Water Birth
Pros/cons of a water birth
Kaitlin Gauna, LM, CPM
Despite ACOG/AAP’s statement that waterbirth carries no benefits, the American Association of Birth Centers has collected data that indicates there are some potential benefits associated with waterbirth.
Pros
Lower rates of episiotomy
Higher rates of intact perineum
Possibly lower rates of 3rd or 4th-degree tears
Possibly lower rates of postpartum hemorrhage
Less medication use for pain relief—this may be important for women who want or need to avoid epidurals or narcotic medications during labor.
Possibly fewer NICU admissions after waterbirth (it is not known whether the lower NICU admission rates are due to waterbirth itself or because women are asked to leave the tub for the birth at the slightest hint of problems with the fetal heart rate)
Cons
We need more research evidence on waterbirth (in particular, research studies with appropriate comparison groups), which makes it more difficult to make a truly informed choice.
Umbilical cord snaps are rare but possible. Care providers must avoid placing too much traction on the cord when guiding the infant out of the water.
Several case reports of water aspiration have been made, but these cases have not been observed in any prospective research study since 1999, and almost all of the infants in the case reports made a complete recovery.
Although large research studies have not shown any increase in the risk of infection, several case reports of infections after waterbirths have been reported. This risk can be lowered by regularly culturing the hospital water supply, hoses, and tubs and by installing filters when necessary.
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