Monday, November 12, 2012

The ACM's draft Water immersion for labour and or birth

Well it has been a while since I have written, and this is due to being very busy with four units of study, work and family life.
I am looking forward to the semester finishing so that I can have some free time to blog, play and have some fun...... However I have taken some time out of my study plan today to write this blog, as I am very frustrated about this issue.

Firstly yes I think water is a fantastic source for women to use for pain relief, and if I had my time over again I would have a water-birth - so I am no opposed to this concept, in fact I am highly supportive of it. But equally so I think it is important to maintain a safe environment for both mother and fetus (baby).

Please have a look at this draft position statement on the ACM Website: Water immersion in labour and / or birth:

Here are some excerpts:

Position Statement on use of water immersion for labour and birth
"The ACM supports the choice of all women at term to have the opportunity to access water immersion for labour and/or birth."........
 This opening creates a problem for me as not 'all' women are suitable for water immersion - and I think that this statement is a potential problem because it could be seen as encouraging 'all' women even those with a know high risk factor to use water immersion (in the bath/pool) - this in fact could work against the college if there was an adverse outcome.
However equally the problem arises when such tight restrictions (the current policy for water immersion states only low risk women) are placed on women who don't necessarily fall into the 'high' or 'low' risk category......

The other major problem I have is in the achieving best practice.......all maternity services to be encouraged to provide telemetry... for water immersion ( that is CTG monitoring in the bath/pool)
To achieve best practice use of water immersion for labour and birth, it is necessary for:
 all maternity services to be encouraged to provide women with access to water immersion in labour and/or birth including telemetry as required;

My concern with this is two fold, one if a woman needs a CTG (fetal monitoring) then it is considered that she has a risk factor that should not necessarily be in the water - and are we putting her more at risk?
Second issue is that but stating this point even the low risk women might end up having monitoring in the water...will we be opening Pandora's box?

What I really like about the position statement is the following excerpt....because this tells women that they can so 'NO' and have the right to say "NO" to any treatment they do not want.
Informed decision-making, informed consent, and right of refusal are accepted legal principles in Australia. Each and every woman has the right to make informed decisions, including consent or refusal of any aspect of her care. Women must be respected in the choices that they make.
I also think that the College is compromising the position of midwives on this issue, because most state-wide hospital policies all state that 'water immersion for labour/and or birth is recommended for low risk women'.
We have only recently taken the step to have water immersion in labour and/or birth accepted as a part of the childbirth care options.....and some hospitals are still not offering this to 'low risk' women let alone 'all' women.....lets take some baby steps first....otherwise we will lose the lot.....all it will take is one bad outcome and it's gone.........

Take some time out and give some feedback

DEADLINE FOR SUBMISSIONS: 5pm (Canberra time) 21th December 2012: Submissions received after this date will not be considered.
Submissions (and any questions about this consultation process) may be sent by email to:

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