Water birth as an alternative delivery: A case control study

Objective: To assess the maternal and neonatal morbidity associated with wa ter birth. Methods: We analysed water births retrospectively in a matched-pair study. Results: A total of 100 women requested water birth between August 1994 and February 1998. Seventy-eight (78 %) of these women were delivered in water . In the control group five women had a secondary Caesarean section. There were three operative vaginal deliveries after attempted water birth and eig ht in the control group. Patients delivered in the water had significantly fewer episiotomies (30 vs. 53; p < 0.001), and less use of oxytocin (16 vs. 49; p < 0.001), pain medication (39 vs. 46), and epidural anaesthesia (1 v s. 18; p < 0.001) than patients delivered conventionally. There were no dif ferences between the groups in major perineal tears (6 vs. 5), 5-minute Apg ar scores < 7 (1 vs. 0), or fetal cord pH values < 7.15 (13 vs. 7). Postpar tal maternal or neonatal morbidity was uncommon and did not differ between the groups. Conclusion: With appropriate patient selection and surveillance water birth does not seem to entail increased maternal or neonatal risks. Water birth may be more comfortable because of the lower episiotomy rate without a high er rate of major perineal lacerations and the reduced need for oxytocin and pain medication.