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Background
Women with low-risk pregnancies who birthed at a Birth Centre co-located at a northern
Queensland tertiary hospital have the option to birth in water. Controversy exists
over the perineal outcomes for waterbirths. To provide women with advice regarding
birth options, more evidence is required. This study aimed to assess whether there
was any difference in the rates and severity of perineal trauma for women with low-risk
pregnancies who birthed in water compared to those who did not birth in water.
Methods
Perinatal data pertaining to all women who gave birth at a Birth Centre, co-located
within the grounds of a tertiary referral hospital, during the period 1 October 2010
– 31 December 2021 were reviewed retrospectively.
Results
Of the 1,748 women who birthed in the Centre during the study period.
702 (40.2%) birthed in water. Women who birthed in water were statistically more likely
to have an intact perineum (that is not have any genital trauma) compared to women
who did not birth in water (ꭓ2 = 6.643, df=1, p=0,10). Similarly, women who birthed in water were statistically
less likely to have severe perineal trauma (defined as a third- or fourth-degree tear),
compared to those who did not birth in water (ꭓ2= 7.448, df = 1, p=0.006). Secondary outcomes were also statistically significant.
Women who birthed in water required less narcotic analgesia compared to those who
did not birth in water (ꭓ2= 41.538, df = 1, p=0.000), and were less likely to have a postpartum haemorrhage
(ꭓ2= 7.565, df = 1, p=0.006).
Implications
In this low-risk population, waterbirth is associated with an increase in intact perineums
and a decrease in severe perineal trauma. Women who are choosing to avoid narcotic
analgesia would benefit from waterbirth. Midwives counselling women on the benefits
of waterbirth can present these findings to assist women in making decisions regarding
their birth options and use of water in labour and birth. Given these positive outcomes
of data pertaining to over a decade of practice, we feel confident in providing this
information to women who plan to birth in the Birth Centre.
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© 2022 Published by Elsevier Inc.
