You might find this reference useful to counter at least some of these arguments Laura:
http://www.biomedcentral.com/content/pdf/1471-2393-14-60.pdf
Abstract
Background: Immersion in water during labour is an important non-pharmacological method to manage labour pain, particularly in midwifery-led care settings where pharmacological methods are limited. This study investigates the association between immersion for pain relief and transfer before birth and other maternal outcomes.
Methods: A prospective cohort study of 16,577 low risk nulliparous women planning birth at home, in a freestanding midwifery unit (FMU) or in an alongside midwifery unit (AMU) in England between April 2008 and April 2010.
Results: Immersion in water for pain relief was common; 50% in planned home births, 54% in FMUs and 38% in AMUs. Immersion in water was associated with a lower risk of transfer before birth for births planned at home (adjusted RR 0.88; 95% CI 0.79–0.99), in FMUs (adjusted RR 0.59; 95% CI 0.50–0.70) and in AMUs (adjusted RR 0.78; 95% CI 0.69–0.88). For births planned in FMUs, immersion in water was associated with a lower risk of intrapartum caesarean section (RR 0.61; 95% CI 0.44–0.84) and a higher chance of a straightforward vaginal birth (RR 1.09; 95% CI 1.04–1.15). These beneficial effects were not seen in births planned at home or AMUs.
Conclusions: Immersion of water for pain relief was associated with a significant reduction in risk of transfer before birth for nulliparous women. Overall, immersion in water was associated with fewer interventions during labour. The effect varied across birth settings with least effect in planned home births and a larger effect observed for planned FMU births.
All the best
Soo
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Laura Iannuzzi
Sent: 23 March 2014 09:18
To: [log in to unmask]
Subject: ACOG committee opinion on water immersion
Dear members,
I have just discovered this new ACOG opinion on water immersion and water birth
this seems a real strong position through a strong medical lense...
it concludes as following:
"Summary
Immersion in water during the first stage of labor may be appealing to some and may be associated with decreased pain or use of anesthesia and decreased duration of labor; however, there is no evidence that immersion in water during the first stage of labor otherwise improves perinatal outcomes. Immersion therapy during the first stage of labor should not prevent or inhibit other elements of care, including appropriate maternal and fetal monitoring.
In contrast, the safety and efficacy of immersion in water during the second stage of labor have not been established, and immersion in water during the second stage of labor has not been associated with maternal or fetal benefit. Given these facts and case reports of rare but serious adverse effects in the newborn, the practice of immersion in the second stage of labor (underwater delivery) should be considered an experimental procedure that only should be performed within the context of an appropriately designed clinical trial with informed consent.
Although not the focus of specific trials, facilities that plan to offer immersion in the first stage of labor need to establish rigorous protocols for candidate selection, maintenance and cleaning of tubs and immersion pools, infection control procedures, monitoring of mothers and fetuses at appropriate intervals while immersed, and protocols for moving women from tubs if urgent maternal or fetal concerns develop."
you probably already knew this, but I thought it was worthy to share and start some reflections on this. In Italy ( where the medical dominance is still high) this opinion has the potential to be used more against midwifery practices than to contribute to the knowledge about waterimmersion , this opinion is probably going to be used a lot...
Wish you all a nice day
Laura Iannuzzi
Laura Iannuzzi
RM, BMid, PGCert, MSci , Phd student - Health Studies School of Health Sciences, The University of Nottingham Room B33, B floor, Queen's Medical Centre Nottingham, NG7 2HA