Water birth. Risk & Benefits

Lilia S. Chua, MD, FPOGS, FPSUOG
Annual Post Graduate Course
Tarlac Medical Society
Nov. 28, 2020
Chua, L. Water Birth Risks & Benefits. 2020. https://www.linkedin.com/in/lilia-serrano-chua/

RISKS and BENEFITS
Outline
 History & time line of water birth practice
 Researches & studies
 Pros & cons for the mother
 Pros & cons for the newborn
 Case reports on newborn complications
 Recommendations on

 History & time line of water birth practice
 legends of South Pacific islanders gave birth in shallow
sea water and of Egyptian pharaohs born in water
(Janet Balaskas, 2004)

 History & time line of water
birth practice
 The first water birth - Europe 1805
in France (Avery 2013).
 Cold water birth - 1960s, Russian,
pioneer by Dr. Igor Tjarkovsky
(Avery 2013, Phillips 2014).
 Warm water birth - 1970s, France,
Dr. Frederick Leboyer (1975) & Dr.
Michel Odent, used warm birth
pools. “Aquatic ape theory "
(Phillips 2014).

History & time line of water birth practice
 1980s and 1990s, UK, Europe and Canada.
Michael Rosenthal, MD
-Obstetrician
-1st waterbirth, 1985
-Family Birthing Center,
Upland, USA
Dianne Garland, UK
-Midwife & educator
-Established
waterbirth in 2000
Barbara Harper, US
-RN, CLD, CCCE,
midwife
-Founder/Director of
Waterbirth
International
-Waterbirth
Certification and
Education Courses

 Researches on waterbirth
A meta analysis on Cochrane reviews combining
11 RCT on water immersion during labor and during
birth (Cluett & Burns 2009)

Terminologies:
Water immersion Waterbirth

Terminologies:
hydrotherapy land birth

PROS & CONS
Other Local Birthing Homes:
1. Shiphrah Birthing Home, Taytay, Rizal
2. Briones-Escuadro Women’s Health Clinic, Nueva Ecija

Maternal
RISKS BENEFITS
 Perineal Tears/Trauma
 Postpartum Blood Loss
unquantified
 Highr Normal Vaginal Birth
 Less Maternal Transfers to
Hospital and Hospitalizations
 Less Pain/Need for Pain
Relief
 Higher Maternal Satisfaction

RISKS & BENEFITS for MOTHERS

RISK and BENEFITS
Similar risk on Pelvic Floor Function and
Maternal Infection in both water birth
and and birth

RISKS & BENEFITS
Equal risks on
 Newborn Death
 Apgar Scores
 Umbilical Cord pH
 Shoulder Dystocia
 Newborn Infections
Large Studies needed on
 Breathing Difficulty
 Group B Strep
To compare water birth and
land birth.
 Higher Umbilical Cord
Tears in water birth, &
 Lower NICU or Special
Care Nursery Admissions
Under healthiest condition.

RISKS & BENEFITS
 Newborn Transfers to
Hospital
 Hospitalizations
 Newborn Microbiome
 Newborn Hypothermia
 Newborn Resuscitation

RISKS & BENEFITS
CASE REPORTS 1994 - 2017
Umb. Cord tear 3.1 / 1,000 water
births. 2014
Water aspiration resulting in
hyponatremia, resp. distress
9
Drowning 6
Legionella 4
Pseudomonas 2
Berkholderea picketti from
water aspiration
1

RISKS & BENEFITS
CASE REPORTS 1994 – 2017
GBS Meningitis 1
Herper Simplex 1
H. influenza 1
Neonatal sepsis w/ adenovirus - mother
+diarrhea
1
Pseudomonas meningitis 1
Ruptured eardrum, Pseudomonas & E.
coli
1

PROS & CONS
•

•
RECOMMENTATIONS:
1. Immersion, for healthy
uncomplicated pregnancy
37 to 41 6/7 weeks
2. Insufficient data; Birth
occur on land, not in
water.
3. Informed consent
4. Well-designed prospective
study
5. Rigorous protocol for
candidate selection

Lilia S. Chua, MD, FPOGS, FPSUOG
Annual Post Graduate Course
Tarlac Medical Society
Nov. 28, 2020

Water birth. Risk & Benefits

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