[Insert table 4 near here]
There was a statistically significant association between the groups and admission to the NNU for a suspected infectious condition (p=0.035). 6.17% of land birth neonates were admitted to the NNU for this reason compared with 5.1% WWI and 2.06% in the waterbirth group. 5.45% of neonates born on land required the administration of antibiotics compared with 2.55% and 2.47% in the WWI/WB groups respectively. This had borderline significance (p=0.053).
There was a significant difference between the groups in pharmacological analgesia use (p<0.001) where there was a much lower proportion of water births using pharmacological analgesia. In addition, significant differences were also observed between the groups in their first (p<0.001) and second (p<0.001) stage labour length where water births had the shortest median duration although this was not matched for parity. There was no significant difference between the proportion of SVB and instrumental births between land and WWI births (p=0.697). Waterbirths were not included here as they are unable to have an assisted birth.
When analysing rates of perineal trauma, we combined WWI/WB to form one group. Obstetric Anal Sphincter Injury was similar between groups (4.5% of land births and 2.5% of water/WWI births had 3rd/4th degree lacerations). Overall, a similar proportion had no tears in each group (15.4% land and 14% WWI/WB). A subgroup analysis was performed for those that did not have assisted deliveries (that is all spontaneous vaginal births), or epidurals, across all groups. A significant association between the type of birth (land vs water/WWI) and type of perineal trauma (p=0.021) was found in this group of patients. 7.7% of land births had an episiotomy and 5.5% of water/WWI births had episiotomies; 4% of land births and 2.6% of water/WWI births had 3rd/4th degree lacerations; slightly higher proportions of WWI/water births had 1st or 2nd degree tears.
There was a significantly higher proportion of patients with post-partum haemorrhage in the land birth group compared to the water/WWI birth group (p=0.036). There was 1 cord avulsion in the water birth group (0.41%) with zero occurring in either the land or WWI groups.