Table 6 Barriers and facilitators to water immersion during childbirth

Safety concerns

 Potential risks associated with waterbirth after cesarean section

[15]

 Obstetric complications

[12]

Cultural factors

 Lack of support from family members and health professionals

[10]

Limited resources

 Lack of necessary equipment or facilities to support waterbirth

[12]

Facilitators of water immersion in childbirth

 Resources

  Availability of bathtubs and appropriate usage techniques

[17]

  Availability of cardiotocographic equipment compatible with water immersion

[17]

 A culture of support for water immersion during childbirth

  Clear and consistent eligibility criteria for water immersion during childbirth

[17]

  Promoting a natural childbirth experience without unnecessary medical interventions

[15, 17]

 Support for the mother

  Support from health professionals

[10, 12, 14, 17, 20]

  Support for partners during water immersion childbirth, including emotional and physical support

[14]

 Training and support for healthcare professionals who attend water immersion childbirths, including proper techniques and safety precautions

  Learning through observation of successful water immersion childbirths to improve technique and confidence

[12]

  Professional waterbirth training and senior staff support

[17, 18, 20]

  Positive impact of coworker presence during water immersion childbirths on patient outcomes and healthcare provider satisfaction

[20]

  Confidence to improve with the experience of attending such births

[18, 20]

  Provision of clear and accurate information to pregnant women about the benefits and risks of water immersion childbirths

  Promotion of water immersion through education

[16, 17]