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Maternal Immersion in Water OK in Early Labor, Not Recommended During Delivery — Physician’s First Watch

Medical News |
March 21, 2014

Maternal Immersion in Water OK in Early Labor, Not Recommended During Delivery

By Diane J. Angelini

Maternal immersion in water may help ease pain during the first stage of labor, but it is not recommended in second-stage labor, according to the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

In an evidence review, the groups found that immersion during first-stage labor is associated with decreased use of epidural, spinal, or paracervical anesthesia (risk ratio, 0.90) and no difference in risk for perineal trauma or tears. However, it's unclear whether other interventions affected these outcomes.

Reported complications associated with immersion during labor's second stage included infections, compromised neonatal thermoregulation, umbilical cord avulsion or rupture if the infant is lifted incorrectly from the tub, and respiratory distress secondary to water aspiration.

I agree with the committee's conclusions that water immersion during the first stage of labor, while possibly diminishing maternal pain, does not seem to improve any other perinatal outcomes; and that immersion during second-stage labor should be limited to clinical trials because of its potential to cause neonatal complications.

Diane J. Angelini, EdD, CNM, FACNM, FAAN, NEA-BC, is an associate editor with NEJM Journal Watch Women's Health, from which this story was adapted.

Reader Comments (2)

Yasmin Adam

I agree women should not deliver in water

Yasmin Adam

Need the full text

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