An increasing number of hospitals are offering women the option of laboring in a warm tub. However, not all facilities allow the actual birth to occur in the water, citing the lack of evidence on the safety of water births.
In 2014, the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) issued joint guidelines stating that delivering a baby in water, also called 'water immersion,' provides no health benefits for the mother or child. Worse, they say, it can be dangerous or even fatal. In updated 2016 recommendations, the same two groups stated while water immersion in the first stage of labor may shorten labor and decrease the use of epidurals, birth should occur "on land, not in water."
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However, a new study might help to persuade the governing bodies to change their minds. According to Dr. Elizabeth Cluett and her two colleagues in an updated 2011 Cochrane review, there is no evidence of increased risk of harm to the baby or mother from birthing in water.
Analyzing 15 studies totaling 3,663 women, the researchers examined the effects of water immersion during the first and second stages of labor. They found that birthing in water had no impact on the rates of spontaneous vaginal delivery, the need for interventions such or forceps, or cesarean section rates. However, those who birthed in the tub were slightly less likely to need an epidural than those who did not use immersion.
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The authors were unable to find sufficient evidence that laboring or birthing in the water increases the risk of harm to mothers or babies.
The findings reiterate what midwives and birthing centers have known for years. According to Dr. Thomas Poder, "The current study missed some important points, that is, maternal relaxation and satisfaction and promotion of a model of obstetric care more focused on the needs of mothers, particularly the empowerment of women to realize their full potential."