Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 11 , ISSUE 3 ( May-June, 2019 ) > List of Articles


Controversial Issue in Water Birth to Reduce Perineal Trauma

Surahman Hakim, Budi I Santoso, Ali Sungkar, Raymond Surya, Adly N Al Fattah

Keywords : Episiotomy, Perineal trauma, Water birth

Citation Information : Hakim S, Santoso BI, Sungkar A, Surya R, Al Fattah AN. Controversial Issue in Water Birth to Reduce Perineal Trauma. J South Asian Feder Obs Gynae 2019; 11 (3):207-211.

DOI: 10.5005/jp-journals-10006-1688

License: CC BY-NC 4.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Introduction: Perineal trauma becomes a concern during childbirth. One method to reduce perineal trauma is through water birth; however, there is still a lack of publication about water birth. This study aims to appraise the benefit of water birth to reduce the perineal trauma. Materials and methods: Searching was conducted on Pubmed®, Cochrane Library®, and Medline® using keywords or MeSH. There were 4 eligible articles consisting of 1 case-control, 1 clinical trial, and 2 systematic reviews. Appraisal determining the validity, importance, and applicability (VIA) was conducted by two independent authors guided by British Medical Journal (BMJ) Evidence-based Medicine Toolkit. Results: There were no difference percentage of intact perineum (RR 1.16; 95% CI 0.99–1.35), episiotomy (RR 0.93; 95% CI 0.80–1.08), second degree tear (RR 0.94; 95% CI 0.74–1.20), and third/fourth degree tear (RR 1.37; 95% CI 0.86–2.17) between water birth and conventional birth in a systematic review. Another review showed that water birth decreased the use of episiotomy and the severity of perineal laceration. A prospective trial study concluded that water birth caused less requirement for obstetric intervention; however, it impacted to more perineal laceration. Another study showed lower episiotomy and higher intact perineum rates in water birth group. Conclusion: There is still inconsistency of water birth in reducing perineal trauma.

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