The results of two recent research studies have added to our knowledge about the benefits of water for labour and birth.
The first, a Swedish comparative study by Ulfsdottir et al (2017), found that women giving birth in water had a lower risk of second-degree perineal tears, shorter labours and significantly less interventions (including artificial rupture of membranes, internal CTG and augmentation with synthetic oxytocin). There were no differences in Apgar scores or admissions to neonatal intensive care unit and the women reported a more positive birth experience. Three of the babies in the waterbirth group were noted to have cord avulsion and, while none of them were admitted to special care or suffered any complications as a result, the study authors remind midwives to watch out for this problem, which can easily be solved by clamping the cord.
The second study is The Waterbirth Project: São Bernardo Hospital experience (Camargo et al 2018). This quantitative observational study analysed the maternal and neonatal outcomes of 90 pregnant women who gave birth in water at São Bernardo Hospital in Portugal. In this study, being in water also reduced the time that the women were in labour. Nearly a third of the women did not have vaginal examination and 57.8% either had no tears or just a first degree tear. The authors noted that the babies’ APGAR and Aqua APGAR (a specially modified APGAR score designed to be used for waterbirth) scores were excellent.
As Camargo et al (2018) conclude, “These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women.”