Accouchement dans l'eau

Water birth is labor and sometimes delivery that occurs in water, usually a birthing pool. The American College of Obstetricians and Gynecologists does not recommend birthing in water as the safety has not been determined. Proponents believe childbirth in water results in a more relaxed, less painful experience that promotes a midwife-led model of care. Critics argue that the safety of waterbirth has not been scientifically proven and that a wide range of adverse neonatal outcomes have been documented, including increased mother or child infections and the possibility of infant drowning. A 2018 Cochrane Review of water immersion in the first stages of labor found evidence of fewer epidurals and few adverse effects but insufficient information regarding giving birth in water. A moderate to weak level of evidence indicates that water immersion during the first stage of childbirth reduces the pain of labor. A 2018 Cochrane Review found that immersion at this stage reduces the use of epidural analgesia; however, there is no clear evidence on the benefits of immersion for the second stage of labor, namely delivery (sometimes called full water birth). There is no evidence of increased adverse effects for immersion during the first or second stages of labor. There is not strong evidence that a water birth reduces tearing or perineal trauma. Water birth may offer perineal support for the mother, and some theorize that this may decrease the risk of tearing and reduce the use of episiotomy. A 2014 review reported that water immersion during the first stage of labor can reduce the length of that stage, labor pain, and the use of epidural or spinal analgesia. It is also associated with a lower rate of cesarean delivery and stress urinary incontinence symptoms 42 days after delivery. The review reported that immersion during labor did not appear to increase the rate of infections for the mother or the baby, and APGAR scores for the newborn infant were similar to those of conventional births.