title: The effects of immersion in water on labor, birth and newborn and comparison with epidural analgesia and conventional vaginal delivery.
abstract: OBJECTIVE
  To document the practice of labour in water, to assess the effects of water immersion during labor and/or birth (labour stages 1, 2 and 3) on maternal, fetal and neonatal wellbeing and to compare the outcomes and safety with conventional vaginal deliveries and deliveries with epidural analgesia.
  
  
  METHODS
  Two-hundred and seven women electing for waterbirth (n=207) were compared with women having conventional vaginal deliveries (n=204) and vaginal deliveries with epidural analgesia (n=191). Demographic data, length of 1(st), 2(nd) and 3(rd) stage of labor, induction and episiotomy requirements, perineal trauma, apgar scores, NICU requirements and VAS scores were noted.
  
  
  RESULTS
  The 1(st) stage of labor was shorter in waterbirths compared with vaginal delivery with epidural analgesia but the 2(nd) and 3(rd) stage of labor were shortest in patients having waterbirth compared with conventional vaginal delivery and vaginal delivery with epidural analgesia. Patients having waterbirth had less requirement for induction and episiotomy but had more perineal laceration. All women having waterbirths had reduced analgesia requirements and had lower scores on VAS. There was no difference in terms of NICU admission between the groups. Apgar scores were comparable in both groups. There were no neonatal deaths or neonatal infections during the study.
  
  
  CONCLUSIONS
  The study demonstrates the advantages of labor in water in terms of reduction in 2(nd) and 3(rd) stage of labor, reduction in pain and obstetric intervention such as induction or amniotomy.
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Mollamahmutoğlu
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Moraloğlu
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Sebnem
authors.initials: S
authors.lastname: Ozyer
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Filiz Akın
authors.initials: FA
authors.lastname: Su
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Rana
authors.initials: R
authors.lastname: Karayalçın
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Necati
authors.initials: N
authors.lastname: Hançerlioğlu
authors.affiliation: Water Birth Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Uzunlar
authors.affiliation: Neonatology Unit, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Dilmen
keywords: Water birth; analgesia; neonatal outcome