The water birth versus land birth study for pregnant women at low-risk of complications
Water birth Access at Term to Estimate Risks and Benefits In Research cohorTs in Hospital (WATERBIRTH): prospective cohort feasibility study
Professor Sue Kildea
600 participants
Oct 2, 2014
Observational
Conditions
Summary
Water birth occurs when a baby is born fully submerged in water. There is a lack of strong (Level 1) evidence to conclusively agree on the safety or risk of water birth. We aim to determine if it is possible to run a large study that examines the safety of water birth compared to land birth in women with low-risk pregnancies. In this study, we will test recruitment parameters, research processes, and outcome measures (for mother and baby) to assess the feasibility of a main study. If this study proves feasible and funding is obtained, then we will consider an international study across multiple sites (subject to ethical approval) with the primary purpose of testing safety for babies who are born under water.
Eligibility
Inclusion Criteria11
- years or older
- do not require interpreter
- weigh less than 100 kilograms
- low obstetric risk
- suitable for intermittent auscultation in labour
- singleton viable pregnancy
- admitted to birth suite in spontaneous labour at term
- vertex presentation
- intact membranes or draining clear liquor (PROM <24 hours)
- maternal and fetal observations within normal limits
- vaginal bleeding within normal limits (i.e. no more than a 'show')
Exclusion Criteria17
- years or younger
- require an interpreter or legal guardian for consent
- weigh 100 kilograms or more
- obstetric risk factors
- not suitable for intermittent auscultation in labour
- multiple pregnancy or fetal demise
- blood born infection e.g. Hepatitis B, C and HIV
- major congenital anomalies
- admitted to birth suite in labour <37+0 or >42 weeks' gestation
- induction or planned caesarean
- non-vertex presentation
- meconium-stained liquor
- abnormal maternal or fetal observations
- any suspected or proven active infectious illness
- requesting narcotic or epidural analgesia
- any contraindication to intermittent fetal heart rate monitoring
- vaginal bleeding more than 'show'
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Interventions
Participants who intend to have a water birth on admission to birth suite will be allocated to a room with water birth facilities and have one-to-one care in labour by a midwife who is credentialed to conduct water births in accordance with evidence-informed guidelines. Women may access water immersion in labour and in the absence of an indication to exit the pool; the woman will proceed to give birth under water.
Locations(1)
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ACTRN12616000973415