• V C Nikodem.
• Department of Obstetrics and Gynaecology, University of the Witwatersrand, Coronation Child & Maternal Hospital, PO Box 3331, Halfway House, Johannesburg, South Africa, 1685. 091niko@chiron.wits.ac.zo
• Cochrane Db Syst Rev. 2000 Jan 1(2):CD000111.

BackgroundImmersion in warm water may help with relaxation, pain relief and increased elasticity of the birth canal. On the other hand, there may be risks associated with decreased mobility and inhalation of water by the baby, as well as increased risk of maternal infection.ObjectivesThe objective of this review was to assess the effects of immersion in water during pregnancy, labour or birth on maternal, fetal, neonatal and caregiver outcomes.Search StrategyThe Cochrane Pregnancy and Childbirth Group trials register was searched and study authors were contacted.Selection CriteriaAdequately controlled trials comparing the use of any kind of bath tub which allows immersion of the abdomen in water compared with non-immersion during pregnancy, labour or birth.Data Collection And AnalysisTrials were assessed for inclusion and quality by the reviewer and a colleague.Main ResultsThree trials involving 988 women were included. No statistically significant differences between immersion and no immersion were detected for use of pain relief, augmentation and duration of first stage of labour, meconium stained liquor and perineal trauma. Neonatal outcomes such as Apgar scores, umbilical arterial pH values and neonatal infection rates also showed no differences.Reviewer's ConclusionsThere is not enough evidence to evaluate the use of immersion in water during labour.

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