Table 1 Summary of qualitative papers exploring women´s experiences of waterbirth

Clews et al. [8]

United Kingdom

2019

A systematic meta-synthesis

of qualitative studies

5 studies, which included a total of 346 women

In-depth

Interviews

Semi-structured

Interviews

Skype audio

semi-structured

interviews

Interviews

Questionnaire

Interviews

Meta-ethnography,

reciprocal translational análisis

Hospitals, researchers and online social media

To explore women’s experiences of waterbirth

Four themes were identified: women’s knowledge of waterbirth; women’s perception of physiological birth; water, autonomy and control; and waterbirth: easing the transition.

Poder et al. [9]

Canada

2020

A mixed-method approach, combining systematic reviews of the literature

and patient focus groups to identify attributes and levels explaining women’s preferences.

17 women

Focus groups

Questionnaire

Discrete choice

experiment

Convenience sampling method, recruited through the research team’s personal and professional networks

To identify the factors that are most significant for women when deciding whether to give birth in water or not

The study considered six attributes: birth mode, duration of the labor phase, pain sensation, risk of severe tears in the perineum during the expulsion of the newborn, risk of death of the newborn, and general condition of the newborn (Apgar) score at 5 min.

Fair et al. [10]

UU.EE.

2020

Qualitative

23 women

Semi-structured interviews.

Grounded theory

The women were recruited from an obstetrics and gynecology center in a mid-sized city in the south eastern United States.

To investigate the decision-making process of women who choose to give birth in water

Three main themes emerged: Beliefs and desires; actions and agency; empowerment and accomplishment

Gonçalves et al. [11]

Portugal

2019

Qualitative, phenomenological study

13 women

Semi-structured interviews

Content analysis

Online purposive selection to recruit participants for this study

To gain a deeper understanding of the experiences of mothers who have undergone one or multiple water births

The following categories were presented: water benefits; and manifestations

of satisfaction with the experience of physiological labour in water by the woman.

Lewis et al. [12]

Australia

2018

Qualitative exploratory design

296 women

Telephone interviews.

Thematic analysis

Publicly-funded hospital located in Western Australia

To explore the perceptions and experiences of women who have given birth, regardless of their decision to opt for a water birth or not

The benefits of planning a water birth are numerous, including pain relief, a desire for a natural birth, the potential for a calming and peaceful environment, and recommendations from healthcare professionals. However, the most significant factor in ensuring a successful water birth is having a supportive team present. Midwives are often cited as the primary source of support, which is essential for the mother’s well-being and the successful delivery of the baby.

Participants described their water birth experiences using a range of adjectives, such as empowering, unforgettable, quick, natural, firming, painful, and lengthy.

Ulfsdottir et al. [13]

Sweden

2018

Qualitative

20 women

In-depth interviews

Content analysis

From a clinic located in Stockholm

To investigate and describe the perceptions and experiences of women who have given birth while immersed in water

Three categories were found: “Synergy between body and mind”, “Privacy and discretion”, and “Natural and pleasant”.

Antonakou et al. [14]

Greece

2018

Qualitative

12 women

Individual interviews

Thematic analysis

An open invitation through the website birthscientist.gr, a scientific society that promotes natural childbirth in Greece

To explore the essential concepts and themes that arise from analyzing the experiences of women who underwent labor and delivery while immersed in water

Three main themes were identified: Water use as a natural way of birth; mixed

messages from the healthcare professionals, and; partner’s supportive role during water

birth.

McKenna et al. [15]

Scotland

2013

Qualitative

8 women

Semi-structured interviews

Interpretative phenomenological analysis

From the obstetric unit of a Scottish healthcare center

To investigate the utilization of water immersion as a delivery method for women who have had a previous cesarean section and desire to have a vaginal birth in water

The study revealed three prominent themes: “minimizing,“ “maximizing,“ and “managing.“

The participants’ interviews uncovered the following themes:

Firstly, the women reported that water birth helped minimize medical intervention during childbirth.

Secondly, they emphasized that water birth maximized their experience in four crucial ways: physical benefits, psychological benefits, choice, and control.

Finally, the third theme related to how women managed the potential risks associated with water birth, along with navigating the expectations and behaviors of their families, friends, and healthcare professionals involved in their care.

Carlsson et al. [16]

Sweden

2020

Qualitative

111 women

Online questionnaire interviews with open-ended questions

Qualitative content analysis.

From two hospitals in Sweden.

To explore retrospective descriptions about benefits, negative experiences and information related to waterbirths

Two themes were identified related to benefits: (a) physical benefits: the water eases labour progression while offering buoyancy and pain relief; and (b) psychological benefits: improved relaxation and control in a demedicalized and safe setting. Two themes were identified related to negative experiences: (a) equipment-related issues due to the construction of the tub and issues related to being immersed in water; and (b) fears and worries related to waterbirth. In regard to preparatory information, respondents reported a lack of general and specific information related to waterbirths, even after they contacted birthing units to ask questions.