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.