Evidence Based Guidelines for Midwifery-Led Care in Labour

Women’s experiences of using water for labour and birth are generally positive in terms of feeling relaxed, involved in decision-making and being more in control (Richmond 2003; Hall and Holloway 1998).

The use of water as pain relief during labour has been found to be effective, resulting in less use of epidural/spinal for pain relief during labour (Cluett and Burns 2009).

It is not advisable to use any narcotic analgesia when women are in the pool. Use of Nitrous Oxide (Entonox) is routinely used in conjunction with water immersion.

Water immersion during labour is associated with no difference in type of birth, five minute Apgar Scores, neonatal infection and admission to neonatal units (Cluett and Burns 2009). There is some evidence to suggest that the length of the first stage may be reduced.

There is little to recommend the use of arbitrary points during labour to dictate when birth pools should or should not be used and no evidence to suggest that the use of water should be limited to a specific duration.

Two national surveys suggested that there was no evidence of a link between neonatal morbidity and mortality and immersion in water during labour (Gilbert and Tookey 1999; Alderdice et al. 1995).