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Taking the reins: A grounded theory study of women's experiences of negotiating water immersion for labour and birth after a previous caesarean section

Published:August 01, 2022DOI:https://doi.org/10.1016/j.wombi.2022.07.171

      Abstract

      Background

      Women seeking a vaginal birth after a caesarean section (VBAC) frequently want to keep their subsequent labour and birth free from intervention. Water immersion (WI) during labour is potentially an effective tool for women having a VBAC for its natural pain-relieving properties. However, negotiating access to WI can be difficult, especially in the context of VBAC.

      Aim

      To explore women's experiences of negotiating WI for labour and birth in the context of VBAC.

      Methodology

      This Grounded Theory study followed Strauss and Corbin's framework and analytic process. Twenty-five women planning or using WI for their VBAC labour or birth were recruited from two midwifery practices and a social media group across Australia. Participants were interviewed during pregnancy and/or postnatally.

      Findings

      ‘Taking the reins’, the core category explaining the women’s experiences of assuming authority over their birth, comprised five categories: ‘Robbed of my previous birth experience’; ‘My eyes were opened’; ‘Water is my tool for a successful VBAC’; ‘Actioning my choices and rights for WI’, and ‘Empowered to take back control’. ‘Wanting natural and normal’ was the driving force behind women’s desire to birth vaginally. Two mediating factors: Having someone in your corner and Rules for birth facilitated or hindered their birth choices, respectively.

      Conclusion

      The women became active participants in their healthcare by seeking information and options to keep their birth experience natural and normal. Support from other women and advocacy in the form of continuity of midwifery care was crucial in successfully negotiating WI for their VBAC when navigating the complex health system.

      Keywords

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      References

        • Devarajan S.
        • Talaulikar V.S.
        • Arulkumaran S.
        Vaginal birth after caesarean. Obstetrics.
        Gynaecol. Reprod. Med. 2018; 28: 110-115
        • Cluett E.R.
        • Burns E.
        • Cuthbert A.
        Immersion in water during labour and birth.
        Cochrane Database Syst. Rev. 2018; 5: CD000111
        • McKenna J.A.
        • Symon A.G.
        Water VBAC: exploring a new frontier for women's autonomy.
        Midwifery. 2014; 30: e20-e25
      1. OECD. Health at a Glance 2019; 2019
      2. Word Health Organisation. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva, 2018.

        • World Health Organization
        WHO Statement on caesarean section rates. World Health Organization Human Reproduction Programme.
        Reproductive health matters U6. 23. 2015: 149
      3. Australian Institute of Health Welfare. Australia's mothers and babies. Canberra: AIHW, 2021.

        • Cox K.J.
        • Bovbjerg M.L.
        • Cheyney M.
        • Leeman L.M.
        Planned home VBAC in the United States, 2004–2009: outcomes, maternity care practices, and implications for shared decision making.
        Birth. 2015; 42: 299-308
      4. RANZCOG. Birth after previous caesarean secion. In: RANZCOG, editor. Australia; 2019.
        • AIHW
        National Core Maternity Indicators.
        AIHW, Canberra2021
        • Gardner K.
        • Henry A.
        • Thou S.
        • Davis G.
        • Miller T.
        Improving VBAC rates: the combined impact of two management strategies.
        Aust. N. Z. J. Obstet. Gynaecol. 2014; 54: 327-332
        • Homer C.S.E.
        • Davis D.L.
        • Mollart L.
        • et al.
        Midwifery continuity of care and vaginal birth after caesarean section: a randomised controlled trial.
        Women Birth. 2021;
        • Homer C.S.
        • Johnston R.
        • Foureur M.J.
        Birth after caesarean section: changes over a nine-year period in one Australian state.
        Midwifery. 2011; 27: 165-169
        • Toohill J.
        • Gamble J.
        • Creedy D.K.
        A critical review of vaginal birth rates after a primary Caesarean in Queensland hospitals.
        Aust. Health Rev. 2013; 37: 642-648
        • Lundgren I.
        • Morano S.
        • Nilsson C.
        • Sinclair M.
        • Begley C.
        Cultural perspectives on vaginal birth after previous caesarean section in countries with high and low rates - a hermeneutic study.
        Women Birth. 2020; 33: e339-e347
        • Keedle H.
        • Peters L.
        • Schmied V.
        • Burns E.
        • Keedle W.
        • Dahlen H.G.
        Women's experiences of planning a vaginal birth after caesarean in different models of maternity care in Australia.
        BMC Pregnancy Childbirth. 2020; 20: 381
        • Jackson M.K.
        • Schmied V.
        • Dahlen H.G.
        Birthing outside the system: the motivation behind the choice to freebirth or have a homebirth with risk factors in Australia.
        BMC Pregnancy Childbirth. 2020; 20: 254
        • Yang Y.Z.
        • Ye X.P.
        • Sun X.X.
        Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery.
        Clin. Invest Med. 2017; 40: E135-E145
      5. World Health Organization. WHO recommendations non-clinical interventions to reduce unnecessary caesarean sections: World Health Organization; 2018.
        • Shaw-Battista J.
        Systematic review of hydrotherapy research: does a warm bath in labor promote normal physiologic childbirth?.
        J. Perinat. Neonatal Nurs. 2017; 31: 303-316
        • Barry P.L.
        • McMahon L.E.
        • Banks R.A.
        • Fergus A.M.
        • Murphy D.J.
        Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting.
        BMJ Open. 2020; 10e038080
        • Feeley C.
        • Cooper M.
        • Burns E.
        A systematic meta-thematic synthesis to examine the views and experiences of women following water immersion during labour and waterbirth.
        J. Adv. Nurs. 2021; 00: 1-15
        • Keedle H.
        • Schmied V.
        • Burns E.
        • Dahlen H.G.
        A narrative analysis of women's experiences of planning a vaginal birth after caesarean (VBAC) in Australia using critical feminist theory.
        BMC Pregnancy Childbirth. 2019; 19: 142
        • Cooper M.
        • McCutcheon H.
        • Warland J.
        A critical analysis of Australian policies and guidelines for water immersion during labour and birth.
        Women Birth. 2017; 30: 431-441
        • Birks M.
        • Mills J.
        Grounded Theory: A Practical Guide.
        Sage, 2015
        • Corbin J.
        • Strauss A.
        Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory.
        Sage publications,, 2015
      6. Australian Bureau of Statistics. Education and Work, Australia. Survey data over time on current or recent study, educational attainment, and employment. 2021. https://www.abs.gov.au/statistics/people/education/education-and-work-australia/may-20212022).
      7. Australian Institute of Health Welfare. Health literacy. In: Government A, editor. Canberra: AIHW; 2020.

