Abstract:
:Immersion in water has been suggested as a beneficial alternative for labor, delivery, or both and over the past decades has gained popularity in many parts of the world. Immersion in water during the first stage of labor may be associated with decreased pain or use of anesthesia and decreased duration of labor. However, there is no evidence that immersion in water during the first stage of labor otherwise improves perinatal outcomes, and it should not prevent or inhibit other elements of care. The safety and efficacy of immersion in water during the second stage of labor have not been established, and immersion in water during the second stage of labor has not been associated with maternal or fetal benefit. Given these facts and case reports of rare but serious adverse effects in the newborn, the practice of immersion in the second stage of labor (underwater delivery) should be considered an experimental procedure that only should be performed within the context of an appropriately designed clinical trial with informed consent. Facilities that plan to offer immersion in the first stage of labor need to establish rigorous protocols for candidate selection, maintenance and cleaning of tubs and immersion pools, infection control procedures, monitoring of mothers and fetuses at appropriate intervals while immersed, and immediately and safely moving women out of the tubs if maternal or fetal concerns develop.
journal_name
Pediatricsjournal_title
Pediatricsauthors
American Academy of Pediatrics Committee on Fetus and Newborn.,American College of Obstetricians and Gynecologists Committee on Obstetric Practice.doi
10.1542/peds.2013-3794subject
Has Abstractpub_date
2014-04-01 00:00:00pages
758-61issue
4eissn
0031-4005issn
1098-4275pii
peds.2013-3794journal_volume
133pub_type
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