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Factors Associated With Normal Physiologic Birth for Women Who Labor In Water: A Secondary Analysis of A Prospective Observational Study

Carpenter, Jane; Burns, Ethel; Smith, Lesley

Authors

Jane Carpenter

Ethel Burns



Abstract

Introduction: Research to understand factors associated with normal physiologic birth (unassisted vaginal birth, spontaneous labor onset without epidural analgesia, spinal, or general anesthetic, without episiotomy) is required. Laboring and/or giving birth in water has been shown to be associated with a high proportion of physiologic birth but with little understanding of factors that may influence this outcome. This study explored factors associated with normal physiologic birth for women who labored in water. Methods: We conducted a secondary analysis of a UK-based prospective observational study of 8064 women at low risk of childbirth complications who labored in water. Consecutive women were recruited from birth settings in England, Scotland, and Northern Ireland. Planned place of birth, maternal characteristics, intrapartum events, and maternal and neonatal outcomes were measured. Univariable and multivariable logistic regression modelling explored factors associated with normal physiologic birth. Results: In total, 5758 (71.4%) of women who labored in water had a normal physiologic birth. Planned birth in the community (adjusted odds ratio [aOR], 2.58; 95% CI, 2.22-2.99) or at an alongside midwifery unit (aOR, 1.21; 95% CI, 1.04-1.41) was positively associated with normal physiologic birth compared with planned birth in an obstetric unit. Duration of second stage (aOR, 0.66; 95% CI, 0.62-0.70), duration in the pool [aOR, 0.93; 95% CI, 0.90-0.96), and birth weight of the neonate (aOR, 0.74; 95% CI, 0.65-0.85) were negatively associated with normal physiologic birth. Parity was not associated with normal physiologic birth in multivariate analyses. Discussion: Our findings largely reflected wider research, both in and out of water. We found midwifery-led birth settings may increase the likelihood of normal physiologic birth among healthy women who labor in water, irrespective of parity. This association supports growing evidence demonstrating the importance of planned place of birth on reducing intervention rates and adds to research on labor and birth in water.

Citation

Carpenter, J., Burns, E., & Smith, L. (2022). Factors Associated With Normal Physiologic Birth for Women Who Labor In Water: A Secondary Analysis of A Prospective Observational Study. Journal of Midwifery and Women's Health, 67(1), 13-20. https://doi.org/10.1111/jmwh.13315

Journal Article Type Article
Acceptance Date Oct 18, 2021
Online Publication Date Jan 14, 2022
Publication Date 2022-01
Deposit Date Mar 31, 2022
Publicly Available Date Apr 1, 2022
Journal Journal of Midwifery and Women's Health
Print ISSN 1526-9523
Electronic ISSN 1542-2011
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 67
Issue 1
Pages 13-20
DOI https://doi.org/10.1111/jmwh.13315
Keywords Birth setting; Birthing pool; Intrapartum; Midwifery-led care; Normality; Water immersion; Waterbirth
Public URL https://hull-repository.worktribe.com/output/3959181

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Copyright Statement
© 2022 The Authors. Journal of Midwifery &Women’s Health published byWiley Periodicals LLC on behalf of American College of Nurse Midwives (ACNM). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.





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