Summary:
Objectives of study: Comparison of chosen parameters of the I. - III. stage of labour by women, who
conducted waterbirth (Group A) and by women,whodelivered conventionally in horizontal position
(Group B) and comparison of perinatal and postnatal results of newborns in both groups.
Design: Retrospective study.
Setting: Department of Obstetrics and Gynecology, District Hospital Znojmo.
Methods: Group A constitute 70 women, who delivered in the period 1. 1. 1998 - 30. 9. 2002 into the
water (fetus was expelled under water). Control group B formed 70 women, who delivered in
a conventional (horizontal position) and in the same time they didnot have any contraindication to
waterbirth. At first we compared the length of I. and II. stage of labour, the number of episiotomies,
the number of some other kinds of injuries, the postpartal uterine hypotony and the volume of blood
loss. In the second phase we evaluated clinical condition of the newborn.
Results:Waterbirth have chosen 1.95% of the women in our department during this period. There is
no statistically significant difference in the duration of I. stage of labour in both groups. The II. stage
was prolonged to 9 against 6 minutes in group A, most probably because of hydroanalgetic effect of
warm water, due to some inhibition of contractions and „no interference access“ to labour. There is
no statistical difference in complications during and after the labour in both groups. By group A we
found statistically significant higher number of spontaneous, I. grade perineal ruptures, then in
group B and we found reciprocal situation in number of episiotomies in both groups. There were
no somatic differences by the newborns in both groups after delivery and we didnot find higher
occurrence of postnatal pathology by the waterbith babies either.
Conclusion: Waterbirth is type of alternative obstetrics, which the women in birth demand, but
which the obstetritians and neonatologists are afraid of, and which they consider to be possibly
hazardous in the same time. There is documented evidence of much less performed episiotomies
(nearly of 60%) and higher percentage deliveries without any injury (about of 9%).We didnot prove
any life or health threatening complication by the women in birth or by their newborns. Newborns
from group A have completely comparable peri - and postnatal examination and investigation
results with group B. In our study group we didnot find higher occurrence of bleeding hypotonic
uterus, infections or hypotension by the mother, comparing with the control group.
There is often mentioned temporary bluish colour of the newborns by the critics of waterbith. This
appearance we cannot comprehend as a cyanotic demonstration of fetal hypoxia but much more as
the consequence of slower transformation from fetal to neonatal blood circulation. The same effect
we can observe by the newborns, who were delivered conventionally in horizontal position and who
are afterwards longer time connected by umbilical cord. Clear evidence for this contention is
completely physiological evaluation and postnatal examination of all newborns by neonatologist
after delivery and objective results of ABR and lactate from umbilical artery, which exclude fetal
hypoxia too.
As the conclusionwe can claim, that waterbirth nowadays is one of legitimate methods of alternative
obstetrics. The results of our study did confirm that this way of delivery doesnot represent any risk
for the mother or the newborn and that there is no reason for an anxiety of obstetritian and
neonatologist.
Key words:
waterbirth, hydroanalgesia, peripartal complications and injuries, fetal hypoxia
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