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Waterbirth Abstracts

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These are easy to read and understand and are beautifully presented.

Here are a couple of waterbirth studies from pubmed. All of them say "infection is not increased"

 Fetal Diagn Ther 2000 Sep-Oct;15(5):291-300

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Waterbirths: a comparative study. A prospective study on more than 2,000 waterbirths.

Geissbuhler V, Eberhard J.

Clinic for Obstetrics and Gynecology, Thurgauisches Kantonsspital, Frauenfeld, Switzerland. vgeissbuehler@bluewin.ch

BACKGROUND: Waterbirths were introduced in 1991 as part of a new birth concept which consisted of careful monitoring and birth management, restrictive use of invasive methods and free choice of different birth methods. METHODS: After the introduction of this new birth concept a prospective observational study was initiated. All parturients of the region give birth in our clinic without preselection, ours being the only birth clinic of the region. 2% of the parturients will be referred to a larger birth clinic (university clinic) mainly because of preterm births before the end of the 33rd week of pregnancy. Every one of the 7,508 births between November 1991, and May 21, 1997, was analyzed. In this article the birth parameters of mother and child in the most often chosen spontaneous birth methods will be compared to assess the safety of alternative birth methods in general and of waterbirths in particular. 2,014 of these 5,953 spontaneous births were waterbirths, 1,108 were Maia-birthing stool births and 2,362 bedbirths (vacuum extractions not included). RESULTS: The parity and age of the mother as well as the newborn's birth weight are comparable in all 3 groups: waterbirth, Maia-birthing stool, and bedbirths. An episiotomy was performed in only 12.8% of the births in water, in 27. 7% of the births on the Maia-birthing stool and in 35.4% of the bedbirths. These differences are statistically significant. In spite of the highest episiotomy rates, the bedbirths also show the highest 3rd- and 4th-degree laceration rates (4.1%), thus the difference between the rates for bedbirths and alternative births methods for severe lacerations is significant. The mothers' blood loss is the lowest in waterbirths. Fewer painkillers are used in waterbirths and the experience of birth itself is more satisfying after a birth in water. The average arterial blood pH of the umbilical cord as well as the Apgar scoring at 5 and 10 min are significantly higher after waterbirths. Infections of the neonate do not occur more often after waterbirths. No case of water aspiration or any other perinatal complication of the mother or child which might be water-related was reported. CONCLUSION: Waterbirths and other alternative forms of birthing such as Maia-birthing stool do not demonstrate higher birth risks for the mother or the child than bedbirths if the same medical criteria are used in the monitoring as well as in the management of birth. Copyright 2000 S. Karger AG, Basel.


 Harefuah 1998 Feb 1;134(3):161-4, 248 Related Articles, Books, LinkOut

[Experience with under-water birth]

[Article in Hebrew]

Lachman E, Finelt Z.

Dept. of Obstetrics and Gynecology, Yoseftal Hospital, Eilat.

Underwater birth is now deemed an acceptable type of delivery. Safety is a recurring consideration, the main concern being that of drowning. But in reports of 19,000 underwater births no untoward events were noted. Also, need for pain relief and of intervention during labor were both reduced. The short term indicators of neonatal outcome were good. A recent review explains 5 different physiological factors which inhibit initiation of fetal breathing under warm water. Many studies have shown no increase in risk of infection of either mother or baby. We report our experience with 26 women, 23 of whom actually delivered in the pool with excellent results. We believe that birth under water is safe and beneficial if done properly for low-risk patients.

 : Eur J Obstet Gynecol Reprod Biol 2000 Jul;91(1):15-20 Related Articles, Books, LinkOut
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A retrospective comparison of water births and conventional vaginal deliveries.

Otigbah CM, Dhanjal MK, Harmsworth G, Chard T.

Department of Obstetrics and Gynaecology, Homerton Hospital, London, UK.

