Research offers reassurance for expectant mothers considering a water birth

Giving birth in water is associated with a reduced risk of excessive bleeding and perineal tearing for mothers and with babies born in water being less likely to need specialist care, a new study has found.

In a paper co-authored by De Montfort University Leicester (DMU)’s Dr Tina Harris and published by the BMC Pregnancy & Childbirth journal, researchers showed that the likelihood of key maternal and neonatal complications associated with waterbirths was low.

Photo by Hu Chen on Unsplash (2)
(Image: Hu Chen/Unsplash)

The observational study, which involved an analysis of 46,088 low and intermediate risk vaginal births across 35 NHS Trusts in England, showed that 6,264 (13.6%) were recorded as delivering their baby in the water.

Of those 6,264 babies born, the research highlighted that there was no association between waterbirth and specific adverse outcomes for either the mother or the baby.

More specifically, the paper outlines there was no association between those women who chose to give birth in water and four common concerns, including:

  • Severe perineal tear for mothers
  • Excessive bleeding for mothers
  • Babies born with a low Apgar score (the Apgar score is a test given to newborns soon after birth to check a baby's heart rate, breathing, and other signs to see if extra medical care or emergency care is needed)
  • Babies requiring neonatal care after birth.

“Immersion in water during labour is associated with a number of maternal benefits however for birth in water the situation is less clear,” explained Dr Harris, who is an active researcher at DMU's Centre for Reproduction Research.

“While we can’t say there is no associated risk, what we can report from this study is that the association with each of these concerns and waterbirths is a positive one.

“These are four common birthing factors that expectant mothers may be concerned about and we found an association of reduced risk for all four.”

The research provides further evidence for NICE (The National Institute for Health and Care Excellence) on risks associated with waterbirths.

The study also explored the characteristics of those women who gave birth in water and found that women living in deprived areas are half as likely to have a water birth than those living in affluent areas and that younger women and women from black and minority ethnic backgrounds were also less likely to have a waterbirth.

“Most NHS Trusts do have a birthing pool  so all women should have access to giving birth in water, but our study has revealed that some women, from socially deprived areas and from the BAME community, are less likely to have a waterbirth. So we want to understand why that is,” continued Dr Harris. 

“Hopefully this research will give women more information and reassurance to help them with their decision on whether or not to have a waterbirth. It’s important that pregnant women have access to as much information as possible to make an informed choice.”

As well as being an Associate Professor in the Faculty of Health and Life Sciences at DMU, Dr Harris is also a registered midwife with an NMC (Nursing and Midwifery Council)-recognised teaching qualification and in 2016, she was appointed Senior Clinical Lead (Midwifery) for the National Maternity and Perinatal Audit at the Royal College of Obstetrics and Gynaecology.

Posted on Friday 4th June 2021

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