A case series on maternal and neonatal outcomes of hydrotherapy during labor and childbirth

Abstract

Hydrotherapy, is also called as aquatic or water therapy, and its benefits include improved muscle strength and endurance, increased joint range of motion and enhanced cardio respiratory functioning and reduced cardio metabolic risk profile. Utilization of hydrotherapy during labor and child birth is increasing globally among the educated public. Despite its exclusive benefits, data on its safety and outcomes are still lacking especially in India. Hence it is the need of the hour for the clinicians to discuss the potential benefits and safety of water birth and utilize it particularly for women with uncomplicated pregnancy who prefer physiological childbirth and wish to avoid the use of pharmacological pain relief methods. To assess and validate about the maternal and neonatal outcomes of hydrobirthing from a series of parturients who volunteered for the utilization of hydrotherapy during labor and childbirth.This case series consist of 26 out of 33 pregnant women who opted for hydrobirthing between 1 December 2015 and 31 April 2019 at a tertiary care hospital with NABH accreditation. Booked cases with uncomplicated pregnancy and who were on regular antenatal check up, with gestational age >37 <42 weeks and were included in the study after obtaining the informed consent. The dataset was limited to vaginal delivery following spontaneous labor and included pre-specified outcomes such as labor pain, perineal tear , episiotomy, post partum hemorrhage (PPH), temperature after delivery and apgar scores of the new born to evaluate the maternal and fetal outcomes following hydrotherapy and the results were discussed. The present case series onhydro birthing has demonstrated that it is one among the safe natural mode of labor without any serious maternal and neonatal complications. Further study on a large scale with evaluation of long-term outcomes would help to generalise the observed outcomes of the present study.

The use of hydrotherapy in the first stage of labour: A systematic review and meta‐analysis

“…This study observed that no difference was seen between the hydrotherapy and control groups in terms of blood loss amounts and postpartum Hb and Hct levels. These findings are similar to the results of the studies by Gautham and Devi (2020) and Zhang and Yang (2022). Contrary to our study, two studies found that water immersion was effective in reducing postpartum haemorrhage (Burns et al, 2022; Cristina et al, 2022).…”

“…fourth-degree lacerations between water and land birth groups while increasing the rate of first-and second-degree tears. There are however various other studies with contrary reports (Dahlen et al, 2013;Gautham & Devi, 2020). These inconsistent results for the effect of hydrotherapy on perineal outcomes may be related to differences in study samples' age, parity, intrapartum care and the follow-up methods used.…”