Waterbirth - experiences of women, and professional experiences of the attending midwives

ISRCTN	ISRCTN15500495
DOI	https://doi.org/10.1186/ISRCTN15500495
Sponsor	University of Western Macedonia, Department of Midwifery
Funder	Investigator initiated and funded

Submission date: 09/09/2026
Registration date: 22/09/2026
Last edited: 11/09/2026

Recruitment status: Recruiting
Overall study status: Ongoing
Condition category: Pregnancy and Childbirth

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
Waterbirth is increasingly being offered as an option for women with uncomplicated pregnancies and is associated with a more positive childbirth experience for many women. However, evidence regarding maternal and neonatal outcomes, as well as women's and midwives' experiences of waterbirth in Greece, is limited. This study aims to compare maternal and neonatal outcomes and childbirth experiences between women who gave birth in water and women who had vaginal births outside water. The study also aims to explore the experiences of midwives who support waterbirths in Greece and identify factors associated with perinatal outcomes and childbirth experiences.

Who can participate?
Women aged 18 years or older who gave birth in Greece, either in water or by vaginal birth outside water, and are able to provide informed consent can participate. Registered midwives with experience in supporting waterbirths in Greece are also eligible to participate.

What does the study involve?
Participants will be recruited through social media, professional organisations, maternity hospitals and professional networks across Greece. Women and midwives who agree to participate will take part in an online interview during which a structured questionnaire will be completed. Women will be asked about their pregnancy, labour, birth and postnatal experience, while midwives will be asked about their experience of supporting waterbirths. No medical treatment or intervention will be provided as part of this study.

What are the possible benefits and risks of participating?
There are no direct medical benefits to participants. However, the information collected may contribute to improving maternity care and the evidence base regarding waterbirth in Greece. Participation involves minimal risk. Some participants may feel emotional discomfort when recalling their birth experiences, but they may decline to answer any question or withdraw from the study at any time without consequence.

Where is the study run from?
The study is run from the University of Western Macedonia, Greece. Data collection will be conducted online, with participants recruited from across Greece.

When is the study starting and how long is it expected to run for?
October 2026 to October 2027.

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Nikoleta Chatzipanagiotidou, BSc, MSc, PhD Candidate, Department of Midwifery, University of Western Macedonia, Greece, n.chatzipanagiotidou@gmail.com

Contact information

Ms Nikoleta Chatzipanagiotidou
Scientific, Principal investigator

Department of Midwifery
School of Health Sciences
University of Western Macedonia
Ptolemaida
50200
Greece

ORCID ID	0009-0000-1082-7173
Phone	+30 24610-68050
Email	dmw0033@uowm.gr; n.chatzipanagiotidou@gmail.com

Dr Dimitrios Papoutsis
Public

Department of Midwifery
School of Health Sciences
University of Western Macedonia
Ptolemaida
50200
Greece

Phone	+30 24610-68050
Email	dpapoutsis@uowm.gr

Study information

Primary study design	Observational
Observational study design	Cross sectional study
Scientific title	Waterbirth in Greece: the perinatal outcomes and childbirth experiences of women and the professional experiences of the attending midwives
Study acronym	WATERBIRTH
Study objectives
Ethics approval(s)	Approved 09/03/2026, Research Ethics Committee, University of Western Macedonia (University Administration Building, University of Western Macedonia, ZEP Campus, 50100 Kozani, Greece, Kozani, 50100, Greece; +30 24610-56200; ehde@uowm.gr), ref: 372/09.03.2026
Health condition(s) or problem(s) studied	Waterbirth
Methodology	The study is cross-sectional observational study conducted in Greece. Women who experienced a waterbirth, women who experienced a vaginal birth outside water (comparison group), and registered midwives with professional experience in supporting waterbirths will be invited to participate. Once the participants are recruited, quantitative and qualitative data will be collected through structured questionnaires administered during online interviews. Quantitative data will be analysed using descriptive and inferential statistical methods, while qualitative data will be analysed using thematic analysis. The study aims to compare perinatal outcomes and childbirth experiences between women who gave birth in water and women who had vaginal birth outside water, as well as to explore the professional experiences of midwives supporting waterbirths.
Intervention type	Other
Primary outcome measure(s)	Comparison of maternal and neonatal perinatal outcomes between women who gave birth in water and women who had a vaginal birth outside water measured using a structured questionnaire. The maternal outcomes include perineal trauma, postpartum haemorrhage, management of the third stage of labour and maternal complications. The neonatal outcomes include Apgar score, neonatal intensive care unit admission, need for resuscitation and neonatal complications, measured at a single assessment during the online interview Women's childbirth experience will be compared between waterbirth and vaginal birth outside water and assessed measured using a structured questionnaire including quantitative items and qualitative responses at a single assessment during the online interview Midwives' professional experience of supporting waterbirths measured using a structured questionnaire including quantitative items and qualitative responses at a single assessment during the online interview
Key secondary outcome measure(s)	Identify independent predictors (risk factors) that are associated with the perinatal outcomes, the childbirth experience of women, and the professional experience of attending Midwives measured using a structured questionnaire including quantitative items and qualitative responses at a single assessment during the online interview
Completion date	01/12/2027

Eligibility

Participant type(s)
Age group	Adult
Lower age limit	18 Years
Upper age limit	45 Years
Sex	All
Target sample size at registration	300
Key inclusion criteria	1. Women aged ≥18 years who gave birth in water in Greece and are able to provide informed consent 2. Women aged ≥18 years who gave birth on dry land (not in the water) in Greece and are able to provide informed consent (control group) 3. Registered midwives with experience in supporting waterbirths in Greece who are able to provide informed consent 4. Participants must be able to communicate in Greek and complete the study questionnaire
Key exclusion criteria	1. Women aged <18 years 2. Women who had a waterbirth but not in Greece 3. Registered midwives who do not support waterbirths in Greece 4. Individuals unable to provide informed consent 5. Participants unable to communicate in Greek or complete the questionnaire 6. Incomplete questionnaires
Date of first enrolment	01/10/2026
Date of final enrolment	01/10/2027

Locations

Countries of recruitment

Greece

Study participating centres

Results and Publications

Individual participant data (IPD) Intention to share	No

Editorial Notes

09/09/2026: Trial's existence confirmed by Research Ethics Committee, University of Western Macedonia.