{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:34:58Z","timestamp":1790807698732,"version":"4.1.0"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Despite patient interest, there is little evidence regarding waterbirth. This review sought to compare maternal and perinatal outcomes in waterbirth, compared with landbirth. This search was conducted using MEDLINE, Google Scholar, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, and Cochrane Library from inception to November 15, 2021, with no language or geographic restrictions. Review was registered with PROSPERO under registration number: CRD42021288576. Selection criteria included randomized controlled trials of women with singleton cephalic gestations at \u226536 weeks comparing waterbirth to landbirth. The primary outcome was a perinatal composite outcome. Secondary outcomes included maternal and individual perinatal outcomes. Summary measures were reported as relative risk or mean difference with 95% confidence intervals using random effects model of DerSimonian and Laird. I\n            2 (Higgins I\n            2)\u2009&gt;\u20090% was used to identify heterogeneity. Six trials including 706 patients were included. When reported, all patients were \u2265 37 weeks' gestation. Labor augmentation (41.7 vs. 84.7%, p\u2009&lt;\u20090.0001) and neuraxial anesthesia (10.5 vs. 72.4%, p\u2009&lt;\u20090.0001) were less common with waterbirth. Estimated blood loss, postpartum hemorrhage, perineal laceration, episiotomy, mode of delivery, and perinatal outcomes did not differ between groups. Chorioamnionitis and endometritis were not reported by any trial. Maternal satisfaction was higher (p\u2009=\u20090.01) and pain scores lower (p\u2009=\u20090.003) with waterbirth. Length of first stage (p\u2009&lt;\u20090.00001), third stage (p\u2009=\u20090.02), and labor (p\u2009=\u20090.04) were shorter with waterbirth. The composite perinatal outcome could not be calculated due to lack of individual patient data. Compared with landbirth, waterbirth was associated with lower rates of neuraxial anesthesia and lower pain scores, with improved maternal satisfaction.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1764145","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T23:59:47Z","timestamp":1676505587000},"page":"1134-1142","source":"Crossref","is-referenced-by-count":12,"title":["Waterbirth: A Systematic Review and Meta-Analysis"],"prefix":"10.1055","volume":"41","author":[{"given":"Sara","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Illinois Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Angarita","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahithi","family":"Talasila","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Berghella","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"issue":"05","key":"ref3","first-page":"468","article-title":"Experience of water birth delivery in Iran","volume":"12","author":"S Chaichian","year":"2009","journal-title":"Arch Iran Med"},{"key":"ref4","first-page":"4","article-title":"Comparison between water birth and land birth in terms of fetal and neonatal outcomes","volume":"5","author":"M Ghasemi","year":"2014","journal-title":"Iranian J Neonatol"},{"issue":"09","key":"ref7","first-page":"1554","article-title":"Comparison of the effects of water and traditional delivery on birthing women and newborns","volume":"19","author":"M RY Gayiti","year":"2015","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/j.1471-0528.2004.00132.x","article-title":"A pilot study for a randomised controlled trial of waterbirth versus land birth","volume":"111","author":"J Woodward","year":"2004","journal-title":"BJOG"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1046\/j.1523-536X.2001.00084.x","article-title":"Immersion in water in the first stage of labor: a randomized controlled trial","volume":"28","author":"K Eckert","year":"2001","journal-title":"Birth"},{"issue":"05","key":"ref10","first-page":"CD000111","article-title":"Immersion in water during labour and birth","volume":"5","author":"E R Cluett","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"e231","DOI":"10.1097\/AOG.0000000000001771","article-title":"Committee Opinion No. 679: Immersion in Water During Labor and Delivery","volume":"128","author":"Committee Opinion No","year":"2016","journal-title":"Obstet Gynecol"},{"key":"ref12","first-page":"ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"M Cumpston","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"71","key":"ref13","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"issue":"04","key":"ref14","first-page":"622","article-title":"Neonatal outcomes after delivery in water","volume":"138","author":"A L Lanier","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/S0002-9378(98)70325-4","article-title":"Is there an association between water baths during labor and the development of chorioamnionitis or endometritis?","volume":"178","author":"P A Robertson","year":"1998","journal-title":"Am J Obstet Gynecol"}],"container-title":["American Journal of 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