THE EFFECTS OF WHIRLPOOL BATHS IN LABOR - A RANDOMIZED, CONTROLLED TRIAL

Background: Showers and tubs in labor were not generally used in our c enter When three whirlpool baths (Jacuzzis) were ordered as part of ou r renovations, a randomized, controlled trial was initiated to explore their effects on narcotic and epidural requirements. Methods: This st udy employed an intent-to-treat design, and the sample size was estima ted to account for the fact that some women would be unable to use the tub. The experimental group of 393 women was offered the tub during l abor and the control group of 392 women received conventional care. Re sults: No births occurred in the tub. The tub group required fewer pha rmacologic agents than controls (66% vs 59%, p = 0.06), experienced fe wer deliveries by forceps and vacuum (p = 0.019), and were more likely to have an intact perineum than the standard-care group (p = 0.019). Labor was longer for the tub group (p = 0.003), who coincidentally wer e more primiparous and in earlier labor on admission. No differences w ere noted in the low rates of maternal and newborn signs of infection in women with ruptured membranes. A subset of mothers expressed satisf action with the tub experience and labor support. The cesarean rate am ong both groups was lower (8.9%) than our overall rate (16.6%) during the study period Conclusions: Whirlpool baths in labor have positive e ffects on analgesia requirements, instrumentation rates, condition. of the perineum and personal satisfaction. Further study of the effects on labor length, pain, influence of labor support, and psychological o utcomes is being planned.