Study confirms… Women who labour in water have lower rate of epidural analgesia
23 June 2016: K.D. Brainin
Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia (cervix not opening) in first stage of labour
To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia.
Design Randomised controlled trial.
Setting University teaching hospital in southern England.
Participants 99 nulliparous women with dystocia in active labour at low risk of complications.
Interventions Immersion in water or standard augmentation for dystocia (amniotomy and intravenous oxytocin).
Main outcome measures:
Primary: epidural analgesia and operative delivery rates.
Secondary: augmentation rates with amniotomy and oxytocin, length of labour, maternal and neonatal morbidity including infections, maternal pain score, and maternal satisfaction with care.
Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5).
They showed no difference in rates of operative delivery (49% v 50%, 0.98 (0.65 to 1.47), NNT 98), but significantly fewer received augmentation (71% v 96%, 0.74 (0.59 to 0.88), NNT 4) or any form of obstetric intervention (amniotomy, oxytocin, epidural, or operative delivery) (80% v 98%, 0.81 (0.67 to 0.92), NNT 5).
Labouring in water under midwifery care may be an option for slow progress in labour, reducing the need for obstetric intervention, and offering an alternative pain management strategy.
(Extract from abstract of Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour by Elizabeth R Cluett, Ruth M Pickering, Kathryn Getliffe, Nigel James, St George Saunders published in British Journal of Midwfery January 26, 2004)
Women who receive less medical intervention generally stay in hospital for a shorter period of time.
The combination of an intervention free birth – with a short hospital stay result in a better experience for mother and baby.
Hospital staff and resources can be employed more efficiently.
Importantly – this results in significant financial savings!
A birth pool is a simple, inexpensive piece of equipment that can make a major impact on the quality of care and cost of having a baby.
The experience of hospitals who have birth pools shows that the cost of installing a pool is soon recouped by savings achieved through the reduced use medical methods of pain relief and intervention and shorter hospital stays.
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