{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:00:27Z","timestamp":1787029227051,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>The use of hydrotherapy during childbirth has gained relevance due to the demand for natural childbirth and greater respect for the woman\u2019s choice. Studies have shown benefits such as less use of epidural analgesia, increased ability to cope with pain, shorter labor, and a better overall birth experience. Objective: The main objective of this study was to generate further evidence on maternal and birth outcomes associated with the use of hydrotherapy during labor, specifically aiming to describe the effects of water immersion during all stages of labor (first, second, and third) on women. Methodology: A retrospective cohort study was carried out on a random sample of women who gave birth at the Costa del Sol Hospital between January 2010 and December 2020. The calculated sample size was 377 women and the data were extracted from their partograms. After data extraction, two groups were formed: one group used hydrotherapy during childbirth (n = 124), while the other group included women who did not use hydrotherapy during the childbirth process (n = 253). Results: The results highlight significant differences in pain perception, analgesia use, types of labor, and delivery times between the two groups. Women who did not use hydrotherapy reported higher pain perception, with a median (IQR) of 8 (7\u20139) on a numerical scale, compared to a median (IQR) of 6 (5\u20137) for the hydrotherapy group. Furthermore, the group without hydrotherapy required epidural analgesia in 40% of cases, while in the hydrotherapy group, it was only necessary in 20%. In terms of the type of delivery, the hydrotherapy group had more spontaneous vaginal deliveries compared to the non-hydrotherapy group, which had more operative vaginal deliveries. The overall duration of labor was longer in the hydrotherapy group, especially in women who arrived at the hospital late in labor. Conclusions: Hydrotherapy is associated with a longer time to delivery. Women with a higher pain tolerance tend to opt for hydrotherapy instead of epidural analgesia.<\/jats:p>","DOI":"10.3390\/nursrep14020095","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T06:50:52Z","timestamp":1716274252000},"page":"1251-1259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Hydrotherapy on the Management of Childbirth and Its Outcomes\u2014A Retrospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5415-9960","authenticated-orcid":false,"given":"Elena","family":"Mellado-Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7906-5656","authenticated-orcid":false,"given":"Lourdes","family":"D\u00edaz-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4019-8555","authenticated-orcid":false,"given":"Jonathan","family":"Cort\u00e9s-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4650-2159","authenticated-orcid":false,"given":"Juan Carlos","family":"S\u00e1nchez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Piqueras-Sola","sequence":"additional","affiliation":[{"name":"Virgen de las Nieves University Hospital, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Higuero Mac\u00edas","sequence":"additional","affiliation":[{"name":"Costa del Sol University Hospital, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-1222","authenticated-orcid":false,"given":"Raquel","family":"Rodr\u00edguez-Blanque","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain"},{"name":"San Cecilio University Hospital, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/birt.12473","article-title":"A Retrospective Comparison of Waterbirth Outcomes in Two United States Hospital Settings","volume":"47","author":"Bailey","year":"2020","journal-title":"Birth"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.enfcli.2017.10.004","article-title":"Uso de Hidroterapia Durante El Parto: Evaluaci\u00f3n Del Dolor, Uso de Analgesia y Seguridad Neonatal","volume":"28","author":"Palacio","year":"2018","journal-title":"Enferm Clin"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.midw.2018.06.005","article-title":"Culture, Bathing and Hydrotherapy in Labor: An Exploratory Descriptive Pilot Study","volume":"64","author":"Benfield","year":"2018","journal-title":"Midwifery"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1590\/1516-3180.20131315T2","article-title":"Immersion in Water in Labour and Birth","volume":"131","author":"Cluett","year":"2013","journal-title":"Sao Paulo Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"102622","DOI":"10.1016\/j.midw.2019.102622","article-title":"\u201cAfter Having a Waterbirth, I Feel like It\u2019s the Only Way People Should Deliver Babies\u201d: The Decision Making Process of Women Who Plan a Waterbirth","volume":"82","author":"Fair","year":"2020","journal-title":"Midwifery"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1515\/jpm-2018-0220","article-title":"Intrapartum Care","volume":"46","author":"Hinkson","year":"2018","journal-title":"J. Perinat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/JPN.0000000000000260","article-title":"Systematic Review of Hydrotherapy Research","volume":"31","year":"2017","journal-title":"J. Perinat. Neonatal Nurs."