Dear HON DR Kim Hames (Minister For Health, Western Australia)

We are two mothers writing to you as residents within the the Rockingham and Peel regions. We are firm advocates for the availability of women's choices in birth, which is why we are requesting a revision of the policy in Water Births across WA (and in particular at Rockingham General Hospital).

THE WATERBIRTH PROBLEM AT ROCKINGHAM HOSPITAL
As it stands, policy at Rockingham Hospital (and some other public hospitals in the state) will allow a woman to utilise the birth pool during the first stage of labour (water immersion), however the midwife will then request that the woman exit the birth pool in time for the second stage of labour (during the pushing phase and actual birth).

WHY IS THIS AN ISSUE
In doing so this can be disruptive to the labour process and the hormones of birth. Besides being uncomfortable for women it can also cause a reversal of dilation.Not to mention that a woman's pain relief has now been removed at a point where most other pain relief options are off the menu. She also misses out on the benefits of water birth.

WHAT ARE THE BENEFITS OF WATER BIRTH?

Studies have shown the benefits of water birth are as follows (evidencebasedbirth.com/waterbirth/):

• higher rates of spontaneous vaginal births
• decreased episiotomy rate
• better chance of birthing with an intact perineum 
• used less pain medications compared to women who had land births
• women who had waterbirths had average pain ratings that were lower than all the women who had land births—even lower than the women with epidurals

HOW SAFE IS WATER IMMERSION?
The safety of water immersion during labour has already been firmly established (Cluett et al. 2009).

HOW SAFE IS WATER BIRTH?

Based on the data that we have, waterbirth is a reasonable option for low-risk women during childbirth, provided that they understand the potential benefits and risks. If women have a strong desire for waterbirth, and there are experienced care providers who are comfortable in attending waterbirths, then at this time there is no evidence to deny women this option of pain relief.

Although we need more research on waterbirth, the available research shows that universal bans on waterbirth are not evidence-based."

WHAT OPTIONS ARE CURRENTLY AVAILABLE?

Currently the options available for a woman in the Rockingham and Peel Region wishing to deliver their baby in water are to travel to Fiona Stanley, King Edward Birthing Centre or have a planned Home Birth.

We feel that this is not adequate as many women:

-may not be comfortable with the long drive to Fiona Stanley Hospital, to King Edward Memorial Hospital or feel comfortable with a home birth. It is imperative that local options be made available to provide woman with the birthing options they are entitled to.

Having experienced three (3) water births between us, we are acutely aware of the excellent benefits offered by waterbirth.

WHAT DO WE WANT FROM YOU?

To change this we need you to effect a policy across WA public hospitals allowing women who are labouring in water to remain in the water to birth their babies.This also means that midwives in labour wards all need to be trained in waterbirth delivery, so that you can guarantee no matter which midwife you get she has the training to safely assist you to have your baby in water.

We ask that you please consider this request and act to the benefit of the local community.

We would very much appreciate a response to this letter advising of the steps you are taking to address this request.

We thank you in advance for consideration of this matter.

Yours sincerely,

Kelly Evans & Kylie Rose