      8. World Health Organization W. Health Promotion Glossary. In: Division of Health Promotion EaCH, editor. Geneva: World Health Organization 1998.

        • Keedle H.
        • Schmied V.
        • Burns E.
        • Dahlen H.G.
        The journey from pain to power: a meta-ethnography on women’s experiences of vaginal birth after caesarean.
        Women Birth. 2018; 31: 69-79
      9. Gleeson D.M., Craswell A., Jones C.M. It takes a virtual village: Childbearing women's experience of a closed Facebook support group for mothers. Women Birth 2021.

        • Gleeson D.M.
        • Craswell A.
        • Jones C.M.
        Women’s use of social networking sites related to childbearing: an integrative review.
        Women Birth. 2019; 32: 294-302
        • Johnson N.L.
        • Scott S.F.
        • Brann M.
        Our birth experiences are what binds US": women’s motivations for storytelling about birth to build motherwisdom.
        Commun. Stud. 2020; 71: 649-668
        • Sanders R.A.
        • Crozier K.
        How do informal information sources influence women’s decision-making for birth? a meta-synthesis of qualitative studies.
        BMC Pregnancy Childbirth. 2018; 18: 21
        • Renfrew M.J.
        • McFadden A.
        • Bastos M.H.
        • et al.
        Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care.
        Lancet. 2014; 384: 1129-1145
        • Nicholls S.
        • Hauck Y.L.
        • Bayes S.
        • Butt J.
        Exploring midwives’ perception of confidence around facilitating water birth in Western Australia: a qualitative descriptive study.
        Midwifery. 2016; 33: 73-81
        • Newnham E.C.
        Birth control: Power/knowledge in the politics of birth.
        Health Sociol. Rev. 2015; 23: 254-268
        • Carolan M.
        • Hodnett E.
        ‘With woman’ philosophy: examining the evidence, answering the questions.
        Nurs. Inq. 2007; 14: 140-152
        • Leap N.
        Woman-centred or women-centred care: does it matter?.
        Br. J. Midwifery. 2009; 17: 12-16
        • Sandall J.
        • Soltani H.
        • Gates S.
        • Shennan A.
        • Devane D.
        Midwife-led continuity models versus other models of care for childbearing women.
        Cochrane Database Syst. Rev. 2016; 4: CD004667
      10. Council of Australian Governments Health Council C. Woman‐Centred Care: Strategic Directions for Australian Maternity Services. 2019.

        • Coates D.
        • Thirukumar P.
        • Henry A.
        Making shared decisions in relation to planned caesarean sections: what are we up to?.
        Patient Educ. Couns. 2020; 103: 1176-1190