AIMS Journal, 2025, Vol 37, No 1
Art by Sophie Jenna
Latest update from the PIMS team!
The NIHR (National Institute for Health and Care Research) recently asked the Campaigns team to provide our views on the research, conclusions and the potential implications of the June 2024 waterbirth research study:
Maternal and neonatal outcomes among spontaneous vaginal births occurring in or out of water following intrapartum water immersion: The POOL cohort study[1]
This large-scale UK study adds to this 2022 review on the evidence for the safety of waterbirths,[2] and to this March 2024 study;[3] it found no increase in rates of adverse outcomes for women or babies. This is important given that the NICE guideline currently states that there is insufficient high-quality evidence to either support or discourage giving birth in water.[4]
We are concerned by the professional reticence to offering waterbirth in obstetric units. This has been a longstanding issue for callers to our helpline. Research has found[5] a lack of equity of access to waterbirths for Black and Asian women and those from deprived areas.
AIMS calls for all maternity units to offer access to waterbirth to all women who want it.
[1] Sanders J, Barlow C, Brocklehurst P, Cannings-John R, Channon S, Cutter J, et al. (2024) Maternal and neonatal outcomes among spontaneous vaginal births occurring in or out of water following intrapartum water immersion: The POOL cohort study. BJOG; 131(12): 1650–1659. https://doi.org/10.1111/1471-0528.17878
[2] Burns E, Feeley C, Hall PJ, et al. (2022) Systematic review and meta-analysis to examine intrapartum interventions, and maternal and neonatal outcomes following immersion in water during labour and waterbirth. BMJ Open;12:e056517. https://bmjopen.bmj.com/content/12/7/e056517
[3] McKinney, Jordan A. et al. (2024) Water birth: a systematic review and meta-analysis of maternal and neonatal outcomes. American Journal of Obstetrics & Gynecology, Volume 230, Issue 3, S961-S979.e33 https://www.ajog.org/article/S0002-9378(23)00604-X/fulltext
[4] NICE (2023) Intrapartum care. Water birth 1.9.24 www.nice.org.uk/guidance/ng235/chapter/Recommendations#pain-relief-during-labour
[5] Aughey, H., Jardine, J., Moitt, N. et al. Waterbirth: a national retrospective cohort study of factors associated with its use among women in England. BMC Pregnancy Childbirth 21, 256 (2021). https://doi.org/10.1186/s12884-021-03724-6
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