Cochrane · systematic review · CD000111
Immersion in water during labour and birth
Cluett, ER, Burns, E, Cuthbert, A · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
16
No studies
4
Included studies
NR
No studies 4 · 20%Ungraded 0 · 0%Very low 9 · 45%Low 4 · 20%Moderate 3 · 15%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Immersion in water compared to no immersion during first stage of labour in water during labour and birth
Population: women in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mode of birth (spontaneous vaginal birth) Immersion in water vs no immersion during first stage of labour | RR 1.01 [0.97, 1.04] | 6 studies · 2559 participants | Moderate Downgraded: risk of bias |
Mode of birth (instrumental vaginal birth) Immersion in water vs no immersion during first stage of labour | RR 0.86 [0.7, 1.05] | 6 studies · 2559 participants | Low Downgraded: risk of bias |
Mode of birth (caesarean section) Immersion in water vs no immersion during first stage of labour | RR 1.27 [0.91, 1.79] | 7 studies · 2652 participants | Low Downgraded: risk of bias, imprecision |
Use of analgesia (regional) Immersion in water vs no immersion during first stage of labour | RR 0.91 [0.83, 0.99] | 5 studies · 2439 participants | Moderate Downgraded: risk of bias |
Perineal trauma (third‐ or fourth‐degree tears) Immersion in water vs no immersion during first stage of labour | RR 1.36 [0.85, 2.18] | 4 studies · 2341 participants | Moderate Downgraded: risk of bias |
Perinatal death Immersion in water vs no immersion during first stage of labour | no estimate extracted | NR | No studies |
Admission to neonatal intensive care unit Immersion in water vs no immersion during first stage of labour | RR 1.3 [0.42, 3.97] | 2 studies · 1511 participants | Low Downgraded: risk of bias, imprecision |
Neonatal infection Immersion in water vs no immersion during first stage of labour | RR 2 [0.5, 7.94] | 5 studies · 1295 participants | Very low Downgraded: risk of bias |
Estimated blood loss (mL) Immersion in water vs no immersion during first stage of labour | no estimate extracted | 2 studies · 153 participants | Very low Downgraded: risk of bias, imprecision |
Immersion in water compared to no immersion during second stage of labour in water during labour and birth
Population: women in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mode of birth (spontaneous vaginal birth) Immersion in water vs no immersion during second stage of labour | RR 1.02 [0.96, 1.08] | 1 study · 120 participants | Low Downgraded: risk of bias, imprecision |
Mode of birth (instrumental vaginal birth) Immersion in water vs no immersion during second stage of labour | RR 1 [0.06, 15.62] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Mode of birth (caesarean section) Immersion in water vs no immersion during second stage of labour | RR 0.33 [0.01, 8.02] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Use of analgesia (regional) Immersion in water vs no immersion during second stage of labour | no estimate extracted | NR | No studies |
Perineal trauma (third‐ or fourth‐degree tears) Immersion in water vs no immersion during second stage of labour | no estimate extracted | NR | No studies |
Perinatal death Immersion in water vs no immersion during second stage of labour | RR 3 [0.12, 72.2] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Admission to neonatal intensive care unit Immersion in water vs no immersion during second stage of labour | RR 0.78 [0.38, 1.59] | 2 studies · 291 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal infection, including markers of infection such as pyrexia and raised white cell count: Neonatal temperature less than 36.2oC at birth Immersion in water vs no immersion during second stage of labour | RR 0.98 [0.3, 3.2] | 1 study · 109 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal infection, including markers of infection such as pyrexia and raised white cell count: Neonatal temperature greater than 37.5oC at birth Immersion in water vs no immersion during second stage of labour | RR 2.62 [0.73, 9.35] | 1 study · 109 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal infection, including markers of infection such as pyrexia and raised white cell count: Fever reported in first week Immersion in water vs no immersion during second stage of labour | RR 0.53 [0.1, 2.82] | 1 study · 171 participants | Very low Downgraded: risk of bias, imprecision |
Estimated blood loss (mL) Immersion in water vs no immersion during second stage of labour | no estimate extracted | NR | No studies |