Waterbirth and pelvic floor injury: a retrospective study and postal survey using ICIQ modular long form questionnaires

Cortes, Eduardo; Basra, Ramandeep; Kelleher, Con

doi:10.1016/j.ejogrb.2010.11.012

Cited by 43 publications

(49 citation statements)

References 18 publications

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“…Only one study compared waterbirth with different landbirth positions finding it to be protective of perineal trauma in comparison to using a birth-stool and squatting positions but less protective than all-fours/kneeling positions . Compared to landbirth in general, an increase in incidence of perineal trauma was found in waterbirth (Cortes et al, 2011, Geissbuehler et al, 2004, Mollamahmutoğlu et al, 2012 contradicting previous research which found no difference in trauma rates between land and waterbirth (Cluett and Burns, 2009). …”

Section: Summary Of Included Studiescontrasting

confidence: 55%

“…While Geissbuehier et al (2004) found a reduction in 3 rd and 4 th degree tears with waterbirth in comparison to landbirth for nulli-and multi-gravid women combined; Cortes et al (2011) found an increase. This study, however, only considered nulligravid women and cannot be compared to other included studies considering waterbirth and 3 rd and 4 th degree tears due to the possible inclusion of episiotomies , Mollamahmutoğlu et al, 2012 in their data.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…Waterbirth: This systematic review found more second degree tears compared to rates of intact perinea and 1 st degree tears (Cortes et al, 2011 but with more intact perinea in multipara women (Mollamahmutoğlu et al 2012). Only one study compared waterbirth with different landbirth positions finding it to be protective of perineal trauma in comparison to using a birth-stool and squatting positions but less protective than all-fours/kneeling positions .…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…This study, however, only considered nulligravid women and cannot be compared to other included studies considering waterbirth and 3 rd and 4 th degree tears due to the possible inclusion of episiotomies , Mollamahmutoğlu et al, 2012 in their data. Cortes et al (2011) findings were linked to the length of immersion in water during labour and the study proposed the water caused an increase in perineal elasticity, shortening the second stage but giving less time for the tissues to stretch. This contradicts Cluett and Burns (2009) who suggested a potential benefit of waterbirth is an increase in elasticity of the birth canal and perineum which may reduce the incidence and severity of tearing.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…However, Altman et al (2007) and Cortes et al (2011) documented all degrees of perineal trauma as one outcome (Altman et al, 2007, Cortes et al, 2011 and others included anterior trauma in addition , Geissbuehler et al, 2004.…”

Section: All-fours and Kneeling Positionsmentioning

confidence: 99%

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The effect of maternal position at birth on perineal trauma: A systematic review

Lodge

Haith-Cooper

2016

British Journal of Midwifery

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Perineal trauma is associated with short and long term maternal morbidity. Research has found that maternal position at birth can influence perineal trauma. However, no evidence examining specific maternal positions, including waterbirth and how these can influence incidence and degree of perineal trauma could be found. The evidence is important to help reduce trauma rates and improve information for women and midwives.To address this dearth in reliable evidence, a systematic review was conducted.Seven studies met the inclusion criteria. Compared to landbirth, waterbirth was found to cause an increase in perineal trauma. Kneeling and all-fours positions were most protective of an intact perineum. Allowing for different variables; sitting, squatting and using a birth-stool caused the greatest incidence of trauma.The findings of this review demonstrate further research is required around perineal guarding in alternative birth positions and how parity affects trauma rates with waterbirth in order that women may be advised appropriately. However, this review suggests findings that midwives can use when discussing alternative birth positions with women.

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