A new review of the evidence supports the option of water birth for healthy women in labour.
A team led by Dr Ethel Burns of Oxford Brookes University, UK, analysed 36 studies of maternal or neonatal outcomes after using a birthing pool. This covered 157,546 participants.
In BMJ Open today, the team report: "Water immersion significantly reduced use of epidural, injected opioids, episiotomy, maternal pain, and postpartum haemorrhage."
Results also found an increase in maternal satisfaction and the chance of an intact perineum. There was no raised risk of the umbilical cord snapping, caesarean section, or other neonatal outcomes.
The authors state: "Water immersion during labour using a birth pool to achieve relaxation and pain relief during the first and possibly part of the second stage of labour is an increasingly popular care option in several countries.
"It is used particularly by healthy women who experience a straightforward pregnancy, labour spontaneously at term gestation and plan to give birth in a midwifery led care"
While the popularity of water birth is rising, "there is debate about the safety of intrapartum water immersion," they write.
"This review endorses previous reviews showing clear benefits resulting from intrapartum water immersion for healthy women and their newborns," the authors conclude.
They add that future birthing pool research should also look at factors that influence birth interventions and outcomes, such as different care practices and birth settings.
Clare Livingstone, from the Royal College of Midwives, said: “This is really good news for women choosing to have a water birth or thinking of having one.
“Water births are becoming more widely available for women across the UK, but this isn’t the case everywhere. The challenge now is to ensure this choice is open to all women wherever they live.
“What is needed now is to see more research into water births in midwife led settings and in women’s homes. This will give us a broader picture of the impact of water births across all the places in which women give birth.”
Burns, E. et al. Systematic review and meta-analysis to examine intrapartum interventions, and maternal and neonatal outcomes following immersion in water during labour and waterbirth. BMJ Open 6 July 2022 doi: 10.1136/bmjopen-2021-056517
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