Comparison between Water Birth and Land Birth in terms of Fetal and Neonatal Outcomes

Document Type: Original Article


1 Assistant Professor of Obstetrics and Gynecology, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

2 Assistant Professor of Obstetrics and Gynecology, Omolbanin Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 General Physician, Vice Chancellor of Research, Razavi Hospital, Mashhad, Iran


Introduction: Although warm water is used for labor pain reduction, there is controversy regarding the potential complications of water birth. Therefore, this study was performed to evaluate fetal and neonatal complications of water birth versus those observed in conventional modes of delivery.
Methods:This clinical randomized trial was performed on 200 pregnant women at Mashhad Omolbanin Hospital in years 2008-2009. In total, 100 subjects were allocated to the conventional delivery group and 100 women were included in the water birth group. In the water birth group, the patients were allowed to move freely and fluid intake was not limited. In the conventional delivery group, delivery was performed on a bed via a routine mode of delivery. Delivery duration, neonatal infection during the first week after delivery, early neonatal Apgar score, neonatal eye infection, and rate of NICU admission were compared between the two groups. Finally, 88 women in the conventional delivery group and 83 cases in the water birth group remained in the study. After data collection, data were analyzed using SPSS version 14, and Kolmogorov–Smirnov, Chi-square, and t-student tests were performed. P-value less than 0.05 was considered significant.
Results:The mean duration of the first stage (P<0.344), second stage (P=0.372), and third stage (P=0.523) of labor was not statistically different between the two groups. Cesarean section rate in the conventional delivery group was significantly higher than that of the water birth group (P=0.018). Also, 1- (P=0.026) and 5-minute (P≤ 0.001) Apgar scores in the water birth group were significantly higher than those of the conventional delivery group. No significant differences were observed between the two groups in terms of other variables.
Conclusion:Water birth can decrease labor pain and reduce the need for medical interventions; also, it does not have any adverse effects on the neonate. Therefore, it can be a suitable alternative for conventional deliveries. With proper selection of individuals and accurate monitoring during delivery, water birth can be a completely healthy method without further risks for the mother or the fetus.