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EDITORIAL COMMENT": We accepted this paper for publication because there is a lot of anecdotal discussion about water birth in obstetric practice but very few studies where the labours have been scientifically appraised and an attempt made to compare them with another group of patients. This paper attempts to make such a comparison and provides information which should interest all obstetricians and midwives. It is difficult to imagine how there could ever be a controlled trial on the usefulness of waterbirth compared with other methods of delivery. As the authors point out, there are so many advocates for waterbirth in the United Kingdom that compilation of scientific information and its publication must be encouraged. This study is small and we would encourage those who practise waterbirths to at least present an audit of the complications both maternal and fetal that occur with this method of delivery.

Summary: The use of birthing pools during labour is increasing in the United Kingdom. This is without good scientific evidence of their efficacy or safety. To further investigate the value and safety of intrapartum hydrotherapy, an historical cohort study was performed in a District General Hospital in Liverpool. The study group consisted of 100 women of low obstetric risk who used the birthing pool at some stage during their labours and the control group consisted of 100 women who were matched in terms of age, parity and obstetric history but laboured and delivered in air. The main outcome measures were operative delivery rates, duration of labour, analgesic requirements, perineal trauma and Apgar scores at 1 and 5 minutes. The results showed that nulliparas who used the birthing pool had significantly reduced operative delivery rates, a shorter second stage of labour, reduced analgesic requirements and a lower incidence of perineal trauma. In multiparas there were significant reductions in analgesic requirements.