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~ Submersion in Water During Early Labor May Reduce Pain, Stress, Improve Birth Experience, Study Says

Kaisernetwork.org Daily Reproductive Health Report ~ January 28, 2004

Submersion in a pool of water during early labor may reduce pain, stress and the need for pain medication in women giving birth for the first time, according to a study published in the Jan. 26 online issue of BMJ, Reuters reports (Reuters, 1/26). Dr. Elizabeth Cluett and colleagues at the University of Southampton in England studied 99 women who were delivering for the first time and were experiencing slow labor -- defined as dilation of less than one centimeter per hour. Forty-nine women were placed in birthing pools for the first stage of labor, while the remaining 50 women received standard care, including the use of oxytocin to strengthen contractions (Ahlstrom, Irish Times, 1/27). Approximately 50% of the women laboring in water received an epidural to ease labor pains, compared with two-thirds of the women who received standard care during early labor, the researchers report (Laurance, Independent, 1/26). Although prior to the study most doctors assumed that all women experiencing slow labor would require labor augmentation with oxytocin or by having their water broken, almost 30% of women laboring in water did not need to have their labor augmented and 20% required no obstetric intervention (Irish Times, 1/27). In addition, the women in the water group said they felt less pain and were more satisfied with their freedom of movement during early labor (Meikle, Guardian, 1/26). According to the study, the women laboring in water reported higher satisfaction overall with the birthing process, compared with women who did not labor in water (Independent, 1/26). The average duration of labor and the incidence of caesarean section delivery were about the same for both groups (Irish Times, 1/27).

Conclusions
England's National Childbirth Trust, which has campaigned for the provision of birthing pools under the National Health Service, welcomed the findings, according to London's Independent. More than 90% of maternity units in the country have birthing pools, but only 2% of laboring women use them, the Independent reports (Independent, 1/26). "Given the cost to the women and the health service of birth interventions that can be avoided when water is used, it makes sense for every unit to offer this option," Mary Newburn, head of policy research for NCT, said. The researchers said that further study is needed on the medical outcomes of infants born to women who labor in water (Guardian, 1/26).

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