ArticleInternational urogynecology journal2019
Does water birth affect the risk of obstetric anal sphincter injury? Development of a prognostic model.
Article in International urogynecology journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Pooled it
- Comparative Efficacy of Water and Conventional Delivery during Labour: A Systematic Review and Meta-Analysis.Journal of healthcare engineering · 2022Pooled it
- Hospital waterbirth for low-risk birthing people: findings of a randomized controlled trial.AJOG global reports · 2025Article
- Effects of Water Immersion Versus Epidural as Analgesic Methods during Labor among Low-Risk Women: A 10-Year Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2024Article
- Alternate Birth Strategies.International journal of women's health · 2023Review
- Waterbirth: a national retrospective cohort study of factors associated with its use among women in England.BMC pregnancy and childbirth · 2021Observational
- Predictors of obstetric anal sphincter injury during waterbirth: a secondary analysis of a prospective observational study.International urogynecology journal · 2020Observational
- Are women attending a midwifery-led birthing center at increased risk of anal sphincter injury?International urogynecology journal · 2020Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisObstetric anal sphincter injury (OASI) is a significant complication of vaginal delivery. Water birth has become a popular preference for women giving birth in the UK, however, there is limited data on the risk of OASI following water birth. Our aim was to assess OASI risk in low-risk women giving birth in water without medical intervention compared with on land and to create a prognostic model for OASI prediction.
methodsThis was a retrospective study of 15,734 low-risk women giving birth by spontaneous vaginal delivery between January 2008 and October 2014 in a midwifery-led unit (MLU). Patient factors and delivery data were analysed to identify differences between water and land births. Univariate analysis determined factors that statistically predicted OASI and was then used to create multivariate analysis. Significant multivariate factors were used to create a prognostic model to predict likelihood of OASI.
resultsOASI rates were 1.6% on land and 3.3% in water [odds ratio (OR) 2.10, 95% confidence interval (CI) 1.5-2.94). Multivariate analysis confirmed water birth, ethnicity and parity as independent risk factors for OASI (adjusted OR water birth: 1.77 (CI 1.25-2.51). Our prognostic model showed Black and Asian primigravidae following water birth had the highest risk of OASI and white multiparae on land the lowest.
conclusionThis study of comparable low-risk women shows an increased risk of OASI following water birth compared with land birth. Use of this prognostic model will help women determine their risk of OASI following birth in water or on land.
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