Hospital Water Birth: Interim Results of a Pilot Randomized Control Trial [ID 2683557]

INTRODUCTION: Water birth is a method of pain relief during labor associated with decreased pain and increased satisfaction. Randomized control trials (RCTs) about water birth and safety outcomes are needed. We conducted an RCT of hospital water birth versus land birth to compare maternal/neonatal outcomes, and differences in analgesia/anesthesia use. This is an updated interim analysis of our findings (Clinical trial: NCT05175599). METHODS: After IRB approval, low-risk pregnant adults were offered study participation between 25 and 34 weeks of gestation. Enrollment began January 2022 using a computer-generated 2:1 (water birth-to-land birth) allocation ratio. Participants in both arms were offered routine care and all available pain relief, with those in the water birth arm given the additional option of birth in the tub. Participants in both groups were excluded if they developed risk factors, including hypertension, preterm labor, or nonvertex presentation. Descriptive and inferential statistics were computed. RESULTS: Overall, n=182 have been enrolled and n=157 have given birth. Following exclusions, n=96 (n=67 water birth, n=29 land birth) remained eligible for the study. Significantly fewer participants had epidural or intravenous narcotic analgesia in the water birth group (37.3% versus 82.8% land birth; P<.0001). Ultimately in the water birth group, n=35 (52.2%) gave birth in water. Using the Birth Satisfaction Scale-Revised Indicator scale, water birth patients expressed a significantly higher level of satisfaction (Mdn=33.0 versus 29.0 land birth; P=.009). To date, no adverse events occurred. CONCLUSION: These preliminary findings suggest that when offered to low-risk laboring people, hospital water birth reduces pain and increases satisfaction without leading to adverse events.