Maternal And Perinatal Outcomes Among Low Risk Women Giving Birth In Water: A Retrospective Study In A Maternity & Infant Health Hospital Over 7 Years

Objective: To investigate the effects of giving birth in water on perinatal outcomes. Methods: The clinical data of 50,574 healthy primiparas with singleton pregnancies and cephalic presentation from January 2010 to December 2016 were retrospectively reviewed. A total of 5420 subjects (mean age, 27.57 +/- 3.07 y) who received water delivery (water birth group) and a total of 45,154 subjects (mean age, 26.87 +/- 2.96 y) who underwent conventional labor and delivery (conventional delivery group) were recruited. The neonatal outcomes including the incidences of neonatal asphyxia and need for transfer to the neonatal intensive care unit (NICU), the maternal outcomes including the visual analogue scale (VAS), duration of labor, postpartum bleeding, perineal laceration, and postpartum urinary retention, were collected and analyzed. In addition, maternal vaginal culture test was preformed to observe the incidence of maternal infection. The clinical data regarding patients who underwent medical interventions including amniotomy, valium and oxytocin have been collected and analyzed as well. Results: The incidence of neonatal asphyxia was significantly lower in the water birth group than that in the conventional delivery group (P = 0.025), whereas there were no differences in need for transfer to NICU between the two groups (P = 0.455). The VAS pain scores 30 and 60 min after cervical dilation of 3 cm in the conventional delivery group were significantly higher than those of the water birth group (both P<0.001). Meanwhile, the incidences of perineal lacerations (second- and third-degree) and postpartum urinary retention in water birth group were significantly lower than those in the conventional delivery group (all P<0.05). However, the duration of labor and 24 h postpartum bleeding as well as the maternal bacterial culture results were similar between the two groups (all P>0.05). Moreover, there was less patients underwent medical intervention in water birth group compared with the conventional delivery group (almost all P<0.05). Conclusions: Birth in water can reduce maternal pain, II & III degree perineal lacerations, and postpartum urinary retention, and is associated with a lower rate of neonatal asphyxia without the increased risk of maternal infections. In addition, birth in water can reduce the need for the medical intervention.