[Advantages and disadvantages of water birth. A systematic review of the literature]

Abstract

Context: Water birth is under debate among professionals. For the proponents of this approach, immersion in water during labour and birth may increase maternal relaxation, reduce analgesia requirements and promote a model of obstetric care more focused on the needs of mothers, particularly the empowerment of women to realize their full potential. In contrast, major critics cite a risk of inhalation of water for the newborn and a risk of infection for the mother and the newborn.

Objective: This review tracks the state of scientific knowledge about water birth in order to determine if it can be generalized in hospitals.

Method: A systematic review of the literature was conducted in PubMed, Embase and Cochrane Database. The period covered is from January 1989 to May 2013. The level of evidence of the studies was assessed with the analysis guide of the Haute Autorité de santé.

Results: The level of evidence of the studies identified goes from moderate to low, particularly as regard to studies analysing the expulsion phase.

Conclusion: It is possible to recommend immersion in water during the labour phase. No recommendation can be made as regard to the foetal expulsion phase.

Keywords: Accouchement; Birth; Eau; Immersion; Revue systématique; Systematic review; Water.