ArticleObstetrics and gynecology2020
Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion.
Article in Obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Comparative Efficacy of Water and Conventional Delivery during Labour: A Systematic Review and Meta-Analysis.Journal of healthcare engineering · 2022Pooled it
- Is a randomized controlled trial of waterbirth possible? An Australian feasibility study.Birth (Berkeley, Calif.) · 2022Trial
- Otitis Externa in a Newborn After Waterbirth-A Case Report Followed by a Literature Review.Journal of clinical medicine · 2026Article
- 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
- Effect of audio-visual therapy on pain and anxiety in labor: A randomized controlled trial.European journal of obstetrics & gynecology and reproductive biology: X · 2023Article
- Potential Implications of Emerging Nontraditional Childbirth Practices On Neonatal Health.The Journal of pediatrics · 2023Article
- Maternal and neonatal outcomes following waterbirth: a cohort study of 17 530 waterbirths and 17 530 propensity score-matched land births.BJOG : an international journal of obstetrics and gynaecology · 2022Article
- Waterbirth: current knowledge and medico-legal issues.Acta bio-medica : Atenei Parmensis · 2022Article
- Perception and knowledge of Saudi women about water birth: A cross-sectional study.Belitung nursing journal · 2022Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion compared with deliveries in the matched control group without water immersion. Secondary outcomes included adverse neonatal diagnoses, maternal infections, and perineal lacerations.
methodsWe conducted a retrospective study using electronic health record data (2014-2018) from two health systems (eight hospitals), with similar clinical eligibility, associated with low risks of intrapartum complications, and implementation policies for waterbirth. The water immersion group included women intending waterbirth. Water immersion was recorded prospectively during delivery. The comparison population were women who met the clinical eligibility criteria for waterbirth but did not experience water immersion during labor. Comparison cases were matched (1:1) using propensity scores. Outcomes were compared using Fischer's exact tests and logistic regression with stratification by stage of water immersion.
resultsOf the 583 women with water immersion, 34.1% (199) experienced first-stage water immersion only, 65.9% (384) experienced second-stage immersion, of whom 12.0% (70) exited during second stage, and 53.9% (314) completed delivery in the water. Neonatal intensive care unit or special care nursery admissions were lower for second-stage water immersion deliveries than deliveries in the control group (odds ratio [OR] 0.3, 95% CI 0.2-0.7). Lacerations were lower in the second-stage immersion group (OR 0.5, 95% CI 0.4-0.7). Neonatal intensive care unit or special care nursery admissions and lacerations were not different between the first-stage immersion group and their matched comparisons. Cord avulsions occurred for 0.8% of second-stage water immersion deliveries compared with none in the control groups. Five-minute Apgar score (less than 7), maternal infections, and other adverse outcomes were not significantly different between either the first- or second-stage water immersion groups and their control group.
conclusionHospital-based deliveries with second-stage water immersion had lower risk of NICU or special care nursery admission and perineal lacerations than matched deliveries in the control group without water immersion.
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