Systematic Review of Hydrotherapy Research

Abstract

Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices. Studies examined more than 30 fetal and neonatal outcomes, and no benefit or harm of hydrotherapy was identified. Two trials had anomalous findings of increased newborn resuscitation or nursery admission after hydrotherapy, which were not supported by additional results in the same or other studies. Review findings demonstrate that intrapartum immersion hydrotherapy is a helpful and benign practice. Hydrotherapy facilitates physiologic childbirth and may increase satisfaction with care. Maternity care providers are recommended to include hydrotherapy among routine labor pain management options and consider immersion to promote progress of normal or protracted labor, particularly among women with preferences to avoid obstetric medications and procedures.

Intact Perineum: What are the Predictive Factors in Spontaneous Vaginal Birth?

“…Our analysis showed no statistically significant association between hydrotherapy and intact perineum (OR 0.821; 95% CI 0.580-1.162; p=0.266). In a systematic review on the use of hydrotherapy before conventional childbirth it was concluded that maternity care providers should include hydrotherapy among routine labour pain management options and consider immersion to promote progress of normal or protracted labour, particularly among women with intention to avoid obstetric medications and procedures (33). However, no reference was made about the effect on perineal damage.…”

“…In several studies the birth weight was found to be associated with severe perineal trauma (25,36-38). Birth weight is an important factor which influences the rates of episiotomies (18,33). Despite this, other studies revealed no effect of birth weight on perineal damage (14) and that birth weight was not associated with the performance of episiotomies (14,39).…”

Factors influencing the use of birth pools in the United Kingdom: Perspectives of women, midwives and medical staff

“…Immersion in water for labour provides a number of benefits, including analgesia (Eberhard et al., 2005; da Silva et al., 2009), relaxation (Benfield et al., 2010; Ulfsdottir et al., 2018), reduced likelihood of intervention (Burns et al., 2012; Henderson et al., 2014), increased breastfeeding initiation and higher maternal satisfaction (Lathrop et al., 2018). Limited research on the safety of waterbirth indicates no evidence of increased risk of an adverse outcome for women or neonates from immersion in water for labour or birth (Taylor et al., 2016; Shaw-Battista, 2017; Cluett et al., 2018; Vanderlaan et al., 2018).…”

Barreiras à implementação de recomendações para assistência ao parto normal: revisão rápida de evidências

“…Algumas mulheres não desejam receber intervenções médicas durante o parto, o que pode interferir na escolha do local do parto; por outro lado, outras esperam intervenções, o que pode ser entendido pelos profissionais como indicador de sua passividade e aceitação do modelo de cuidado medicalizado (12,16). As mulheres podem apresentar dificuldades em aceitar a analgesia epidural por medo do procedimento e de seus riscos (21); entretanto, a escolha da analgesia epidural como primeiro método de alívio da dor pode restringir o uso de métodos não farmacológicos (29).…”

“…Na dimensão da gestão dos serviços e sistemas de saúde, a falta de medicamentos e outros insumos é uma barreira para a assistência adequada ao parto (13,16,17,20,21,29). Problemas de infraestrutura podem prejudicar a privacidade da mulher, e a ausência de espaços adequados impede a presença de acompanhantes (16,19,21).…”