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A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery

Yinglin Liu12, Yukun Liu12, Xiuzhi Huang3, Chuying Du1, Jing Peng4, Peixian Huang1 and Jianping Zhang12*

  • * Corresponding author: Jianping Zhang

  • † Equal contributors

Author Affiliations

1 Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No 107, Yanjiang West Road, Guangzhou, Guangdong 510120, China

2 Key Laboratory of malignant tumor gene regulation and target therapy of Guangdong Higher Education Institutes, Sun Yat-sen University, Guangzhou, Guangdong, China

3 Department of Obstetrics and Gynecology, HuiZhou Municipal Central Hospital, Huizhou, PR, China

4 Department of Obstetrics and Gynecology, GuangDong Women and Children Hospital, Guangzhou, PR, China

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BMC Pregnancy and Childbirth 2014, 14:160  doi:10.1186/1471-2393-14-160

Published: 6 May 2014



Water immersion during the first stage of labor can reduce the length of the first stage and epidural/spinal analgesia use; however, there is limited information regarding other outcomes. Our purpose was to compare maternal and neonatal outcomes of women who underwent water immersion during the first stage of labor with those who underwent conventional labor and delivery.


Healthy primipara with singleton pregnancies and cephalic presentation were included in the study. Patients were allowed to choose water immersion during labor or conventional labor and delivery. For water immersion, the water temperature was maintained at 35-38°C and subjects left the tub on complete cervical dilatation. A visual analogue scale (VAS) was used to assess pain during labor. Other outcome measures included duration of labor, type of delivery, blood loss, pelvic floor dysfunction and symptoms of stress urinary incontinence (SUI) at 42 days after delivery, infant Apgar scores, and need for transfer of the infant to the neonatal intensive care unit.


Thirty eight subjects (mean age, 28.66 ± 3.08 y) received water immersion and 70 (mean age, 27.89 ± 2.99 y) underwent conventional labor and delivery. There were no differences in maternal height, weight, age, gestational age, gravidity, and newborn weight between the groups (all, p>0.05). VAS pain scores were significantly greater in the conventional labor group at 30 min and 60 min after a cervical dilatation of 3 cm (30 min: 10 [9, 10] vs. 6 [5, 8]; 60 min: 10 [10, 10] vs. 7 [6, 8], respectively, both, p<0.001). The duration of labor and postpartum bleeding were similar between the groups (all, p>0.05). The cesarean section rate was higher in the conventional labor group (32.9% vs. 13.2%, p=0.026). The 1-minute and 5-minute Apgar scores were similar between the groups. Maternal and neonatal culture results were similar between the groups. SUI symptoms at 42 days after delivery was significantly higher in the conventional labor group (25.5% vs. 6.1%, respectively, p=0.035).


Water immersion can reduce labor pain, and is associated with a lower rate of cesarean delivery and SUI symptoms at 42 days.

Water birth; Water immersion during labor; Analgesia; Labor duration; Puerperal infection