The author reports no conflict of interest or relevant financial relationships.
Article first published online: 4 SEP 2013
© 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 42, Issue 5, pages 588–594, September/October 2013
How to Cite
Simpson, K. R. (2013), Underwater Birth. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 42: 588–594. doi: 10.1111/1552-6909.12235
- Issue published online: 10 SEP 2013
- Article first published online: 4 SEP 2013
- Manuscript Accepted: MAY 2013
- water immersion during labor;
- underwater birth;
- water birth;
- natural childbirth;
- perinatal patient safety
To determine potential risks and/or benefits of underwater birth for mother and infant.
The PubMed, Cochrane Library, EMBASE, and CINAHL online databases were searched for relevant English language articles related to research about underwater birth published from 1966 to April 2013. Reference lists of articles retrieved were reviewed to identify additional potentially pertinent publications.
Two randomized controlled trials comparing underwater birth to traditional birth (“on land”) were identified and served as the primary focus of the analysis. One systematic review of water immersion during labor and birth, one systematic review of neonatal risks of underwater birth, and case reports of neonatal morbidity after underwater birth were also identified. Guidelines regarding underwater birth from professional organizations were reviewed.
Data from the two randomized controlled trials were extracted and organized under the following headings: author, year, setting, country, study design, sample size, participants, outcomes, findings and comments. Systematic reviews, case reports, and guidelines from professional organizations were summarized.
Research findings and guidelines from professional associations were evaluated regarding potential risks and benefits of underwater birth to the mother and infant.
Only two randomized controlled trials comparing underwater birth to birth on land have been published. Results suggest minimal benefit of underwater birth to the mother and no benefit to the infant. Both studies were underpowered to adequately evaluate risk of neonatal harm; however, a number of cases of neonatal morbidity have been reported. Based on these findings, underwater birth requires more rigorous study. In the United States, underwater birth is not supported by the American Academy of Pediatrics or the American College of Obstetricians and Gynecologists outside the context of a randomized controlled trial.