Obstetric and neonatal outcomes for women intending to use immersion in water for labour and birth in Western Australia (2015–2016): A retrospective audit of clinical outcomes

Lewis, Lucy; Hauck, Yvonne; Butt, Janice; Hornbuckle, Janet

doi:10.1111/ajo.12758

Cited by 20 publications

(46 citation statements)

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“…Although the randomized control trial included only women intending a waterbirth, the US hospital‐based study included a broader population of women intending only labor in the water as well as women intending waterbirth . The other studies from Italy and Australia are less clear, lacking a statement as to whether the sample was limited to women intending waterbirth . The current study excluded women who only wanted hydrotherapy and did not intend to give birth in the water.…”

Section: Discussionmentioning

confidence: 99%

“…Although no other studies have documented the water immersion experience or provided the same detailed outcomes for a US hospital‐based population intending waterbirth, a few studies provide some data on tub exit . One study that took place in a US hospital documented hydrotherapy use during labor for births managed by nurse‐midwives and provided estimates of service demand for hospitals considering hydrotherapy services .…”

Section: Discussionmentioning

confidence: 99%

“…The study included 10,290 neonates not born in water, 6534 born in water, and 1573 classified as “intended waterbirth,” which is not clearly defined but implies that women in this group all experienced water immersion. The other studies include an examination of 2505 women using a waterbirth tub from 19 different obstetric units in Italy, an Australian retrospective chart review of 303 women who had either water immersion for labor or waterbirth attended by midwives at a birth center for low‐risk women affiliated with a tertiary public hospital, and the often‐cited English study designed to assess feasibility of a randomized control trial for waterbirth . This English study randomized 60 women to waterbirth (n = 40) or land birth (n = 20).…”

Section: Discussionmentioning

confidence: 99%

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Who Gives Birth in the Water? A Retrospective Cohort Study of Intended versus Completed Waterbirths

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Vacquier

Simon

et al. 2019

J Midwife Womens Health

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Introduction: Most waterbirth studies have been conducted outside the United States with a primary focus on birth outcomes. Studies to date provide limited information about how often women choosing waterbirth end water immersion before the birth and about the reasons for tub exit. This study examines a cohort of women intending a hospital-based waterbirth and documents the timing and reasons for tub exit. Demographic, clinical, and intrapartum care provider characteristics among women completing waterbirth were compared with those who exited the water prior to birth.Methods: This is a collaborative, multisite study from 2 health systems (8 hospitals) using retrospective electronic health records from August 2014 through December 2017. Results:Of 576 women who entered the waterbirth tub, 48% exited prior to the birth. The primary reasons for exit were maternal choice (50%), medical indication (32%), and provider decision (13%). Women exiting in the first stage did so primarily by choice (57%), whereas medical indication (42%) was the most common reason among women exiting in the second stage. Women who completed waterbirth did not differ from those who exited prior to birth with regard to age, race, ethnicity, country of origin, language, marital status, or intrapartum care provider specialty. Women completing waterbirth were more likely to have previously given birth (72% vs 47%) and to have a provider with more water immersion births during the study period (65% vs 55%). Discussion:Giving birth in the tub was associated with parity and intrapartum care provider experience. Half of the women intending waterbirth in this study exited the tub, with variation in exit reason by stage and provider type. It is important for women to understand that they or their provider may change the birth plan based on labor progress and maternal experience.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Who Gives Birth in the Water? A Retrospective Cohort Study of Intended versus Completed Waterbirths

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Vacquier

Simon

et al. 2019

J Midwife Womens Health

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“…1,4 Water immersion during labor has shown mixed results for perineal integrity. 2,5 Studies have not demonstrated neonatal harm from the use of hydrotherapy in the first stage of labor. 7 The body of evidence that addresses the safety of hydrotherapy during birth (waterbirth) is not extensive, with few studies conducted in the United States.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Waterbirth in a US Hospital‐Based Midwifery Practice: A Retrospective Cohort Study of Water Immersion During Labor and Birth

