Ireland issues first national guidelines for water births

Ireland has introduced its first national clinical practice guidelines for water births, aiming to standardize care and support informed choices for expectant mothers. Developed by the HSE's National Women and Infants Health Programme and approved by the Institute of Obstetricians and Gynaecologists, these guidelines establish a consistent approach to using birthing pools in all maternity settings, including hospitals and homes.

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This will support high-quality, evidence-based care and there will be less of units doing their own thing.

The new document details patient monitoring, practical standards for water temperature and depth, and emergency procedures. "This will support high-quality, evidence-based care and there will be less of units doing their own thing," said Paula Barry, lead author of the guidelines and an assistant director of midwifery at The Coombe Hospital in Dublin. She emphasized that the guidelines are for healthy women with low-risk pregnancies, outlining strict eligibility criteria such as being term, in normal labor, and without conditions like high blood pressure or diabetes.

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It's for healthy women with a low-risk pregnancy. You're term, you're due, you are in normal labour yourself, no high blood pressure, not diabetic, not twins - all of that we look at.

Barry expressed hope that the criteria could be expanded in the future to accommodate more women. "This is the beginning. We'll plan and move forward and begin to look at how we can accommodate women with risk factors to safely use water for labour and birth," she stated. "Our ultimate aim is to individualise care as best we can, once the care is safe and acceptable to the woman."

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This is the beginning. We'll plan and move forward and begin to look at how we can accommodate women with risk factors to safely use water for labour and birth.

Currently, 12 out of Ireland's 19 maternity units have birthing pools, though not all offer water delivery. The guidelines note that several more units are planning to introduce them. While interest in water births is growing, actual usage varies, with some weeks seeing only a few women utilize the pools. National statistics on water birth numbers are not yet available, but data from home births in 2023 shows that up to 50% of women opting for a home birth labor in water, with about half proceeding to a water birth.

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Our ultimate aim is to individualise care as best we can, once the care is safe and acceptable to the woman.