The aim of this study was to document the practice of water births and compare their outcome and safety with normal vaginal deliveries. A retrospective case-control study was conducted over a five year period from 1989 to 1994 at the Maternity Unit, Rochford Hospital, Southend, UK. Three hundred and one women electing for water births were compared with the same number of age and parity matched low risk women having conventional vaginal deliveries. Length of labour; analgesia requirements; apgar scores; maternal complications including perineal trauma, postpartum haemorrhages, infections; fetal and neonatal complications including shoulder dystocias; admissions to the Special Care Baby Unit, and infections were noted. Primigravidae having water births had shorter first and second stages of labour compared with controls (P<0.05 and P<0.005 respectively), reducing the total time spent in labour by 90 min (95% confidence interval 31 to 148). All women having water births had reduced analgesia requirements. No analgesia was required by 38% (95% confidence interval 23.5 to 36.3, P<0.0001) and 1.3% requested opiates compared to 56% of the controls (95% confidence interval 46. 3 to 58.1, P<0.0001). Primigravidae having water births had less perineal trauma (P<0.05). Overall the episiotomy rate was 5 times greater in the control group (95% confidence interval 15 to 26.2, P<0.0001), but more women having water births had perineal tears (95% confidence interval 6.6 to 22.6, P<0.001). There were twice as many third degree tears, post partum haemorrhages and admissions to the Special Care Baby Unit in the controls, although these differences were not significant. Apgar scores were comparable in both groups. There were no neonatal infections or neonatal deaths in the study. This study suffers from many of the methodological problems inherent in investigation of uncommon modes of delivery. However, we conclude that water births in low risk women delivered by experienced professionals are as safe as normal vaginal deliveries. Labouring and delivering in water is associated with a reduction in length of labour and perineal trauma for primigravidae, and a reduction in analgesia requirements for all women.
this next one is cute, translated from itallian.. .their experience with 500 waterbirths

 : Minerva Ginecol 2001 Feb;53(1):29-34

[Birth in water. A comparative study after 555 births in water]

[Article in Italian]

Thoni A, Murari S.

Divisione di Ostetricia e Ginecologia, Ospedale di Vipiteno, Bolzano, Italy. gynaekologie.sterzing@se-nord.provinz.bz.it

BACKGROUND: The object of our study is to research into the quality of the different delivery positions, offered in our hospital with special focus on the advantages for birth in water. METHODS: From February 1997 to 1 October 2000 we do research retrospectively on data of 555 deliveries in water, 320 on the traditional bed and 125 on the delivery stool give us the possibility to investigate about duration of birth, rate of episiotomies and perineum lacerations, consumption of painkillers, arterial umbilical cord pH and haemoglobin postpartum. RESULTS: In our comparing analysis of the duration of birth we could show a relevant reduction especially for primiparae which had delivered in water. The reduction is only significant for the first part of labor (360 minutes in the pool, 445 minutes on the traditional bed and 420 minutes on the stool) whereas there is no difference for the second part of labor. The significant reduction on episiotomies (1%) in comparison to the one on the traditional bed (20%) or on the stool (10%) for primiparae in water doesn t mean an increase at perineum lacerations. (each 25%). In water we saw no lacerations/injuries of the perineum for 58% of primiparae, on the traditional bed 36% and on the stool 43%. No woman in labour needed a painkiller in the pool. There was no difference found between the three groups referring to the arterial umbilical cord pH or the haemoglobin postpartum. CONCLUSIONS: Our study shows relevant medical advantages for a delivery in water: and a significant reduction of the duration of the first part of labour, significant less episiotomies and perineum lacerations and no need for painkillers. The security of the neonate is guaranteed under attention to the known contraindications.

 J Nurse Midwifery 1989 Jul-Aug;34(4):165-70 Related Articles, Books, LinkOut

Water birth: one birthing center's observations.

Church LK.

This paper discusses the water birth experiences of women who delivered at The Family Birthing Center of Upland, California, from February, 1985 to June 1, 1989. Of the 831 who used warm water immersion during their labor, 483 gave birth in the water with good Apgar scores; and there was only one minor maternal infection. These results clearly suggest that water birth--with certain precautions--is not only a desirable alternative for many women, but also a safe and positive intrapartum intervention.

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