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ejogrb.2006.09.012","article-title":"Maternal and Neonatal Infections and Obstetrical Outcome in Water Birth","volume":"134","author":"Tschudin","year":"2007","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1515\/JPM.2004.057","article-title":"Waterbirths Compared with Landbirths: An Observational Study of Nine Years","volume":"32","author":"Geissbuehler","year":"2004","journal-title":"J. Perinat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0301-2115(99)00238-9","article-title":"A Retrospective Comparison of Water Births and Conventional Vaginal Deliveries","volume":"91","author":"Otigbah","year":"2000","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.5152\/jtgga.2012.03","article-title":"The Effects of Immersion in Water on Labor, Birth and Newborn and Comparison with Epidural Analgesia and Conventional Vaginal Delivery","volume":"2012","author":"Mollamahmutoglu","year":"2012","journal-title":"J. Turk. Ger. Gynecol. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.midw.2007.04.006","article-title":"A Randomised Controlled Trial Evaluating the Effect of Immersion Bath on Labour Pain","volume":"25","year":"2009","journal-title":"Midwifery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/ajo.12758","article-title":"Obstetric and Neonatal Outcomes for Women Intending to Use Immersion in Water for Labour and Birth in Western Australia (2015\u20132016): A Retrospective Audit of Clinical Outcomes","volume":"58","author":"Lewis","year":"2018","journal-title":"Aust. New Zealand J. Obstet. Gynaecol."},{"key":"ref_14","first-page":"468","article-title":"Experience of Water Birth Delivery in Iran","volume":"12","author":"Chaichian","year":"2009","journal-title":"Arch. Iran. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1097\/00003081-200112000-00011","article-title":"Use of Water in Labor and Birth","volume":"44","author":"Mackey","year":"2001","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"180","DOI":"10.11124\/jbisrir-2015-2105","article-title":"The Effect of Waterbirth on Neonatal Mortality and Morbidity: A Systematic Review and Meta-Analysis","volume":"13","author":"Davies","year":"2015","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"#cr-split#-ref_17.1","unstructured":"Servicio Central de Publicaciones del Gobierno Vasco (2010). Gu\u00eda de Pr\u00e1ctica Cl\u00ednica de Atenci\u00f3n al Parto Normal, Servicio Central de Publicaciones del Gobierno Vasco. Agencia de."},{"key":"#cr-split#-ref_17.2","unstructured":"Gu\u00edas de Pr\u00e1ctica Cl\u00ednica en el SNS: OSTEBA No 2009\/01."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"147","author":"Altman","year":"2007","journal-title":"Ann. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Cluett, E.R., Burns, E., and Cuthbert, A. (2018). Immersion in Water during Labour and Birth. Cochrane Database Syst. Rev., 2018.","DOI":"10.1002\/14651858.CD000111.pub4"},{"key":"ref_20","first-page":"551","article-title":"The Effects of Delivery in Water on Duration of Delivery and Pain Compared with Normal Delivery","volume":"26","author":"Kangani","year":"2010","journal-title":"Pak. J. Med. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/0091-2182(93)90014-8","article-title":"Water Immersion and the Effect on Labor","volume":"38","author":"Schorn","year":"1993","journal-title":"J. Nurse Midwifery"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1136\/bmj.37963.606412.EE","article-title":"Randomised Controlled Trial of Labouring in Water Compared with Standard of Augmentation for Management of Dystocia in First Stage of Labour","volume":"328","author":"Cluett","year":"2004","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/j.1547-5069.2002.00347.x","article-title":"Hydrotherapy in Labor","volume":"34","author":"Benfield","year":"2002","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1552-6909.2012.01424.x","article-title":"Efficacy of Warm Showers on Labor Pain and Birth Experiences During the First Labor Stage","volume":"42","author":"Lee","year":"2013","journal-title":"J. Obstet. Gynecol. Neonatal Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1111\/jan.14336","article-title":"Waterbirth in Low-risk Pregnancy: An Exploration of Women\u2019s Experiences","volume":"76","author":"Carlsson","year":"2020","journal-title":"J. Adv. Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"102547","DOI":"10.1016\/j.midw.2019.102547","article-title":"Women\u2019s Experiences of Waterbirth Compared with Conventional Uncomplicated Births","volume":"79","author":"Ulfsdottir","year":"2019","journal-title":"Midwifery"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.midw.2017.12.023","article-title":"Neonatal Outcomes with Water Birth: A Systematic Review and Meta-Analysis","volume":"59","author":"Vanderlaan","year":"2018","journal-title":"Midwifery"},{"key":"ref_28","first-page":"706","article-title":"Continuous Support for Women during Childbirth","volume":"42","author":"Hodnett","year":"2007","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e325","DOI":"10.1016\/j.wombi.2017.12.008","article-title":"The Waterbirth Project: S\u00e3o Bernardo Hospital Experience","volume":"31","author":"Camargo","year":"2018","journal-title":"Women Birth"}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/14\/2\/95\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:45:02Z","timestamp":1760107502000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/14\/2\/95"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,20]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["nursrep14020095"],"URL":"https:\/\/doi.org\/10.3390\/nursrep14020095","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,20]]}}}