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CELEBRATE! profile: Alyssa Crawford

A public health studies major explores how pregnant women approach the decision about whether to have a waterbirth. 

​CELEBRATE! Week offers an annual opportunity to highlight the academic and artisitic achievements of Elon students and faculty. Each day this week, we'll be putting the spotlight on a student scholar's research — what they are seeking to find out, and how they became interested in their project. 

Name​: Alyssa Crawford

Major: Public health studies

Minors: Biology and women, gender and sexuality studies

Faculty mentor: Cynthia Fair, professor of human service studies

Title of research: The Decision Making Process of Women Who Plan Waterbirths


Previous research indicates that the immersion of the body in warm water during any stage of labor has been shown to provide specific benefits to women, including a reduction of pain related to labor, a shorter labor, as well as a higher satisfaction with the birthing experience, though little is known about the decision-making process of women who choose to give birth in water.

This project aimed to understand women’s decision-making process through the use of interviews and response analysis. This study included 23 women (mean age = 33.5 years, mean number of children = 2.5) who had planned a waterbirth with the providers of a prenatal care clinic in a mid-sized southeastern city in the United States, and brought a birthing tub to the hospital. Questions explored how they came to the decision to pursue a waterbirth, sources of information, support systems, and resistance.

Interviews were recorded, transcribed and coded for emergent themes using standard qualitative analytic approaches. Analyses revealed that pain management and a desire for limited medical interventions were the primary reasons for choosing waterbirth. Women sought information about waterbirths from the internet and friends. Many had decided they wanted to explore waterbirth before discussing it with their nurse midwife.

Eight out of 23 participants changed practices in order to have access to waterbirth. Three-fourths experienced resistance toward their decision from others including family, friends, coworkers, and strangers. Twenty participants utilized doulas for emotional and instrumental support. The overwhelming majority were positive about their experience, even if they were unable to give birth in the water, and encouraged other women to consider waterbirth. Most indicated they wanted to have a waterbirth in the future. 

The findings of this study will be used to inform medical providers about why women are choosing waterbirth, and as a way to provide more information to women who are making decisions regarding their birthing plans.

In other words:

Though the benefits of waterbirth have been established through research, little is known about the decision-making process of women who choose to pursue a waterbirth. This project aimed to understand this process through interviews and response analysis. Twenty-three women who had planned a waterbirth were recruited to participate in the study. Preliminary results have shown that women were seeking a way to manage pain, or to avoid medical intervention. Many were seeking a natural birth. Women utilized the internet and friends as major sources of information. The majority of the women experienced resistance toward their decision. Women who have pursued waterbirth are overall enthusiastic about the benefits of using the tub during labor and delivery, and many would choose to plan a waterbirth for future births.

Explanation of study:

This study began as an exploration of a gap in the literature that showed that there was little knowledge of how women make decisions regarding having a waterbirth. Despite the fact that the American College of Obstetricians and Gynecologists has released multiple statements discounting the benefits of waterbirth, women are still seeking to have one. It is important to better understand how women come to this decision in order to provide accurate information to women and providers regarding waterbirth.

What made this research interesting to you? How did you get started?

Pregnancy and childbirth has always been an interest of mine. Even from a young age, I remember being fascinated by women’s bellies, babies, and even my own birth story. I am incredibly lucky to have found a research project that aligns so closely with my own interests, but it wasn’t easy to get to where I am now.

Many people told me that researching pregnancy and childbirth as an undergraduate student would be impossible. However, my research mentor, Cynthia Fair, supported my interests and gave me the opportunity to pursue this project. I never thought that I would be researching waterbirth as a college student, and knew very little about it going into this experience.

The work that I have done has altered my career plans and has given me new insight into childbirth and the experiences of women.


Owen Covington,
4/27/2017 8:05 AM