Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Ng SM(1), Chan SC(1), Chung KY(1)
Affiliation :
(1)Department of Obstetrics & Gynecology, Prince of Wales Hospital, Hong Kong
Introduction :
Water immersion is effective for labour pain relief and reducing the use of epidural analgesia. It promotes positive childbirth experience and freedom of movement. This service aims to enhance normal birth and satisfaction levels.
Objectives :
1. Enhance childbirth experience and higher satisfaction.
2. Facilitate freedom of movement and varied birth positions in the pool.
3. Reduce pharmacological pain relief and labour duration.
Methodology :
This service was planned to start in 2022 and guided by a “Plan-Do-Check-Act” model.
Plan
- Conducted an online survey to understand pregnant women’s interest in water immersion.
- Minor improvement work was made in the delivery suite, specifically the water drainage system.
- Developed guidelines for water immersion.
- Conducted staff training for water immersion and emergency evacuation drills.
Do
- Recruited low-risk women or those interested in water immersion.
- Transferred them to the Mother-Friendly Room and care for them with a designated midwife.
- Monitored labour progress according to the guideline and allowed women to stay in the pool as desired.
Check
- Collected feedback through interviews, questionnaires, and staff input.
Act
- Reviewed feedback and took appropriate actions to improve the service.
Result & Outcome :
Since February 2023, eight women have undergone water immersion for labour pain relief. Seven experienced spontaneous onset of labour, while one required induction due to large for gestation age fetus. The average pain score decreased from 8 to 3 after immersion. Different positions were utilized within the pool. The average duration of the first stage labour was 11 hours. Five women had a normal vaginal delivery, one required vacuum extraction for prolonged second stage, and two underwent emergency Cesarean Sections due to failed induction and no progress of labour, respectively. Despite not all deliveries resulting in a normal vaginal delivery, all women reported excellent pain relief, reduced pressure in the water, enabling freedom of movement. The warm water provided comfort, especially in the back area.
Conclusion:
The introduction of water immersion as an alternative approach to labour pain relief has yielded promising outcomes, contributing to positive childbirth experiences, unrestricted movement, and reduced reliance on pharmacological pain relief. Further exploration and optimization of this service are warranted to enhance the quality of maternity care and empower women for fulfilling childbirth experiences.
