Study finds water birth safe

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Last reviewed: 14.06.2024

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11 June 2024, 19:47

New research confirms that for women with unproblematic pregnancies, having a water birth is as safe as leaving the water before giving birth. The study, "Maternal and neonatal outcomes of vaginal births occurring in or out of water after intrapartum water immersion: the POOL Cohort Study," was published in the journal BJOG: International Journal of Obstetrics and Gynecology.

Researchers studied the birth experiences of more than 87,000 women with unproblematic pregnancies who used water immersion during labor for comfort and pain relief. The study aimed to find out whether staying in the water to give birth is as safe for mothers and their babies as leaving the water before giving birth.

Professor Julia Sanders, professor of clinical obstetrics at Cardiff University, who led the research team, said: “In the UK, around 60,000 women use a birthing pool or bathtub each year to relieve labor pain, but some obstetricians and doctors feared water births could carry additional risks. There have been reports that babies could become seriously ill or even die after water birth, and that mothers were more likely to suffer severe ruptures or excess blood loss. Therefore, a large study was needed to examine the safety of water births. UK.

“We wanted to establish whether a water birth with NHS obstetricians is as safe as a water birth for women and their babies, with a low risk of complications,” says Julia Sanders, professor of clinical obstetrics and gynecology.


The POOL study, carried out by Cardiff University School of Public Health and Clinical Trials Research Centre, examined NHS records of 87,040 women using a pool during labor from 2015 to 2022 in 26 NHS organizations in England and Wales. The researchers looked at the incidence of severe ruptures experienced by women, the incidence of infants requiring antibiotics or breathing assistance in the neonatal unit, and the incidence of infant deaths.

"The main purpose of our study was to answer a question often asked by women who use birthing pools or bathtubs during labor - obstetricians often ask mothers whether they should stay in or out of the water for labor if labor continues unproblematic.

"Among the women we studied, some left the pool to seek additional medical care or additional pain relief. Most of the women who left the pool to seek additional medical care were first-time mothers—1 in 3 first-time mothers left swimming pool for additional medical care, compared with 1 in 20 women who have already given birth," Sanders says.

Overall, the researchers found that approximately half of all women who used a pool during labor gave birth in water.

Researchers have shown that about 1 in 20 first-time mothers and 1 in 100 second-, third-, or fourth-time mothers had a severe rupture. They also found that about 3 in 100 babies required antibiotics or breathing assistance in the neonatal unit after birth, and infant deaths were rare. But the incidence of these and other complications was comparable for births in and out of water.

Their data showed that cesarean section rates were low, less than 6% for first-time mothers and less than 1% for second-, third-, or fourth-time mothers.

"With 10% of women using water immersion to relieve labor pain, the results of this study will have an impact on thousands of women a year in the UK and many more around the world where water immersion during labor is common practice," - says Professor Peter Brocklehurst.

Professor Chris Gale, consultant neonatologist at Chelsea and Westminster Hospital Foundation in London, said: “Many paediatricians and neonatologists worry that water births may pose additional risks for babies, but the study found strong evidence that for women This is not the case with an unproblematic pregnancy."

Rachel Placzynski, a parent representative on the study team and a former antenatal teacher, said: “It is also reassuring to see that obstetricians are noticing potential problems during labor and are encouraging these women to leave the pool so that mothers and their babies can receive appropriate monitoring and care. "

"Our research has scientifically confirmed that water birth does not pose an increased risk to mother and baby. By examining NHS data from more than 87,000 births in England and Wales, we were able to provide information that can support mothers and midwives when making decisions during childbirth," added Professor Sanders.

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