practitioners, such as midwives, must undertake further education and training to become accredited. Method: A three-phase mixed methods approach was used. Phase one used critical discourse analysis to determine who or what informs policies and guidelines related to water immersion for labour and/or birth. Phase two examined policy and guideline informants’ experiences of the development of policies/guidelines, whilst phase three surveyed Australian midwives’ views and experiences of water immersion and their use of and/or involvement in the development of policies and guidelines. Findings: Practitioner accreditation for the facilitation of water immersion was a common finding across all phases of the study. An examination of policies and guidelines found that practitioners, namely midwives, were required to meet additional training requirements to facilitate water immersion. Participants of phases two and three identified and discussed accreditation as a significant challenge to the option of water immersion, particularly where there were inconsistencies across documents and in the interpretation of their content. Conclusion: The need for practitioners to be accredited to facilitate water immersion was identified as a major barrier to availability and therefore, women's ability to access the option. Given these findings, the need for accreditation should be challenged.