Immersion in Water During Active Labor Decreases Postpartum Hematocrit Fall Following Vaginal Delivery

Abstract

<p><strong>OBJECTIVE:</strong> The objective of the study was to investigate the effect of immersion in water strategy during labor on postpartum bleeding by calculating the postpartum reduction rates of the hematocrit values of the patients.</p><p><strong>STUDY DESIGN:</strong> The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (group 1) and the control group (group 2) of 84 women undergoing normal vaginal delivery. Patients who have received additional medical and surgical interventions for alleviation of postpartum hemorrhage, patients who have undergone an episiotomy and/or perineal trauma were not included in the study. All data were taken from patients who have delivered with spontaneous vaginal delivery. Postpartum hematocrit fall rates of the groups have been compared and the effect of immersion in water on postpartum hemorrhage has been evaluated.</p><p><strong>RESULTS:</strong> The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (Group 1) and the control group (Group 2) of 84 women undergoing vaginal delivery at the hospital. The women in the two groups were matched with respect to age, parity, birth weight and gestational age. The mean age of the women was 29.8±4.8 and 30.5±4.9 respectively. The mean hematocrit difference in the first group was 2.08 ± 1.88 and in the second group was 3.81 ± 1.55. The mean percentage of hematocrit reduction in the first group was 5.71% and in the second group 10.23%.</p><p><strong>CONCLUSION:</strong> Our data showed that mean hematocrit level decreases among women following vaginal delivery more than women who give birth vaginally within immersion in water during labor. The percentage of hematocrit reduction in the water birth group was lower than in the control group. Water birth seems to facilitate uterine contractions more efficiently following vaginal delivery.</p>

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

“…Eight of the articles were randomized controlled experimental studies (Abo‐Romia & El‐Adham, 2014; Darsareh et al, 2018; Lee et al, 2013; Maddady et al, 2018; Sert et al, 2020; Solt Kirca & Kanza Gul, 2022; Taghavi et al, 2015; Taşkın & Ergin, 2022), three were quasi‐experimental with controls (Grymel‐Kulesza et al, 2021; Liu et al, 2014; Tuncay et al, 2017), five were retrospective cohort studies (Büyük et al, 2019, 2020; Lewis et al, 2018; Neiman et al, 2020; Sidebottom et al, 2020), three were prospective cohort studies (Barry et al, 2020; Lanier et al, 2021; Seed et al, 2023), and one was a case–control study (Zhao et al, 2017).…”

“…In 14 of the studies included in this review, hydrotherapy was applied by immersion in water (Barry et al, 2020; Büyük et al, 2019, 2020; Darsareh et al, 2018; Grymel‐Kulesza et al, 2021; Lanier et al, 2021; Lewis et al, 2018; Liu et al, 2014; Neiman et al, 2020; Seed et al, 2023; Sert et al, 2020; Sidebottom et al, 2020; Tuncay et al, 2017; Zhao et al, 2017); in five, warm showers were used (Abo‐Romia & El‐Adham, 2014; Lee et al, 2013; Solt Kırca & Kanza Gul, 2022; Taghavi et al, 2015; Taşkın & Ergin, 2022); and in one, a hot shower (Maddady et al, 2018) was applied. It was reported in the studies that the hydrotherapy water temperature varied in the range of 34–38°C (Table 1).…”

“…All of the randomized controlled trials indicated a high risk of bias (Abo‐Romia & El‐Adham, 2014; Darsareh et al, 2018; Lee et al, 2013; Maddady et al, 2018; Sert et al, 2020; Solt Kırca & Kanza Gul, 2022; Taghavi et al, 2015; Taşkın & Ergin, 2022). Among the observational studies included in the review, six reported low (Büyük et al, 2019, 2020; Lewis et al, 2018; Neiman et al, 2020;Seed et al, 2023; Sidebottom et al, 2020), four indicated moderate (Barry et al, 2020; Grymel‐Kulesza et al, 2021; Tuncay et al, 2017; Zhao et al, 2017), and two reported serious (Lanier et al, 2021; Liu et al, 2014) risk of bias (Figures 2 and 3). The quality evaluation resulted in the exclusion of one randomized controlled study and a quasi‐experimental study that carried a serious risk of bias, especially in the outcomes (Stark, 2017; Tosun, 2019).…”

Vivências das enfermeiras obstétricas em assistir à mulher no parto na água em Portugal

“…As recomendações apoiam um nascimento suave e fisiológico e um atendimento do recém-nascido centrado na família. Assim, o clampeamento tardio do cordão umbilical era uma primazia de proteção a criança contra anemia, considerando a importância que o nível de hematócrito e hemoglobina foi maior em outro estudo de parto na água (Buyuk et al, 2019); e o contato pele a pele era recomendado como base para a termorregulação e cuidado ao recém-nascido (Merceret al, 2007). Dessa forma, em nosso estudo o contato pele a pele imediato foi um facilitador para os neonatos nascidos na água, uma vez que após a expulsão e transição em água morna, o recém-nascido era colocado no peito materno e vivenciavam as manobras de adaptação neonatal imediata, isto é, a termorregulação, clampeamento do cordão umbilical oportuno e avaliação imediata do neonato (Agudelo et al, 2021) em ventre materno, com aleitamento materno ainda na primeira hora de vida.…”