title: Observing position and movements in hydrotherapy: a pilot study.
abstract: OBJECTIVE
  To observe and describe the positions and movements women choose while immersed in water during the first stage of labor.
  
  
  METHODS
  Descriptive, observational pilot study.
  
  
  METHODS
  A rural community hospital that provided hydrotherapy in labor.
  
  
  METHODS
  Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice.
  
  
  METHODS
  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.
authors.affiliation: Bronson School of Nursing, Western Michigan University, Kalamazoo, MI 49008, USA. mary.stark@wmich.edu
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Stark
authors.forename: Barb
authors.initials: B
authors.lastname: Rudell
authors.forename: George
authors.initials: G
authors.lastname: Haus
mesh_terms: D003657:Decision Making; D036861:Delivery, Obstetric / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D006875:Hydrotherapy / Q000451:nursing* / Q000523:psychology; D007231:Infant, Newborn; D048949:Labor Pain / Q000451:nursing / Q000523:psychology*; D007747:Labor Stage, First / Q000523:psychology*; D009321:Natural Childbirth / Q000451:nursing* / Q000523:psychology; D010865:Pilot Projects; D011187:Posture; D011247:Pregnancy; D011256:Pregnancy Outcome; D012424:Rural Population; D016896:Treatment Outcome; D014867:Water
chemical_list: D014867:Water