In water or on land? Evaluation of perinatal and neonatal outcomes of waterbirths.

Abstract

SUMMARY

Research objective: Evaluate perinatal and neonatal outcomes comparing a waterbirth to a regular childbirth.

Type of study: Retrospective cohort study.

Name and seat of the workplace: Obstetrics and Gynaecology department, Hospital and health centre Havířov.

Cohort and methodology: Retrospective analysis of a set of childbirths, that took place over a given period of time in Hospital and health centre Havířov. We compared a set of women, that had given a waterbirth to a selected control group of women that had given a regular childbirth.

We evaluated statistical comparability, perinatal and neonatal outcomes in both sets.

Results: From 1.1. 2020 to 28.2. 2021 1083 women gave birth in the delivery department of Havířov hospital, from this set 122 were waterbirths (11,3 %). In our study we only included 101 water deliveries (21 water deliveries were excluded from our study due to perinatal risk factor). We selected 60 women for our control group. Both sets of women were compared and we ruled out any statistically significant differences in age, education, BMI, number of births given, gestation week in time of labour, number of smokers, premature ruptre of membranes, women with previous history of one cesarean section, becoming pregnant by IVF, presence of GBS and fetal weight.

Waterbirth does not affect Apgar score, neonatal adaptation to extrauterine life, umbilical blood pH decrease, complications of infection, the need of intensive care and neonatal mortality.
In waterbith set we have found increased occurence of non-infectious conjunctivitis, treatable by regular eye drops without antibiotics. We have not observed the effect of waterbirth on duration of the first and second stage of labour, total amount of uterotonics used, blood loss determined by obstetrician and uterine hypotonia. We observed in waterbirth group a prolonged third stage of delivery, lesser need for pharmacological stimulation (augmentation) of labour, notably lower use of analgesics, lower ocurrence of birth injuries, shorter inpatient time and more frequent bonding.

Conclusions: In our study we have discovered that waterbirth does not increase the risk for mother and neonate. Despite initial concerns, our outcomes and mother satisfaction has clearly showed that waterbirths are not only a temporary whim, but probably a new integral part of our obstetric care.

KEYWORDS

waterbirth – analgesia with water - childbirth – perinatal and neonatal outcomes