{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:19:55Z","timestamp":1791926395265,"version":"4.3.4"},"reference-count":55,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Nursing and Midwifery Practice Development Unit","award":["Personal award for P Barry\/ 2016-01"],"award-info":[{"award-number":["Personal award for P Barry\/ 2016-01"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,20]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the birth outcomes for women and babies following water immersion for labour only, or for labour and birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Maternity hospital, Ireland, 2016\u20132019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A cohort of 190 low-risk women who used water immersion; 100 gave birth in water and 90 laboured only in water. A control group of 190 low-risk women who received standard care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Logistic regression analyses examined associations between water immersion and birth outcomes adjusting for confounders. A validated Childbirth Experience Questionnaire was completed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Perineal tears, obstetric anal sphincter injuries (OASI), postpartum haemorrhage (PPH), neonatal unit admissions (NNU), breastfeeding and birth experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with standard care, women who chose water immersion had no significant difference in perineal tears (71.4% vs 71.4%, adj OR 0.83; 95% CI 0.49 to 1.39) or in OASI (3.3% vs 3.8%, adj OR 0.91; 0.26\u20132.97). Women who chose water immersion were more likely to have a PPH \u2265500 mL (10.5% vs 3.7%, adj OR 2.60; 95% CI 1.03 to 6.57), and to exclusively breastfeed at discharge (71.1% vs 45.8%, adj OR 2.59; 95% CI 1.66 to 4.05). There was no significant difference in NNU admissions (3.7% vs 3.2%, adj OR 1.06; 95% CI 0.33 to 3.42). Women who gave birth in water were no more likely than women who used water for labour only to require perineal suturing (64% vs 80.5%, adj OR 0.63; 95% CI 0.30 to 1.33), to experience OASI (3.0% vs 3.7%, adj OR 1.41; 95% CI 0.23 to 8.79) or PPH (8.0% vs 13.3%, adj OR 0.73; 95% CI 0.26 to 2.09). Women using water immersion reported more positive memories than women receiving standard care (p&lt;0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women choosing water immersion for labour or birth were no more likely to experience adverse birth outcomes than women receiving standard care and rated their birth experiences more highly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-038080","type":"journal-article","created":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T17:57:04Z","timestamp":1607104624000},"page":"e038080","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting"],"prefix":"10.1136","volume":"10","author":[{"given":"Paula L","family":"Barry","sequence":"first","affiliation":[{"name":"Midwifery, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lean E","family":"McMahon","sequence":"additional","affiliation":[{"name":"National Clinical Programme for Obstetrics & Gynaecology\/National Women & Infants Health Programme, Coombe Women's Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth AM","family":"Banks","sequence":"additional","affiliation":[{"name":"Midwifery, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M","family":"Fergus","sequence":"additional","affiliation":[{"name":"Midwifery, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6074-6718","authenticated-orcid":false,"given":"Deirdre J","family":"Murphy","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynaecology, Trinity College Dublin, Dublin, Ireland"},{"name":"Obstetrics, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,4]]},"reference":[{"key":"2025121422263085000_10.12.e038080.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2010.07.003"},{"key":"2025121422263085000_10.12.e038080.2","unstructured":"Renfrew MJ , Homer CSE , Downe S , et al . 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