Waterbirths and Tearing

J Perinat Med. 2004;32(4):308-14. Related Articles, Links

Comment in: * J Perinat Med. 2004;32(4):306-7.

Waterbirths compared with landbirths: an observational study of nine years.

Geissbuehler V, Stein S, Eberhard J. Department of Obstetrics and Gynecology, Cantonal Hospital, Frauenfeld, Switzerland. verena.geissbuehler@stgag.ch

AIMS: This study compares neonatal and maternal morbidity and mortality between waterbirths and landbirths (spontaneous singleton births in cephalic presentation, vacuum extractions are excluded). METHODS: In this observational study covering nine years, standardized questionnaires were used to document 9,518 spontaneous singleton cephalic presentation births, of which 3,617 were waterbirths and 5,901 landbirths. RESULTS: Landbirths show higher rates of episiotomies as well as third and fourth degree perineal lacerations.

Waterbirths show a higher rate of births “without injuries,” first and second-degree perineal lacerations, vaginal and labial tears. After a waterbirth, there is an average loss of 5.26 g/l blood; this is significantly less than landbirths where there is an 8.08 g/l blood loss on average. In 69.7% waterbirths required no analgesic, compared to 58.0% for landbirths. Water and landbirths do not differ with respect to maternal and neonatal infections. After landbirths, there was a higher rate of newborn complications with subsequent transfer to an external NICU.

During the study, there were neither maternal nor neonatal deaths related to spontaneous labor.

CONCLUSIONS: Waterbirths are associated with low risks for both mother and child when obstetrical guidelines are followed.