Barriers to the Use of Hydrotherapy in Labor

Authors

  • Mary Ann Stark,

    1. PhD, RNC, is an associate professor in the Bronson School of Nursing, Western Michigan University, Kalamazoo, MI.
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  • Michael G. Miller

    1. EdD, ATC, is an associate professor and director of athletic training in the Department of Health, Physical Education and Recreation, Western Michigan University, Kalamazoo, MI.
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Correspondence
Mary Ann Stark, PhD, RNC, Bronson School of Nursing, Western Michigan University, 1903 W. Michigan Ave., Kalamazoo, MI 49008.
mary.stark@wmich.edu

ABSTRACT

Objective: To determine nurses' perceived barriers to the use of hydrotherapy in labor. While effective in relieving pain, reducing anxiety, encouraging relaxation, and promoting a sense of control, hydrotherapy is rarely used during labor.

Design: Comparative descriptive survey design.

Setting: A national convention and perinatal listserves.

Participants: Intrapartum nurses (N=401) attending a national convention (Association of Women's Health, Obstetric, and Neonatal Nurses, 2007; n=225) and members of perinatal listserves (n=176) were recruited.

Methods: A questionnaire was designed for this study (Nurses' Perception of the Use of Hydrotherapy in Labor). The questionnaire was available in paper format and online.

Results: Institutional but not individual characteristics (age, education, and role) were associated with Nurses' Perception of the Use of Hydrotherapy in Labor. Nurses who reported higher epidural rates (r=.45, p=.000) and Cesarean section rates (r=.30, p=.000) reported more barriers. There was no difference in perception of barriers for nurses at hospitals providing different levels of care; there were significant differences when primary care providers were considered. Intrapartum nurses in facilities where certified nurse-midwives do most deliveries reported significantly fewer barriers than nurses who worked in facilities where physicians attended most deliveries (F=6.84, df=2, p=.000).

Conclusion: The culture of the birthing unit in which nurses provide care influences perception of barriers to the use of hydrotherapy in labor. Providing hydrotherapy requires a supportive environment, adequate nursing policies and staffing, and collaborative relationships among the health care team.

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