Trial reportBMJ (Clinical research ed.)2004
Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour.
Trial report in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 7 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- Pooled it
- Immersion in water during labour and birth.The Cochrane database of systematic reviews · 2018Pooled it
- Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care.The Cochrane database of systematic reviews · 2013Pooled it
- Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour.The Cochrane database of systematic reviews · 2013Pooled it
- Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care.The Cochrane database of systematic reviews · 2012Pooled it
- Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2010Pooled it
- Immersion in water in labour and birth.The Cochrane database of systematic reviews · 2009Pooled it
- Hydrotherapy in Pain Management in Pregnant Women: A Meta-Analysis of Randomized Clinical Trials.Journal of clinical medicine · 2024Review
- Effects of Hydrotherapy on the Management of Childbirth and Its Outcomes-A Retrospective Cohort Study.Nursing reports (Pavia, Italy) · 2024Article
- Systematic Reviews and Synthesis without Meta-Analysis on Hydrotherapy for Pain Control in Labor.Healthcare (Basel, Switzerland) · 2024Review
- Safety and Effect of the Use of Hydrotherapy during Labour: A Retrospective Observational Study.Journal of clinical medicine · 2023Article
- Vaginal Birth at Term - Part 1. Guideline of the DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/083, December 2020).Geburtshilfe und Frauenheilkunde · 2022Article
- Observational
- Labor Intervention and Outcomes in Women Who Are Nulliparous and Obese: Comparison of Nurse-Midwife to Obstetrician Intrapartum Care.Journal of midwifery & women's health · 2017Article
- A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery.BMC pregnancy and childbirth · 2014Article
- Birth, bath, and beyond: the science and safety of water immersion during labor and birth.The Journal of perinatal education · 2014Article
- The effects of immersion in water on labor, birth and newborn and comparison with epidural analgesia and conventional vaginal delivery.Journal of the Turkish German Gynecological Association · 2012Article
- The effects of hydrotherapy on anxiety, pain, neuroendocrine responses, and contraction dynamics during labor.Biological research for nursing · 2010Article
- Obstetric risk indicators for labour dystocia in nulliparous women: a multi-centre cohort study.BMC pregnancy and childbirth · 2008Article
- Labouring in water: findings do not fully support conclusions.BMJ (Clinical research ed.) · 2004Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia.
designRandomised controlled trial.
settingUniversity teaching hospital in southern England.
participants99 nulliparous women with dystocia (cervical dilation rate < 1 cm/hour in active labour) at low risk of complications. Interventions Immersion in water in birth pool or standard augmentation for dystocia (amniotomy and intravenous oxytocin).
main outcome measuresPrimary: epidural analgesia and operative delivery rates. Secondary: augmentation rates with amniotomy and oxytocin, length of labour, maternal and neonatal morbidity including infections, maternal pain score, and maternal satisfaction with care.
resultsWomen randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5). They showed no difference in rates of operative delivery (49% v 50%, 0.98 (0.65 to 1.47), NNT 98), but significantly fewer received augmentation (71% v 96%, 0.74 (0.59 to 0.88), NNT 4) or any form of obstetric intervention (amniotomy, oxytocin, epidural, or operative delivery) (80% v 98%, 0.81 (0.67 to 0.92), NNT 5). More neonates of women in the water group were admitted to the neonatal unit (6 v 0, P = 0.013), but there was no difference in Apgar score, infection rates, or umbilical cord pH.
conclusionsLabouring in water under midwifery care may be an option for slow progress in labour, reducing the need for obstetric intervention, and offering an alternative pain management strategy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.