'Water is the answer' - Women's experiences of seeking a normal birth after a previous caesarean section

Abstract

Background: The benefit of water immersion in supporting normal birth in contemporary midwifery practice is now well established. Extending water immersion to women wanting a VBAC, while supported in many guidelines, remains a contested issue. Understanding the reasons women seek water immersion and what it means to them may move the debate forward by reframing the risk discourse that surrounds VBAC and water.

Aim: This presentation will draw on the findings of a qualitative study aimed at theorising women's experiences of negotiating and using water immersion/birth to achieve a VBAC.

Method: Grounded Theory. Twenty-four women planning and/or using water immersion for labour and/or birth after a previous caesarean section participated in a digitally recorded interview. The techniques associated with constant comparison formed the corner stone of the analysis. Ethical approval was granted.

Results: All women in the study described their last birth, which resulted in a caesarean section, as traumatic. They came into their next pregnancy fiercely determined not to repeat the same experience. Women embarked ‘on a mission’ of discovery around birth and more importantly how to maintain their agency through the experience. Along with carefully choosing their lead care provider and birth environment, water immersion became their ‘answer’ to success. With support from their midwife, women gained confidence and developed a narrative to challenge the conventional risk discourse that threatened to prevent them using water. This was challenging, and for some, exhausting especially if the ‘ghosts’ of past experiences persisted. For those women that successfully negotiated the use of water, they described their experiences as ‘life changing’. The sanctuary and privacy afforded by water immersion facilitated an overwhelming sense of control.

Conclusion: This is a significant and relevant topic because the evidence will assist clinicians better understand what is important to women when attempting a VBAC.