Immersion in water in the first stage of labor: A randomized controlled trial

Background: Current forms of analgesia often have significant side effects for women in labor: Bathing in warm water during labor has been reported to increase a woman's comfort level and cause a reduction in painful contract ions. The objective of this trial was to compare immersion in warm water du ring labor with traditional pain management a range of clinical and psychol ogical outcomes. Methods: A prospective randomized controlled trial of 274 pregnant women. who were free from medical and obstetric complications and expecting a singleton pregnancy at term, was conducted at the Women 's and Children's Hospital, a maternity tertiary referral center in Adelaide, Sout h Australia. Women in labor were randomized to an experimental group who re ceived immersion in a bath or to a nonbath group who received routine care. Pharmacological pain relief was the primary outcome that was measured, and secondary outcomes included maternal and neonatal clinical outcomes, facto rs relating to maternal and neonatal infectious morbidity. psychological ou tcomes, and satisfaction with care. Results: The use of pharmacological ana lgesia was similar for both the experimental and control groups; 85 and 77 percent, respectively, used major analgesia. No statistical differences wer e observed in the proportion of women requiring induction and augmentation of labor or in rates of perineal trauma. length of label; made of delivery: or frequency of cardiographic trace abnormalities Neonatal outcomes (birth weight, Apgar score, nursery care, meconium-stained liquor, cord pH estimat ions) revealed no statistically significant differences. Infants of both gr oup women required significantly more resuscitation than routine group wome n. Routine group women rated their overall experience of childbirth more po sitively than bath group women. Psychological outcomes, such as satisfactio n with care or postnatal distress, were the same for both groups. Conclusio n: Bathing in labor confers no clear benefits for the laboring woman but ma y, contribute to adverse effects in the neonate.