Neiman

Austin

Tan

et al. 2019

J Midwife Womens Health

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Introduction Although the safety of water immersion during labor is largely supported by evidence from research, the risks to women and neonates during waterbirth are not well established. The purpose of this study was to generate evidence regarding maternal and neonatal outcomes related to water immersion in labor and during birth. Methods A retrospective cohort study included a convenience sample of women receiving prenatal care at a nurse‐midwifery practice. Participants were categorized into 3 groups: 1) waterbirth, 2) water labor, or 3) neither. Participant characteristics, maternal outcomes, and newborn outcomes were collected at time of birth and health record abstraction. At the 6‐week postpartum visit, another maternal outcome, satisfaction with birth, was measured using the Care in Obstetrics: Measure for Testing Satisfaction (COMFORTS) scale. Analysis included effect size, descriptive statistics (sample characteristics), and maternal and neonatal group differences (analysis of variance and chi‐square) with a significance level of P < .05. Results Women in the waterbirth (n = 58), water labor (n = 61), and neither (n = 111) groups were primarily white, married, and college educated and did not differ by age or education. Women in the waterbirth group were more likely to be multiparous. Nulliparous women who had a waterbirth had a significantly shorter second stage of labor than nulliparous women who did not have a waterbirth (P = .03). The most commonly cited reasons for discontinuation of hydrotherapy were maternal choice (42.6%) and need for pain medication (29.5%). Significantly more women in the waterbirth group experienced a postpartum hemorrhage, compared with water labor or neither (n = 5, n = 3, n = 1, respectively; P = .045); there was no difference in related clinical measures. Neonatal outcomes were not significantly different. Maternal satisfaction was high across all groups. Discussion The results of this study suggest that waterbirth, attended by qualified intrapartum care providers in hospital settings in the United States, is a reasonable option for low‐risk women and their neonates.

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“…Além disso, quando a mulher está imersa em água é impossível a realização de episiotomia (Lewis et al, 2018;Nutter et al, 2014;Mistrangelo et al, 2007;Bodner et al, 2002). Por outro lado, revisão sistemática de Cluett e Burn (2009) não demonstrou diferença significativa em relação aos desfechos perineais no parto na água.…”

Section: Discussionunclassified

Desfechos perineais no centro de parto normal Casa Angela, São Paulo (SP): estudo transversal

Lopes¹

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Introdução: Os traumas perineais são um dos problemas mais frequentes durante o parto e podem afetar a saúde da mulher, interferindo em sua mobilidade, eliminação vesical e intestinal, cuidados gerais ao recém-nascido (RN) e outras atividades diárias. O local do nascimento, os profissionais que prestam assistência à mulher e as intervenções no parto influenciam a ocorrência do trauma perineal. Os centros de parto normal (CPN) favorecem a adoção de práticas para humanizar o parto e nascimento, respeitam sua fisiologia, a autonomia da mulher e dessa forma contribuem para o cuidado perineal. Objetivos: 1) Verificar a prevalência e o grau de lacerações perineais; 2) Analisar a relação entre a ocorrência e o grau da laceração perineal e as variáveis maternas, neonatais e assistenciais; 3) Analisar a relação entre o grau da laceração perineal e a prevalência do reparo perineal; 4) Analisar a relação entre a realização da sutura perineal e a prevalência de complicações na cicatrização perineal; 5) Verificar a prevalência do uso de métodos naturais no cuidado perineal após o parto. Método: Estudo transversal, com coleta de dados nos prontuários das mulheres que deram à luz no CPN perihospitalar Casa Angela, em São Paulo, SP, de janeiro de 2016 a junho de 2017 (n=415). Como exposição, foram considerados: idade materna, cor da pele, parto vaginal anterior, uso de ocitocina, compressa morna, posição no parto, duração do período expulsivo, distocia de ombros, peso e perímetro cefálico do RN, parto na água, grau de laceração perineal e reparo perineal. Como desfechos, foram considerados: laceração perineal, grau da laceração perineal, reparo perineal e complicações no processo de cicatrização. Os dados foram analisados por estatística descritiva e inferencial. O erro tipo I adotado foi de 5%. As variáveis com valor-p <0,20 foram inseridas em um modelo de análise múltipla. O projeto foi aprovado pelo Comitê

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Obstetric and neonatal outcomes for women intending to use immersion in water for labour and birth in Western Australia (2015–2016): A retrospective audit of clinical outcomes

Abstract: Not all women who set out to labour and birth in water achieve their aim. There is a need for high-quality collaborative research into this option of labour and birth, so women can make an informed choice around this birth option.

Cited by 20 publications

References 13 publications

Who Gives Birth in the Water? A Retrospective Cohort Study of Intended versus Completed Waterbirths

Who Gives Birth in the Water? A Retrospective Cohort Study of Intended versus Completed Waterbirths

Outcomes of Waterbirth in a US Hospital‐Based Midwifery Practice: A Retrospective Cohort Study of Water Immersion During Labor and Birth

Desfechos perineais no centro de parto normal Casa Angela, São Paulo (SP): estudo transversal

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