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Taking the plunge: Water immersion for labour and birth amongst women with moderate obstetric risk factors: A prospective cohort study
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  • Emma Seed,
  • Lauren Kearney,
  • Edward Weaver ,
  • Rachael Nugent
Emma Seed
Sunshine Coast University Hospital
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Lauren Kearney
Sunshine Coast Health Institute
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Edward Weaver
Sunshine Coast University Hospital
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Rachael Nugent
Sunshine Coast University Hospital
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Abstract

Objective: This study investigated maternal and fetal outcomes following warm water immersion (WWI) and/or waterbirth compared with land birth for women with moderate obstetric risk factors. Design: Prospective cohort study. Setting: Maternity hospital, Australia, 2019-2020 Population: 1665 participants, some with ‘risk factors’ for adverse perinatal outcomes requiring continuous electronic fetal monitoring (CEFM) during labour. Method: Multivariate logistical regressions were used to determine the odds of neonatal and maternal outcome measures between three groups: waterbirth, WWI and land birth Main outcome measures: Neonatal morbidity and mortality, including neonatal unit admission (NNU). Maternal clinical outcome measures, including mode of birth, perineal injury, postpartum haemorrhage, length of labour and morbidity. Results: NNU admissions for a suspected infectious condition were significantly higher in the land birth group (p=0.035). After accounting for labour duration, epidural use, previous birth mode, and labour onset, no significant difference was detected between land births and WWI/water births in the odds of NNU admission (p=0.200). No babies were admitted to NNU with signs of water inhalation or drowning. Women birthing on land had a higher mean blood loss (p=0.036) and were more likely to be febrile (2% v 0%; p=0.007); Obstetric anal sphincter injury was similar between groups. Pharmacological analgesia use was lower in the WB/WWI group (p<0.001). There was 1 cord avulsion in the waterbirth group (0.41%). Mode of birth was similar between groups (p=0.697). Conclusion: Despite moderate obstetric risk factors such as oxytocin administration and induction of labour; maternal and neonatal outcomes were similar between groups.

Peer review status:UNDER REVIEW

27 Jul 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
29 Jul 2021Assigned to Editor
29 Jul 2021Submission Checks Completed
28 Aug 2021Reviewer(s) Assigned