Gynakol Geburtshilfliche Rundsch. 2007;47(2):76-80.
Giving birth in the water: experience after 1,825 water deliveries. Retrospective descriptive comparison of water birth and traditional delivery methods
Thӧni A, Zech N, Ploner F., Abteilung fur Gynaekologie und Geburtshilfe, Landeskrankenhaus Sterzing, Sterzing, Italien. firstname.lastname@example.org
Methods: We compared 830 primipara deliveries in water with 424 primipara deliveries in the traditional bed and 136 on the delivery stool. We also evaluated the duration of labour, arterial cord blood pH and base excess in the primiparae, and perineal trauma, shoulder dystocia and deliveries after preceding caesarean section as well as rates of neonatal infection in all the 1,825 water births.
Results: The duration of the first stage of labour was significantly shorter with water births than with the other delivery positions. The episiotomy rate for all water births was found to be much lower compared to deliveries carried out in the bed or on the birthing stool. The rate of perineal tears was similar. There were no differences in the duration of the second stage, arterial cord blood pH and base excess. No woman using the water birth method required analgesics. There were 3 shoulder dystocias with water births. Sixty-eight women delivered in water after a preceding caesarean section.
Conclusion: Water births appears to be associated with a significantly shorter first stage of labour, a lower episiotomy rate and reduced analgesic requirements when compared with other delivery positions. If women are selected appropriately, water birth appears to be safe for both the mother and neonate. The rate of water births increased steadily to 49% of all spontaneous deliveries. The episiotomy rate decreased from over 80% to under 10%. The cesarean section rate remained lower than that in the national database. Changes in other obstetric interventions were less pronounced. Conclusion: Alternative delivery methods, particularly water birth, have become popular. This shift has helped keep the cesarean delivery rate low and decrease the episiotomy rate and has prompted more careful use of other obstetric interventions.