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J Obstet Gynecol Neonatal Nurs. 2008 Jan-Feb;37(1):116-22. doi: 10.1111/j.1552-6909.2007.00212.x.

Observing position and movements in hydrotherapy: a pilot study.

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Bronson School of Nursing, Western Michigan University, Kalamazoo, MI 49008, USA.



To observe and describe the positions and movements women choose while immersed in water during the first stage of labor.


Descriptive, observational pilot study.


A rural community hospital that provided hydrotherapy in labor.


Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice.


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.


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.


Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

[Indexed for MEDLINE]

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