REPRODUCTIVE JUSTICE

MEDICALIZATION IN MATERNAL HEALTHCARE

**NOTE**  Medical advancements have saved the lives of women and babies at risk for injury or death during pregnancy and birth.  This site is not about the doctors who properly use interventions to save lives; it is about those who use them unethically for profit or convenience.   Improperly used interventions have led to harm and death of women and babies and obstetrics  is the only field in which mortality rates are rising and non-medically needed interventions such as c-sections are related to 66% of maternal deaths. 

**NOTE**  This site is designed to share valid evidence for those working to change the maternal healthcare system who do not have access to databases of peered research. 

**NOTE** Chronological order allows users to find new data.  It also begs the question of why, when we have known for decades that such practices are harmful, do they not only continue to be used but are increasingly used.

WATER BIRTH

WHAT DOES THE LITERATURE SAY?

2023

American Pregnancy Association (2023). Water Births.  Accessed https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/water-births/

• Article talks about benefits and possible risks.

• 2021

Aughey, Jardine, J., Moitt, N., Fearon, K., Hawdon, J., Pasupathy, D., Urganci, I., & Harris, T. (2021). Waterbirth: a national retrospective cohort study of factors associated with its use among women in England. BMC Pregnancy and Childbirth, 21(1), 256–256. https://doi.org/10.1186/s12884-021-03724-6  Accessed https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03724-6

• CONCLUDED  (summary) "This study found that in this restricted cohort of women giving birth in England, 13.6% were recorded as having a waterbirth. Women of ethnic minority origin, younger women and women of more deprived socioeconomic status are less likely to give birth in water. For the mother, waterbirth was associated with reduced PPH and no association was shown between waterbirth and OASI. For the baby, there was no association between waterbirth and low Apgar score, and neonatal unit admission was less likely in the group born in water. This study therefore shows no association between waterbirth and these adverse outcomes for mother or baby."

2020

Barry, McMahon, L. E., Banks, R. A., Fergus, A. M., & Murphy, D. J. (2020). Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting. BMJ Open, 10(12), e038080–e038080. https://doi.org/10.1136/bmjopen-2020-038080  Accessed  https://bmjopen.bmj.com/content/10/12/e038080

• CONCLUDED: "Women choosing water immersion for labour or birth were no more likely to experience adverse birth outcomes than women receiving standard care and rated their birth experiences more highly."

Maude, & Kim, M. (2020). Getting into the water: a prospective observational study of water immersion for labour and birth at a New Zealand District Health Board. BMC Pregnancy and Childbirth, 20(1), 312–312. https://doi.org/10.1186/s12884-020-03007-6  Accessed  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03007-6

• CONCLUDED: "Water immersion for labour and birth is a positive intervention that benefits well women with uncomplicated pregnancies. This study shows that water immersion for labour and birth in a midwife-led unit with a community-based lead maternity care midwife results in excellent outcomes for women and infants. Water immersion for labour and birth also provides an essential option for women who have a desire to have a spontaneous vaginal birth. The positive outcomes generated from water birthing indicate that this simple intervention may be a useful solution to address the high intervention rates in New Zealand’s birthing population in tertiary and community settings. Midwives in both tertiary and community-based midwives should, therefore, campaign for improved accessibility to water immersion and water birth for women birthing in all birthing setting."

Snapp, C.,  Stapleton, S., Wright, J.,  Niemczyk, N., and Jolles, D. (2020)  The Experience of Land and Water Birth Within the American Association of Birth Centers Perinatal Data Registry, 2012-2017. The Journal of Perinatal & Neonatal Nursing: January/March 2020 - Volume 34 - Issue 1 - p 16-26 doi: 10.1097/JPN.0000000000000450  Accessed https://journals.lww.com/jpnnjournal/fulltext/2020/01000/the_experience_of_land_and_water_birth_within_the.7.aspx

• 
  CONCLUDED: (abstract) "Consumer demand for water birth has grown within an environment of professional controversy. Access to nonpharmacologic pain relief through water immersion is limited within hospital settings across the United States due to concerns over safety. The study is a secondary analysis of prospective observational Perinatal Data Registry (PDR) used by American Association of Birth Center members (AABC PDR). All births occurring between 2012 and 2017 in the community setting (home and birth center) were included in the analysis. Descriptive, correlational, and relative risk statistics were used to compare maternal and neonatal outcomes. Of 26 684 women, those giving birth in water had more favorable outcomes including fewer prolonged first- or second-stage labors, fetal heart rate abnormalities, shoulder dystocias, genital lacerations, episiotomies, hemorrhage, or postpartum transfers. Cord avulsion occurred rarely, but it was more common among water births. Newborns born in water were less likely to require transfer to a higher level of care, be admitted to a neonatal intensive care unit, or experience respiratory complication. Among childbearing women of low medical risk, personal preference should drive utilization of nonpharmacologic care practices including water birth. Both land and water births have similar good outcomes within the community setting."

2014

Harper. (2014). Birth, Bath, and Beyond: The Science and Safety of Water Immersion During Labor and Birth. The Journal of Perinatal Education, 23(3), 124–134. https://doi.org/10.1891/1058-1243.23.3.124   Accessed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210671/#:~:text=Rates%20of%20newborn%20transfer%20to,in%20the%20water%2Dbirth%20sample.

• CONCLUDED:  "Water birth is an option for birth all over the world. World-renowned hospitals, as well as small hospitals and birthing centers, offer water birth as an option to low-risk patients. Although some members of the AAP feel otherwise, the Cochrane review and many other studies find no data that supports safety concerns over water birth.  Women increasingly are seeking settings for birth that honor their ability to give birth without intervention. Water birth increases their chances of attaining the goal of a natural birth without intervention."  (material omitted)

INTRODUCTION PAGE

Last updated June 2024