Water Births Are No More Risky Than Land Births

A new study suggests that water births are safe, and that women who take advantage of them sustain fewer first and second-degree tears.

Researchers at the University of Michigan (U-M; Ann Arbor, USA) conducted a retrospective study that analyzed 397 water births and 2,025 land births from two midwifery practices in a hospital setting. Land birth cases were excluded if they included issues that would preclude them from water birth, such as an epidural, meconium stained fluid, chorioamnionitis, gestational age lower than 37 weeks, or a body mass index (BMI) of over 40 kg/m². Neonatal outcomes included Apgar score and admission to the neonatal intensive care unit (nICU); maternal outcomes included perineal lacerations and postpartum hemorrhage.

The results revealed that there were no differences in outcomes between waterbirth and land birth for nICU admissions (1.8% versus 2.5%, respectively), nor for Apgar scores. Women in the water birth group were less likely to sustain a first‐ or second‐degree laceration, and postpartum hemorrhage rates were similar for both groups. Similar results were obtained when evaluating a land birth subset matched on insurance, hospital location, and parity using propensity scores. The study was published on December 10, 2019, in the journal Birth.

“In this study, water birth was not associated with increased risk to neonates, extensive perineal lacerations, or postpartum hemorrhage,” conclude senior author Professor Lisa Kane Low, PhD, of the U-M School of Nursing. “The long and short of it is that if you use proper techniques...the outcomes are very good. They mirror what we see in international studies of water birth.”

Water immersion during labor is an effective comfort measure for the mother, who gives birth in a water-filled tub, rather than in a hospital bed. Once birthed in the water, the babies are brought out almost immediately, and take their first breath once removed from the tub. Until then, their lungs are filled with water, which is displaced when they hit the air and breathe. The connected umbilical cord provides oxygen. It is important not to re-submerge the babies.

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