Osteba, Health Technology Assessment, Knowledge Management and Evaluation, Basque Foundation for Health Innovation and Research (BIOEF), Barakaldo-Bizkaia, Spain.
La Plana University Hospital, Villarreal-Castellón, Spain.
BMC Pregnancy Childbirth. 2023 May 29;23(1):395. doi: 10.1186/s12884-023-05690-7.
The increasing demand for childbirth care based on physiological principles has led official bodies to encourage health centers to provide evidence-based care aimed at promoting women's participation in informed decision-making and avoiding excessive medical intervention during childbirth. One of the goals is to reduce pain and find alternative measures to epidural anesthesia to enhance women's autonomy and well-being during childbirth. Currently, water immersion is used as a non-pharmacological method for pain relief. This review aimed to identify and synthesize evidence on women's and midwives' experiences, values, and preferences regarding water immersion during childbirth.
A systematic review and thematic synthesis of qualitative evidence were conducted. Databases were searched and references were checked according to specific criteria. Studies that used qualitative data collection and analysis methods to examine the opinions of women or midwives in the hospital setting were included. Non-qualitative studies, mixed-methods studies that did not separately report qualitative results, and studies in languages other than English or Spanish were excluded. The Critical Appraisal Skills Program Qualitative Research Checklist was used to assess study quality, and results were synthesized using thematic synthesis.
Thirteen studies met the inclusion criteria and were included in this review. The qualitative studies yielded three key themes: 1) reasons identified by women and midwives for choosing a water birth, 2) benefits experienced in water births, and 3) barriers and facilitators of water immersion during childbirth.
The evidence from qualitative studies indicates that women report benefits associated with water birth. From the perspective of midwives, ensuring safe water births requires adequate resources, midwives training, and rigorous standardized protocols to ensure that all pregnant women can safely opt for water immersion during childbirth with satisfactory results.
对基于生理原则的分娩护理的需求不断增加,促使官方机构鼓励保健中心提供循证护理,旨在促进妇女参与知情决策,并避免分娩过程中过度医疗干预。目标之一是减轻疼痛并寻找替代硬膜外麻醉的措施,以增强妇女在分娩过程中的自主权和幸福感。目前,水中分娩是一种非药物缓解疼痛的方法。本综述旨在确定并综合关于妇女和助产士在分娩期间对水中分娩的体验、价值观和偏好的证据。
系统综述和定性证据的主题综合。根据具体标准搜索数据库并检查参考文献。纳入使用定性数据收集和分析方法来检查医院环境中妇女或助产士意见的研究。排除非定性研究、未单独报告定性结果的混合方法研究以及非英语或西班牙语的研究。使用批判性评估技能计划定性研究清单评估研究质量,并使用主题综合对结果进行综合。
符合纳入标准的研究有 13 项。定性研究产生了三个关键主题:1)妇女和助产士选择水中分娩的原因,2)水中分娩的益处,3)分娩时水中浸泡的障碍和促进因素。
定性研究的证据表明,妇女报告了与水中分娩相关的益处。从助产士的角度来看,确保安全的水中分娩需要足够的资源、助产士培训和严格的标准化协议,以确保所有孕妇都可以安全地选择在分娩时进行水中浸泡,并取得满意的结果。