{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T08:24:09Z","timestamp":1776155049362,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T00:00:00Z","timestamp":1516147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Sophiahemmet Foundation for Clinical Research"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The literature describes advantages for mothers giving birth in water, but waterbirth is controversial in Sweden and has not been offered at hospitals until recently. This study aimed to describe and compare the characteristics and outcome of waterbirths with those of spontaneous vaginal births at the same clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A retrospective cohort study was conducted on all waterbirths at two maternity units in Sweden from March 2014 to November 2015 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0306), and a consecutively selected comparison group of 306 women having conventional spontaneous vaginal births. Logistic regression was used to analyze the primary outcome; second\u2010degree perineal tears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women giving birth in water had a lower risk of second\u2010degree perineal tears [adjusted odds ratio (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>) 0.6, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.4\u20130.9]). Their labor was shorter (6\u00a0h 3\u00a0min vs. 7\u00a0h 52\u00a0min) and there were significantly fewer interventions than in the comparison group; amniotomy (13.7 vs. 35.3%), internal cardiotocography (11.1 vs. 56.8%), and augmentation with oxytocin (5.2 vs. 31.3%). There were no differences in Apgar scores or admissions to neonatal intensive care unit. The experience of childbirth, measured with a numeric rating scale, was higher in the waterbirth group indicating a more positive birth experience. Three newborns born in water had an umbilical cord avulsion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this low\u2010risk population, waterbirth is associated with positive effects on perineal tears, the frequency of interventions, the duration of labor and women's birth experience. Midwives handling waterbirth should be aware of the risk of umbilical cord avulsion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13286","type":"journal-article","created":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T01:32:40Z","timestamp":1514597560000},"page":"341-348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Waterbirth in Sweden \u2013 a comparative study"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9718-754X","authenticated-orcid":false,"given":"Hanna","family":"Ulfsdottir","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education Karolinska Institute Stockholm Sweden"},{"name":"Sophiahemmet University Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sissel","family":"Saltvedt","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health (KBH) Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Georgsson","sequence":"additional","affiliation":[{"name":"Sophiahemmet University Stockholm Sweden"},{"name":"Department of Clinical Science Intervention and Technology Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,17]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","first-page":"CD000111","article-title":"Immersion in water in labour and birth","author":"Cluett ER","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_3_1","first-page":"26","article-title":"Women's experience of waterbirth","volume":"6","author":"Richmond H","year":"2003","journal-title":"Pract Midwife"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12194"},{"key":"e_1_2_9_5_1","volume-title":"Revisiting waterbirth: an attitude to care","author":"Garland D","year":"2010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12394"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-7-471"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.06.086"},{"key":"e_1_2_9_9_1","first-page":"63","article-title":"Functional disorders: rectocele","volume":"30","author":"Mustain WC","year":"2017","journal-title":"Clin Colon Rectal Surg"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.113855"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1097\/01.AOG.0000445585.52522.14","article-title":"ACOG Committee Opinion no. 594: immersion in water during labor and delivery","volume":"123","author":"ACOG\/AAP","year":"2014","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.11124\/jbisrir-2015-2105"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-309600"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1017\/S0950268815001983","article-title":"Heated birthing pools as a source of Legionnaires\u2019 disease","volume":"144","author":"Collins SL","year":"2015","journal-title":"Epidemiol Infect"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050802556067"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2008.00259.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016340903358812"},{"key":"e_1_2_9_18_1","volume-title":"Obesity: preventing and managing the global epidemic","author":"WHO","year":"2000"},{"key":"e_1_2_9_19_1","volume-title":"Report 2008\u2010130\u20107","author":"Cooperation of National Medical Indications","year":"2011"},{"key":"e_1_2_9_20_1","unstructured":"Royal College of Obstetricians and Gynaecolgists.Green\u2010top Guideline. Stat. No 29. (2007)."},{"issue":"12","key":"e_1_2_9_21_1","first-page":"CD006672","article-title":"Perineal techniques during the second stage of labour for reducing perineal trauma","author":"Aasheim V","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2006.00085.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0001-6349.2001.10182.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-59"},{"key":"e_1_2_9_25_1","first-page":"391","article-title":"Effects of water birth on maternal and neonatal outcomes","volume":"114","author":"Bodner K","year":"2002","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2012.10.002"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2005.01481.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.37963.606412.EE"},{"key":"e_1_2_9_29_1","volume-title":"Intrapartum care for healthy women and babies","author":"NICE Guidelines","year":"2017"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2015.02.013"},{"key":"e_1_2_9_31_1","unstructured":"The Swedish Medical Birth Register: Pregnancies \u00a0Deliveries and Newborn Infants 1973\u20132013 Assisted Reproduction Treatment 1991\u20132012. Sweden 2014."}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13286","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T01:12:10Z","timestamp":1695604330000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,17]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/aogs.13286"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13286","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,17]]},"assertion":[{"value":"2017-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}