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News & Press: AABC News

Leading Maternity Care Providers Develop Guidance on Water Labor and Birth

Wednesday, November 30, 2016   (0 Comments)
Posted by: Kate Bauer

Template Fills Void in Maternity Care Practices

Silver Spring, MD – For the first time, guidance on hydrotherapy during labor and birth has been created by maternity care experts providing health care professionals and institutions with consensus that had been previously lacking on this topic. Four leading providers of maternity care services, American College of Nurse-Midwives (ACNM), the American Association of Birth Centers (AABC), Midwives Alliance of North America (MANA) and National Association of Certified Professional Midwives (NACPM), jointly assembled the guidance template using the most current information and best practices available to outline various roles and responsibilities for caring for women who labor and/or give birth in water.

This new document has been informed by methodologically-sound, peer-reviewed studies that have been published to date. The template format allows for adapting and tailoring the guidance according to the maternity care team members providing the care, their institutions and their birth settings. It will be published in the January/February 2017 issue of the Journal of Midwifery & Women’s Health and is available online now for early review.

“Together with our partners, we sought to fill a large void on best practice guidance for caring for families who desire hydrotherapy during labor and birth,” said ACNM President Lisa Kane Low, CNM, PhD, FACNM, FAAN. “As maternity care providers, we provide evidence-based practices to those we care for. But unfortunately, the available information and official positions on water birth have varied, which has made access to hydrotherapy difficult for those families who want hydrotherapy to be a part of their maternity care experience. This document offers guidance for maternity care professionals to aid them in making sound decisions and giving recommendations to those who want to labor, or labor and give birth, in water.”

“Hydrotherapy has been well integrated into interprofessional maternity care in the United Kingdom since the 1980s with written evidence-based guidelines. Our template offers best practice principles and a standardized approach to providing safe intrapartum immersion for women seeking immersion in the United States,” said Elizabeth Nutter CNM, DNP, co-editor of the guidelines. “Water labor and water birth promote physiologic birth while providing highly effective pain management. Intrapartum immersion empowers the mother to give birth free from unnecessary intervention.”

Lesley Rathbun, MSN, FNP, CNM, president of AABC, said, "Our research supports the safety of water birth as an effective method of labor pain management when used by skilled, anticipatory providers using appropriate criteria. Many AABC birth centers offer water labor and birth, and we are proud to have participated in this document that will improve access and birth choices for mothers in the US.”

Colleen Donovan-Batson, MS, CNM, ARNP, director of Health Policy & Advocacy, MANA, said, "The largest ever research on water birth found that, for low-risk mothers whose labors proceed normally, water immersion is generally a safe pain management option. That's why Midwives Alliance wanted to make sure this best practice guidance is available to care providers."

“Immersion in water for labor and birth supports healthy and normal physiologic childbirth, and people giving birth want it as an option,” said Mary Lawlor, CPM, LM, MA and executive director of NACPM. “These guidelines provide critical evidence-based information that will support choice for childbearing people and sound clinical practice in all birth settings.”

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About ACNM
With nearly 7800 members, ACNM is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. ACNM promotes excellence in midwifery education, clinical practice, and research. With roots dating to 1929, our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM provides research, administers and promotes continuing education programs, establishes clinical practice standards, and creates liaisons with state and federal agencies and members of Congress to increase the visibility and recognition of midwifery care.

About AABC
AABC is a multi-disciplinary membership organization comprised of birth centers, and individuals and organizations that support the birth center concept including certified nurse midwives (CNMs), certified professional midwives (CPMs), physicians, nurses, women and their families. Founded in 1983, AABC is dedicated to developing quality holistic services for childbearing families that promote self-reliance and confidence in birth and parenting. AABC publishes materials on birth centers, sets national standards for birth center operation, and promotes state regulations for licensure and national accreditation by the Commission for the Accreditation of Birth Centers. More information about AABC can be found at

About MANA
MANA is a professional midwifery association uniquely positioned to unite and strengthen all midwives through dedication to innovative education, professional development, and recognized autonomous practice. MANA is committed to enabling transformative research, promoting an evidence-based Midwifery Model of Care, addressing health disparities, and achieving optimal outcomes through normal physiologic birth and healthcare across the lifespan. Learn more at

NACPM is the membership organization specifically representing certified professional midwives (CPM) in the United States. CPMs, a rapidly growing segment of the profession, are primary maternity care providers trained to offer high-quality, evidence-based care to people during the childbearing year, incorporating best practices to foster normal physiologic birth. CPMs may qualify to provide care in all settings, with special training for community-based service in homes and free-standing birth centers. Founded in 2001, NACPM has adopted a policy agenda for promoting integration of CPMs into the maternity care system, addressing barriers to practice, supporting licensing in all 50 states, promoting quality care through clinical practice resources, and engaging in state and federal advocacy to increase all childbearing people’s access to quality care and address birth outcome disparities.

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