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.
Hals E, Oian P, Pirhonen T, et al. A multicenter interventional program to reduce the incidence of anal sphincter tears. Obstet Gynecol 2010 Oct;116(4):901–908. DOI: 10.1097/AOG.0b013e3181eda77a.
Groutz A, Hasson J, Wengier A, et al. Third- and fourth-degree perineal tears: prevalence and risk factors in the third millennium. Am J Obstet Gynecol 2011 Apr;204(4):347.e1–347.e4. DOI: 10.1016/j.ajog.2010.11.019.
de Leeuw JW, Struijk PC, Vierhout ME, et al. Risk factors for third degree perineal ruptures during delivery. BJOG 2001 Apr;108(4): 383–387. DOI: 10.1016/S0306-5456(00)00090-5.
Odent M. Birth under water. Lancet Lond Engl 1983 Dec 24; 2(8365–8366):1476–1477. DOI: 10.1016/S0140-6736(83)90816-4.
Cluett ER, Burns E. Immersion in water in labour and birth. Cochrane Database Syst Rev 2009 Apr;15(2):CD000111. DOI: 10.1002/14651858.CD000111.pub3.
Zanetti-Daellenbach RA, Tschudin S, Zhong XY, et al. Maternal and neonatal infections and obstetrical outcome in water birth. Eur J Obstet Gynecol Reprod Biol 2007 Sep;134(1):37–43. DOI: 10.1016/j.ejogrb.2006.09.012.
Zanetti-Dällenbach R, Lapaire O, Maertens A, et al. Water birth, more than a trendy alternative: a prospective, observational study. Arch Gynecol Obstet 2006 Oct;274(6):355–365. DOI: 10.1007/s00404-006-0208-1.
Pinette MG, Wax J, Wilson E. The risks of underwater birth. Am J Obstet Gynecol 2004 May;190(5):1211–1215. DOI: 10.1016/j.ajog.2003.12.007.
Lim KMX, Tong PSY, Chong Y-S. A comparative study between the pioneer cohort of waterbirths and conventional vaginal deliveries in an obstetrician-led unit in Singapore. Taiwan J Obstet Gynecol 2016 Jun;55(3):363–367. DOI: 10.1016/j.tjog.2016.04.012.
Mollamahmutoğlu L, Moraloğlu O, Ozyer S, et al. The effects of immersion in water on labor, birth and newborn and comparison with epidural analgesia and conventional vaginal delivery. J Turk Ger Gynecol Assoc 2012;13(1):45–49. DOI: 10.5152/jtgga.2012.03.
Nutter E, Meyer S, Shaw-Battista J, et al. Waterbirth: an integrative analysis of peer-reviewed literature. J Midwifery Womens Health 2014 Jun;59(3):286–319. DOI: 10.1111/jmwh.12194.
Edlich RF, Towler MA, Goitz RJ, et al. Bioengineering principles of hydrotherapy. J Burn Care Rehabil 1987 Dec;8(6):580–584. DOI: 10.1097/00004630-198711000-00031.
Thoeni A, Zech N, Moroder L, et al. Review of 1600 water births. Does water birth increase the risk of neonatal infection? J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet 2005 May;17(5):357–361. DOI: 10.1080/14767050500140388.
Cortes E, Basra R, Kelleher CJ. Waterbirth and pelvic floor injury: a retrospective study and postal survey using ICIQ modular long form questionnaires. Eur J Obstet Gynecol Reprod Biol 2011 Mar;155(1): 27–30. DOI: 10.1016/j.ejogrb.2010.11.012.