Neonatal respiratory consequences from water birth


  • The authors have no disclaimers, sources of support and conflicts of interest to disclose. The authors identify an additional individual who has provided assistance in the conduct of this research. That individual is Dr Carl Kuschel, a neonatal paediatrician from Auckland City Hospital at the time. Dr Kuschel's assistance was in preparing the set of X-rays along with a questionnaire for web-based viewing and feedback. Dr Kuschel did not seek any payment for this role and did not receive any. He has previously co-authored a short case series article on water births in the journal (see Nguyen et al.7).

Dr Phil Weston, Department of Paediatrics, Waikato Hospital, Private Bag, Hamilton 3204, New Zealand. Fax: +64 7 839 8775; email:


Aim:  Differentiating features were sought for respiratory distress after water birth versus air birth in term low-risk babies. Clinical and X-ray features were to be assessed to determine if the disease processes could be differentiated.

Methods:  Review of case records and X-rays over a 7-year period for all admitted babies with respiratory distress after water birth and a similar group of babies with respiratory distress after air birth.

Results:  There were 14 water birth babies and 24 air birth babies in the study. The water birth babies showed greater acidosis, greater requirement for ventilation, greater requirement for nitric oxide treatment and greater time to establish feeding. The X-rays could not be reliably allocated to the correct group, but the water birth X-rays were judged to have more severe changes than the air birth babies.

Conclusion:  In low-risk babies with respiratory distress, water birth is associated with a greater level of respiratory morbidity than seen after air birth.