Doubts over water births

Water births have no proven clinical benefits, says a New Zealand study published this week in the journal of the American Academy of Paediatrics.

The study details the cases of four newborns said to have nearly drowned who were admitted to National Women's Hospital in Auckland during a 10-month period. A fifth case occurred after the study was completed.

All the babies recovered.

The report's authors - Sarah Nguyen, Carl Kuschel, Rita Teele, and Claire Spooner - said water births had no proven clinical benefits.

"Despite the increased popularity in water births during the past decade, there is a paucity of reliable scientific evidence about the benefits and hazards associated with this form of birthing."

Mr Kuschel, National Women's clinical director of newborn services, said he hoped the report would stimulate debate and cause people who promoted the procedure to consider whether they were giving the right information.

When news of the report first came out in March it caused a strong reaction, but Mr Kuschel said there had been no such response so far to the publication in the journal Paediatrics.

In an editorial in Paediatrics, Ruth Gilbert, a senior lecturer at the Centre for Paediatric Epidemiology and Biostatistics in London, said adverse events, including death, had been caused by water births.

For some women, cases of problems arising from water births, including those reported from National Women's, would be enough to persuade them to have a non-water birth, Ms Gilbert said.

"Others are prepared to trade off a small risk of a very serious outcome against the perceived benefits of the experience.

"There may also be hope of physical benefits for the infant and mother but there is no clear research evidence that immersion in water during labour reduces duration of labour, perineal tears, or use of analgesia."

Mr Kuschel said there was insufficient information about water births. While it might have been bad luck that five cases of problems connected with water births came into the hospital in a short period, it might also have been the tip of an iceberg.

"My own personal opinion is if it doesn't benefit the mother and places the baby at risk, then what's the point?"

Massey University midwifery lecturer Robyn Maude disagreed there was insufficient research into water births.

An international systematic review of three random control trials in the late 1980s into the use of water for labour and births found no significant statistical differences for women using water compared to those who did not, she said.

"Midwives wouldn't continue to use water if we thought it wasn't safe."

- NZPA

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