Waterbirth Reduces Vaginal and Perineal Tears – New Report

Aquabirths Canberra birth pool iimage
Picture: Lorne Campbell / Guzelian

It’s always exciting when new research into Waterbirths comes out because they’re fairly few and far between. In this case, it’s a report from the USA1 where waterbirth is less well supported than it is in the UK and Europe. The report looks at a variety of outcomes, including how waterbirth reduces the incidence of vaginal and perineal tears, postnatal haemorrhage, Apgar scores and neonatal unit admissions.

Although this wasn’t a randomised control trial, it was a high quality retrospective study which looked at matched comparisons, so ‘like for like’ women with similar pregnancies and risk factors were properly compared. This means that the outcomes can be relied upon to be accurate.

Most outcomes were the same between the two groups (which were women who birthed in water and women who birthed on land). There were no differences between the numbers of women who experienced significant blood loss, but also there were no statistically significant differences between the numbers of babies admitted to the neonatal unit, and Apgar scores were similar between the groups.

There was one big difference though. The numbers of women who experienced first or second degree tears to their vagina or perineum were significantly reduced when the women laboured and birthed in water.

Aquabirths have previously written about the challenges of reducing vaginal and perineal tears, and our concerns about the OASI bundle. It is so important to consider the use of birth pools when looking to reduce the numbers of women who are experiencing these serious birth injuries, which can be life changing. Increasing the number of women who are accessing water to labour and birth in hospital, in midwife led units and at home is a low cost way for Trusts to support normal physiology and reduce the number of unnecessary birth injuries.

The evidence on the safety of waterbirth is overwhelming. We know that birth in water is safe for women and babies. We know how to support waterbirth for women who have a high BMI, are being induced, are having a VBAC or who are carrying Group B Strep. We know how positive and empowering waterbirths2 are for women, and we know how powerful the pain relieving3 aspect of a birth pool is.

So many obstetric units’ birth pools are underused. What can you do to increase the numbers of women using it? Can you take that on as your task for the month?

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