Abstract
Aims: To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives.
Design: A systematic integrated mixed methods review was conducted.
Data sources: MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches.
Review Methods: Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes.
Results: 37 articles (29 studies) were included - quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It’s your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia.
Conclusion: The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the “swing” within these factors directly affected whether birthing pool use was facilitated or inhibited.
Design: A systematic integrated mixed methods review was conducted.
Data sources: MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches.
Review Methods: Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes.
Results: 37 articles (29 studies) were included - quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It’s your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia.
Conclusion: The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the “swing” within these factors directly affected whether birthing pool use was facilitated or inhibited.
| Original language | English |
|---|---|
| Article number | 147 |
| Number of pages | 23 |
| Journal | Reproductive Health |
| Volume | 20 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Dec 2023 |
Keywords
- Analgesia
- Anesthesiology
- Birth pool
- Childbirth
- Guidelines
- Maternity care
- Midwifery
- Neonatology
- Obstetrics
- Physiological birth
- Policies
- Water birth
- Water immersion