Waterbirth--an international overview: Dianne Garland, a freelance UK-based midwife lecturer, spoke at the ICM Brisbane Congress and now gives an update on the practice of waterbirth around the world.

• Auteur: Garland, Dianne
• Tenlastelegging: United Kingdom - Institute for Complementary Medicine

In ancient times it was reported that Egyptian priests and priestesses were born into water; stories from traditional cultures in both North and South America, from the Maoris of New Zealand, from the Samoan people of the Pacific and from Hawaii all bear testimony to a long history of waterbirth.

More recently, in the 1960s came news about the work of Tjarkovsky in Russia and in the 1980s of Odent in Pithiviers, France, who both pioneered a 20th-century way forward offering women facilities for waterbirth in home-made tubs and large paddling pools. The images presented on UK television in the 1980s were very powerful for me, a student midwife training in London. The type of care and support for mothers that seemed integral to waterbirth stimulated my thoughts into practical aspects--how could I learn more about the immense opportunities of increased relaxation offered by the use of water? how could I support mothers with this option? On a personal level, the philosophy of working with women, using all my midwifery skills--watching, listening, sharing and empowering--was the way that I wanted to practise in my new career.

Times have changed again and now we are aware of the birth of thousands of waterbabies recorded in 69 countries as far apart as China, Australia, Guatemala and Iceland.

This article is a short review of practice and some of the challenges placed upon practitioners as they work within their own unique environments supporting the ethos of waterbirth.

International perspectives

Japan: Here, for example, midwife Fuseiko Sei has been practising water labour and waterbirth for many years. Japan is a highly technological country which has nevertheless seen a resurgence over recent years in home birth or, more commonly, 'midwife own home birth' where the expectant mother gives birth in the midwife's own home.

China: The gradual 'westernisation' of medical obstetrics is being challenged by practitioners at Changning hospital in Shanghai. An interest in waterbirths began in 2003 when a Chinese woman married to an American requested this option.

At a recent conference, over 100 practitioners attended a USA/UK presentation on waterbirth. There are barriers owing to differences in culture both from medical care and Chinese traditions but these are now being challenged. However, with a 'one-baby' stance in China, mothers need advice and support before moving away from a strong elective pro-Caesarean section (CS) attitude.

Russia: Home of...