Report: Labor in tub OK but water births unproven

by Lauran Neergaard

Sitting in a tub of warm water can relieve a mom-to-be's pain during the early stages of labor, but actually giving birth under water has no proven benefit and may be risky, say recommendations for the nation's obstetricians.

There's no count of how many babies in the U.S. are delivered in water, but it is increasingly common for hospitals to offer birthing pools or tubs to help relax during labor.

In a report released Thursday, a distinction is made between the two uses, saying that early on immersion may be helpful, as long as some basic precautions are taken.

But there has been little scientific study of underwater delivery, along with a handful of reports over the past decade or so of near-drownings and other risks to the infant, said the joint opinion from the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

Although complications appear to be rare, the report urges that underwater deliveries be performed only in research studies to settle the questions.

"Laboring in water is not the same as delivering under water," said co-author Dr. Jeffrey Ecker of Harvard University, adding that he's cared for numerous women comforted by immersion during labor.

As for delivery, "We want people to do more research," added ACOG committee member Dr. Aaron Caughey of Oregon Health & Science University.

In fact, midwives at Caughey's hospital perform several dozen underwater deliveries a year and are collecting data on how mothers and babies fare, said Cathy Emeis, a certified nurse-midwife at the Oregon university. She cautioned that the numbers are small but so far don't show increased risks.

Pregnant women interested in a water birth at the Oregon facility are required to take a special class and sign a consent form, Emeis said.

"We always acknowledge to our patients that there is not a lot of high-quality evidence that shows there's a benefit to birthing under water," she said.

Thursday's recommendations aren't binding. Birthing in , which proponents say simulates the uterine environment, has been an option for several decades, although more women use it for early labor than delivery, said Tina Johnson of the American College of Nurse-Midwives.

"I don't know that this statement will necessarily change women's desire for that option," said Johnson, whose organization is drafting its own guidelines.

The report recommends that hospitals or birth centers choose low-risk candidates for immersion during labor, keep tubs clean, monitor women appropriately and be able to move them out of the water quickly if a problem occurs.

It says potential risks of underwater delivery include infection, difficulty regulating the baby's body temperature and respiratory distress if the baby inhales water.

not rated yet
add to favorites email to friend print save as pdf

Related Stories

US home births continued steady increase in 2012: CDC

Mar 04, 2014

(HealthDay)—The percentage of U.S. women choosing to give birth at home or in a birthing center rather than a hospital has grown by 56 percent in less than a decade, according to a new government report.

Healthcare providers driving rising Caesarean rates

Mar 12, 2014

(Medical Xpress)—Where a woman gives birth - in a public or private hospital - is a key determinant of whether she has a Caesarean section or not, according to findings from three consecutives surveys of ...

Recommended for you

Eating disorders linked to adverse perinatal outcomes

Oct 22, 2014

(HealthDay)—Maternal eating disorders are associated with adverse pregnancy, obstetric, and perinatal health outcomes, according to a study published in the October issue of the American Journal of Obstetrics & ...

Large variation in cesarean rates across US hospitals

Oct 21, 2014

Cesarean delivery is the most common inpatient surgery in the United States. US cesarean rates increased from 20.7% in 1996 to 32.9% in 2009 but have since stabilized, with 1.3 million American women having had a cesarean ...

User comments