Bioengineering Principles of Hydrotherapy

Edlich, Richard F.; Towler, Michael A.; Goitz, Robert J.; Wilder, Robert P.; Buschbacher, Lois P.; Morgan, Raymond F.; Thacker, John G.

doi:10.1097/00004630-198708060-00031

Cited by 39 publications

(39 citation statements)

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“…For example, we lacked information on the duration of immersion in water, at what stage during labour they entered the water [6], the temperature of the water [18], the size and type of pool used [19], or whether the birth took place in water [5], all factors which may influence the impact of water immersion.…”

Section: Discussionmentioning

confidence: 99%

Immersion in water for pain relief and the risk of intrapartum transfer among low risk nulliparous women: secondary analysis of the Birthplace national prospective cohort study

Lukasse

Rowe

Townend

et al. 2014

BMC Pregnancy Childbirth

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BackgroundImmersion in water during labour is an important non-pharmacological method to manage labour pain, particularly in midwifery-led care settings where pharmacological methods are limited. This study investigates the association between immersion for pain relief and transfer before birth and other maternal outcomes.MethodsA prospective cohort study of 16,577 low risk nulliparous women planning birth at home, in a freestanding midwifery unit (FMU) or in an alongside midwifery unit (AMU) in England between April 2008 and April 2010.ResultsImmersion in water for pain relief was common; 50% in planned home births, 54% in FMUs and 38% in AMUs. Immersion in water was associated with a lower risk of transfer before birth for births planned at home (adjusted RR 0.88; 95% CI 0.79–0.99), in FMUs (adjusted RR 0.59; 95% CI 0.50–0.70) and in AMUs (adjusted RR 0.78; 95% CI 0.69–0.88). For births planned in FMUs, immersion in water was associated with a lower risk of intrapartum caesarean section (RR 0.61; 95% CI 0.44–0.84) and a higher chance of a straightforward vaginal birth (RR 1.09; 95% CI 1.04–1.15). These beneficial effects were not seen in births planned at home or AMUs.ConclusionsImmersion of water for pain relief was associated with a significant reduction in risk of transfer before birth for nulliparous women. Overall, immersion in water was associated with fewer interventions during labour. The effect varied across birth settings with least effect in planned home births and a larger effect observed for planned FMU births.

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Section: Discussionmentioning

confidence: 99%

Immersion in water for pain relief and the risk of intrapartum transfer among low risk nulliparous women: secondary analysis of the Birthplace national prospective cohort study

Lukasse

Rowe

Townend

et al. 2014

BMC Pregnancy Childbirth

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“…Densities of various substances are defined by a pure number value called specific gravity. 4 The specific gravity of an object also determines how much of the object's volume will float under water. 2 The specific gravities of fat, lean muscle, and bone are 0.8, 1, and 1.5 to 2, respectively.…”

Section: Relative Densitymentioning

confidence: 99%

“…The specific gravity of pure water is 1.0. 4 For example, the specific gravity of ice is approximately 0.92; therefore 92% of ice will be submerged to displace enough water so that the upward force of buoyancy will equal the downward force of gravity, and 8% will float above the surface of water. 3 The relative density and specific gravity of an object determine how well an object will float.…”

Section: Relative Densitymentioning

confidence: 99%

“…3 The relative density and specific gravity of an object determine how well an object will float. 4 An object whose specific gravity is equal to that of pure water (1) will float just below the surface of the water. 4 The specific gravity of an object also determines how much of the object's volume will float under water.…”

Section: Relative Densitymentioning

confidence: 99%

“…4 Therefore the deeper a body is immersed in water, the greater the pressure exerted. This fluid pressure is directly proportional to both the depth and density of the fluid.…”

Section: Hydrostatic Pressurementioning

confidence: 99%

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Aquatic Therapy

Levine¹,

Millis²,

Flocker³

et al. 2014

Canine Rehabilitation and Physical Therapy

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Immersion in water in labour and birth

Cluett

Burns

2009

Cochrane Database of Systematic Reviews

165

167

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Background Enthusiasts suggest that labouring in water and waterbirth increase maternal relaxation, reduce analgesia requirements and promote a midwifery model of care. Critics cite the risk of neonatal water inhalation and maternal/neonatal infection. Objectives To assess the evidence from randomised controlled trials about immersion in water during labour and waterbirth on maternal, fetal, neonatal and caregiver outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 June 2011) and reference lists of retrieved studies. Selection criteria Randomised controlled trials comparing immersion in any bath tub/pool with no immersion, or other non-pharmacological forms of pain management during labour and/or birth, in women during labour who were considered to be at low risk of complications, as defined by the researchers. Data collection and analysis We assessed trial eligibility and quality and extracted data independently. One review author entered data and the other checked for accuracy. Main results This review includes 12 trials (3243 women): eight related to just the first stage of labour: one to early versus late immersion in the first stage of labour; two to the first and second stages; and another to the second stage only. We identified no trials evaluating different baths/pools, or the management of third stage of labour. Results for the first stage of labour showed there was a significant reduction in the epidural/spinal/paracervical analgesia/anaesthesia rate amongst women allocated to water immersion compared to controls (478/1254 versus 529/1245; risk ratio (RR) 0.90; 95% confidence interval (CI) 0.82 to 0.99, six trials). There was also a reduction in duration of the first stage of labour (mean difference −32.4 minutes; 95% CI −58.7 to −6.13). There was no difference in assisted vaginal deliveries (RR 0.86; 95% CI 0.71 to 1.05, seven trials), caesarean sections (RR 1.21; 95% CI 0.87 to 1.68, eight trials), use of oxytocin infusion (RR 0.64; 95%CI 0.32 to 1.28,five trials), perineal trauma or maternal infection. There were no differences for Apgar score less than seven at five minutes (RR 1.58; 95% CI 0.63 to 3.93, five trials), neonatal unit admissions (RR 1.06; 95% CI 0.71 to 1.57, three trials), or neonatal infection rates (RR 2.00; 95% CI 0.50 to 7.94, five trials). Of the three trials that compared water immersion during the second stage with no immersion, one trial showed a significantly higher level of satisfaction with the birth experience (RR 0.24; 95% CI 0.07 to 0.80). A lack of data for some comparisons prevented robust conclusions. Further research is needed. Authors’ conclusions Evidence suggests that water immersion during the first stage of labour reduces the use of epidural/spinal analgesia and duration of the first stage of labour. There is limited information for other outcomes related to water use during the first and second stages of labour, due to intervention and outcome variability. There is no evidence of increased adverse ...

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Bioengineering Principles of Hydrotherapy

Cited by 39 publications

References 0 publications

Immersion in water for pain relief and the risk of intrapartum transfer among low risk nulliparous women: secondary analysis of the Birthplace national prospective cohort study

Immersion in water for pain relief and the risk of intrapartum transfer among low risk nulliparous women: secondary analysis of the Birthplace national prospective cohort study

Aquatic Therapy

Immersion in water in labour and birth

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