Evidence Based Birth® EBB 300 - Evidence on Waterbirth
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Feb 14, 2024 Delving into the safety and benefits of waterbirth, the podcast explores findings from randomized trials and observational studies, highlighting lower pain scores, intact perineum, and shorter labor duration. It addresses the challenges of conducting large trials and advocates for broader acceptance of water birth. The discussion also includes the importance of advocating for waterbirth in hospitals and accessing resources for interested individuals.
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Randomized Trials Show Maternal Benefits
- Five randomized trials exist and show maternal benefits like less pain, shorter labors, and higher intact perineum rates.
- Trials are small and underpowered for rare newborn harms, so large RCTs are unlikely.
Large Meta-Analysis Supports Safety
- The 2022 Burns et al. meta-analysis (157,000+ participants) found many maternal benefits and no differences for most neonatal harms.
- The only outcome favoring land birth was higher cord avulsion with water birth.
Largest Matched Observational Study Favors Water Birth
- A 2021 propensity-matched study of 35,060 home/center births found water birth linked to fewer neonatal transfers, respiratory distress, hospitalizations, and lower mortality.
- It did show slightly higher cord avulsion and mild postpartum uterine infection, but no increased hospitalizations.