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CONFERENCE PROCEEDING
Midwives generating evidence: Exploring water birth outcomes through professionally governed data
1
New Zealand College of Midwives, Research, Christchurch, New Zealand
2
University of Otago, Population Health, Christchurch, New Zealand
Eur J Midwifery 2026;10(Supplement 1):A73
ABSTRACT
BACKGROUND:
The New Zealand College of Midwives has developed and maintained a comprehensive national midwifery outcomes dataset focused on continuity of care, derived from midwives’ clinical care records. When midwives govern the data they generate, they can use it to answer questions that matter to the profession and the families they care for.
OBJECTIVES:
To demonstrate how midwives can use quantitative research methods and a midwifery-governed dataset to contribute to the evidence base for water birth.
METHODS:
Methods: This retrospective cohort study analysed low-risk births (term, singleton, cephalic, spontaneous vaginal birth without induction, augmentation, or regional anaesthesia) from the College’s national dataset (2012–2014). Logistic regression and non-inferiority analyses were used to compare maternal and neonatal outcomes between water births and conventional births.
RESULTS:
Among 47,651 women, 15.3% had water births. Water birth was associated with significantly better maternal outcomes, including reduced blood-loss (aOR 0.81, p≤0.001), fewer severe perineal tears (aOR 0.60, p≤0.001), and fewer episiotomies or tears overall (aOR 0.71, p≤0.001). Neonatal outcomes showed slightly higher odds of Apgar <7 at 1 and 5 minutes (NNH 3,333), but non-inferiority tests were inconclusive. Babies born in water were less likely to require resuscitation (aOR 0.85, p=0.001).
CONCLUSIONS:
Water birth is a safe option for women and babies at low risk of complications in labour and birth. Completed in 2018 but not previously reported, this study highlights the value of midwives asking practice-based questions using robust quantitative methods. It underscores the importance of midwives collecting, maintaining, and having control over their practice data – a key requirement for the College when it recently agreed to move to a multidisciplinary, community and hospital shared maternity care record.
KEY MESSAGE:
Professionally maintained datasets can generate midwifery-led evidence to inform practice and policy, and also affirm the value of midwifery research and leadership in shaping the future of maternity care. Continuity of care - outcomes 2
The New Zealand College of Midwives has developed and maintained a comprehensive national midwifery outcomes dataset focused on continuity of care, derived from midwives’ clinical care records. When midwives govern the data they generate, they can use it to answer questions that matter to the profession and the families they care for.
OBJECTIVES:
To demonstrate how midwives can use quantitative research methods and a midwifery-governed dataset to contribute to the evidence base for water birth.
METHODS:
Methods: This retrospective cohort study analysed low-risk births (term, singleton, cephalic, spontaneous vaginal birth without induction, augmentation, or regional anaesthesia) from the College’s national dataset (2012–2014). Logistic regression and non-inferiority analyses were used to compare maternal and neonatal outcomes between water births and conventional births.
RESULTS:
Among 47,651 women, 15.3% had water births. Water birth was associated with significantly better maternal outcomes, including reduced blood-loss (aOR 0.81, p≤0.001), fewer severe perineal tears (aOR 0.60, p≤0.001), and fewer episiotomies or tears overall (aOR 0.71, p≤0.001). Neonatal outcomes showed slightly higher odds of Apgar <7 at 1 and 5 minutes (NNH 3,333), but non-inferiority tests were inconclusive. Babies born in water were less likely to require resuscitation (aOR 0.85, p=0.001).
CONCLUSIONS:
Water birth is a safe option for women and babies at low risk of complications in labour and birth. Completed in 2018 but not previously reported, this study highlights the value of midwives asking practice-based questions using robust quantitative methods. It underscores the importance of midwives collecting, maintaining, and having control over their practice data – a key requirement for the College when it recently agreed to move to a multidisciplinary, community and hospital shared maternity care record.
KEY MESSAGE:
Professionally maintained datasets can generate midwifery-led evidence to inform practice and policy, and also affirm the value of midwifery research and leadership in shaping the future of maternity care. Continuity of care - outcomes 2
| eISSN: | 2585-2906 |
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