Adverse neonatal outcomes of delivery or labour in water

The study aimed to a) estimate the incidence of adverse neonatal outcome in babies delivered in water, b) identify babies who are admitted to special care or die, following labour in water, to examine whether there was evidence that the use of water during labour was associated with adverse outcomes.

By bpsu · April 1, 1994

Lead investigator

Dr R Gilbert

About the study

At the time of the study, the National Epidemiology Unit (Oxford) had a survey in England and Wales investigating the use of water during labour and delivery. Preliminary reports suggested that facilities were widely available and that there were several thousand deliveries in water in 1993. There was little evidence that properly managed delivery in water put babies at risk, although there had been no overall evaluation of the safety of labour or delivery in water. Delivery in water seemed to have been restricted to women perceived as low risk of adverse outcomes; however, the increasing use of water during labour and delivery meant that adverse outcomes were likely to occur. Definitions of low risk and guidelines about what was deemed as safe practice (i.e., care of the pool, water temperature, management of the third stage) varied. In 1993, the Lancet published a letter giving details of one death and a case of HIE following labour in water; preliminary enquiries then revealed another eight cases of death or damage occurring in England since 1992, following, although not necessarily caused by labour or delivery in water (personal communications). Nevertheless, local policies underwent revision in response to these anecdotal reports. It was important to establish whether there was an increased risk associated with the use of water.

Duration

April 1994 – April 1996

Published papers

Alderdice F, Renfrew M, Marchant S, Ashurst H, Hughes P, Berridge G et al. Labour and birth in water in England and Wales BMJ 1995; 310 :837 doi:10.1136/bmj.310.6983.837

Gilbert R E, Tookey P A. Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey BMJ 1999; 319 :483 doi:10.1136/bmj.319.7208.483

Support Group

National Childbirth Trust | enquiries@nct.org.uk