title: Barriers to the use of hydrotherapy in labor.
abstract: OBJECTIVE
  To determine nurses' perceived barriers to the use of hydrotherapy in labor. While effective in relieving pain, reducing anxiety, encouraging relaxation, and promoting a sense of control, hydrotherapy is rarely used during labor.
  
  
  METHODS
  Comparative descriptive survey design.
  
  
  METHODS
  A national convention and perinatal listserves.
  
  
  METHODS
  Intrapartum nurses (N=401) attending a national convention (Association of Women's Health, Obstetric, and Neonatal Nurses, 2007; n=225) and members of perinatal listserves (n=176) were recruited.
  
  
  METHODS
  A questionnaire was designed for this study (Nurses' Perception of the Use of Hydrotherapy in Labor). The questionnaire was available in paper format and online.
  
  
  RESULTS
  Institutional but not individual characteristics (age, education, and role) were associated with Nurses' Perception of the Use of Hydrotherapy in Labor. Nurses who reported higher epidural rates (r=.45, p=.000) and Cesarean section rates (r=.30, p=.000) reported more barriers. There was no difference in perception of barriers for nurses at hospitals providing different levels of care; there were significant differences when primary care providers were considered. Intrapartum nurses in facilities where certified nurse-midwives do most deliveries reported significantly fewer barriers than nurses who worked in facilities where physicians attended most deliveries (F=6.84, df=2, p=.000).
  
  
  CONCLUSIONS
  The culture of the birthing unit in which nurses provide care influences perception of barriers to the use of hydrotherapy in labor. Providing hydrotherapy requires a supportive environment, adequate nursing policies and staffing, and collaborative relationships among the health care team.
authors.affiliation: Bronson School of Nursing, Western Michigan University, Kalamazoo, MI.. Electronic address: mary.stark@wmich.edu.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Stark
authors.affiliation: Athletic training in the Department of Health, Physical Education and Recreation, Western Michigan University, Kalamazoo, MI.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Miller
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006875:Hydrotherapy / Q000451:nursing*; D007743:Labor, Obstetric; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009773:Obstetric Nursing; D011247:Pregnancy; D011795:Surveys and Questionnaires