{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:36:33Z","timestamp":1790807793531,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Maternal preference for warm water immersion (WWI) and waterbirth is increasing, but adoption into obstetric guidelines and clinical practice remains limited. Concerns regarding safety and a paucity of evidence have been cited as reasons for the limited adoption and uptake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim was to investigate maternal and neonatal outcomes after WWI and\/or waterbirth compared with land birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A prospective cohort study was conducted in an Australian public maternity hospital between 2019 and 2020. Maternal and neonatal outcomes for 1665 women who had a vaginal birth were studied.<\/jats:p><jats:p>Primary outcome was admission to the neonatal unit (NNU). Secondary outcomes included neonatal antibiotic administration, maternal intrapartum fever, epidural use and perineal injury. Multivariate logistical regression analyses compared the outcomes between three groups: waterbirth, WWI only and land birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>NNU admissions for a suspected infectious condition were significantly higher in the land birth group (<jats:italic>P<\/jats:italic>\u00a0=\u20090.035). After accounting for labour duration, epidural use and previous birth mode, no significant difference was detected between groups in the odds of NNU admission (<jats:italic>P<\/jats:italic>\u00a0=\u20090.167). No babies were admitted to NNU with water inhalation or drowning. Women birthing on land were more likely to be febrile (2 vs 0%; <jats:italic>P<\/jats:italic>\u00a0=\u20090.007); obstetric anal sphincter injury and postpartum haemorrhage were similar between groups. Regional analgesia use was significantly lower in the WWI group compared to the land birth group (21.02 vs 38.58%; <jats:italic>P<\/jats:italic>\u00a0=\u2009&lt;0.001). There was one cord avulsion in the waterbirth group (0.41%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maternal and neonatal outcomes were similar between groups, with no increased risk evident in the waterbirth and WWI groups.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13555","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T09:36:20Z","timestamp":1657186580000},"page":"59-65","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A prospective cohort study comparing neonatal outcomes of waterbirth and land birth in an Australian tertiary maternity unit"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3764-9519","authenticated-orcid":false,"given":"Emma","family":"Seed","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sunshine Coast Hospital and Health Service  Birtinya Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0299-6537","authenticated-orcid":false,"given":"Lauren","family":"Kearney","sequence":"additional","affiliation":[{"name":"Sunshine Coast Health Institute  Birtinya Queensland Australia"},{"name":"University of the Sunshine Coast  Sunshine Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sunshine Coast Hospital and Health Service  Birtinya Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"QCIF Facility for Advanced Bioinformatics Institute for Molecular Bioscience, The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7366-042X","authenticated-orcid":false,"given":"Rachael","family":"Nugent","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sunshine Coast Hospital and Health Service  Birtinya Queensland Australia"},{"name":"University of the Sunshine Coast  Sunshine Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"WHO Recommendations: Intrapartum Care For A Positive Childbirth Experience","author":"World Health Organisation","year":"2018"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-6138(98)90112-7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2006.10.005"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14336"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2018.1560167"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-160"},{"issue":"5","key":"e_1_2_6_8_1","first-page":"CD000111","article-title":"Immersion in water during labour and birth","volume":"5","author":"Cluett ER","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.11124\/jbisrir-2015-2105"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001771"},{"key":"e_1_2_6_11_1","volume-title":"Water Immersion During Labour and Birth Melbourne","author":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists","year":"2021"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2019.102554"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.17-3-251"},{"key":"e_1_2_6_14_1","first-page":"115","article-title":"The rising rate of labour induction: What is causing the trend?","volume":"99","author":"Walker S","year":"2014","journal-title":"Arch Dis Child Fetal Neonatal Edn"},{"key":"e_1_2_6_15_1","unstructured":"Women and Children's Service Group.Warm water immersion and waterbirth: Workplace instruction.2020."},{"key":"e_1_2_6_16_1","unstructured":"National Health and Medical Research Council.National Statement on Ethical Conduct in Human Research \u2010 May 2015 Update.2007;https:\/\/www.nhmrc.gov.au\/guidelines\u2010publications\/e72. 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