Objective: To observe and describe the positions and movements women choose while immersed in water during the first stage of labor.
Design: Descriptive, observational pilot study.
Setting: A rural community hospital that provided hydrotherapy in labor.
Participants: Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice.
Measures: For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements.
Results: Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed.
Conclusions: Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.