{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:36:35Z","timestamp":1790807795131,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R03HD096094"],"award-info":[{"award-number":["R03HD096094"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Investigate maternal and neonatal outcomes following waterbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study, with propensity score matching to address confounding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Community births, United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Medical records\u2010based registry data from low\u2010risk births were used to create waterbirth and land birth groups (<jats:italic>n<\/jats:italic> = 17 530 each), propensity score\u2010matched on &gt;80 demographic and pregnancy risk covariables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Logistic regression models compared outcomes between the matched waterbirth and land birth groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal: immediate postpartum transfer to a hospital, any genital tract trauma, severe (3rd\/4th degree) trauma, haemorrhage &gt;1000 mL, diagnosed haemorrhage regardless of estimated blood loss, uterine infection, uterine infection requiring hospitalisation, any hospitalisation in the first 6 weeks. Neonatal: umbilical cord avulsion; immediate neonatal transfer to a hospital; respiratory distress syndrome; any hospitalisation, neonatal intensive care unit (NICU) admission, or neonatal infection in the first 6 weeks; and neonatal death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Waterbirth was associated with improved or no difference in outcomes for most measures, including neonatal death (adjusted odds ratio [aOR] 0.56, 95% CI 0.31\u20131.0), and maternal or neonatal hospitalisation in the first 6 weeks (aOR 0.87, 95% CI 0.81\u20130.92 and aOR 0.95, 95% CI 0.90\u20130.99, respectively). Increased morbidity in the waterbirth group was observed for two outcomes only: uterine infection (aOR 1.25, 95% CI 1.05\u20131.48) (but not hospitalisation for infection) and umbilical cord avulsion (aOR 1.57, 95% CI 1.37\u20131.82). Our results are concordant with other studies: waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>New study demonstrates #waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. @TheUpliftLab @BovbjergMarit @31415926abc @NICHD_NIH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17009","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T03:37:45Z","timestamp":1636774665000},"page":"950-958","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Maternal and neonatal outcomes following waterbirth: a cohort study of 17 530 waterbirths and 17 530 propensity score\u2010matched land births"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-0549","authenticated-orcid":false,"given":"ML","family":"Bovbjerg","sequence":"first","affiliation":[{"name":"Epidemiology Program College of Public Health and Human Sciences Oregon State University  Corvallis OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Cheyney","sequence":"additional","affiliation":[{"name":"Department of Anthropology Oregon State University  Corvallis OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AB","family":"Caughey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Oregon Health &amp; Science University  Corvallis OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"BlotkampA.National Maternity and Perinatal Audit: Organisational Report 2019. 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