Joyce C S Camargo1, Vitor Varela2, Fernanda M Ferreira3, Lucila Pougy4, Angela M Ochiai5, Maria Elisabete Santos6, Maria Catarina L R Grande7. 1. Abel Salazar Institute of Biomedical Sciences of the University of Porto, Portugal; School of Arts, Sciences and Humanities of the University of São Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP 03828-000, Brazil. Electronic address: joyce@usp.br. 2. São Bernardo Hospital - Setúbal, Rua Camilo Castelo Branco, 2910-445 Setúbal, Portugal. Electronic address: vitor.varela@chs.min-saude.pt. 3. University of São Paulo, School of Nursing of University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 419, 05403-000 São Paulo, SP, Brazil. Electronic address: fernandamarcal@usp.br. 4. School of Arts, Sciences and Humanities of the University of São Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP 03828-000, Brazil. Electronic address: lucila.pougy@usp.br. 5. School of Arts, Sciences and Humanities of the University of São Paulo, Rua Arlindo Béttio, 1000 - Jardim Keralux, São Paulo, SP 03828-000, Brazil. Electronic address: angelaochiai@usp.br. 6. São Bernardo Hospital - Setúbal, Rua Camilo Castelo Branco, 2910-445 Setúbal, Portugal. Electronic address: elisabete.santos@chs.min-saude.pt. 7. Faculty of Psychology and Educational Sciences of the University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal. Electronic address: cgrande@fpce.up.pt.
Abstract
INTRODUCTION: The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital. METHODS: A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data. BACKGROUND: The Apgar score (at 1min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning. RESULTS: The mean water immersion time was 1h and 46min and had an influence on the duration of labour (mean 5h and 37min), with a statistically significant difference (P=0.004). There was a decreased cervical dilatation time and a shorter duration of the expulsion phase. In the immersion scenario, 30% of the women did not undergo any examination to assess the length of the cervix, and 57.8% presented intact perennial areas or first-degree tears. As for neonatal outcomes, during maternal immersion, 97% maintained normal fetal heart rates (between 110 and 160 beats per minute) and Aqua Apgar was higher than 7, both in the first minute (mean of 9.4) and in the fifth minute of life (mean of 9.9). CONCLUSION: These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women.
INTRODUCTION: The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital. METHODS: A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data. BACKGROUND: The Apgar score (at 1min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning. RESULTS: The mean water immersion time was 1h and 46min and had an influence on the duration of labour (mean 5h and 37min), with a statistically significant difference (P=0.004). There was a decreased cervical dilatation time and a shorter duration of the expulsion phase. In the immersion scenario, 30% of the women did not undergo any examination to assess the length of the cervix, and 57.8% presented intact perennial areas or first-degree tears. As for neonatal outcomes, during maternal immersion, 97% maintained normal fetal heart rates (between 110 and 160 beats per minute) and Aqua Apgar was higher than 7, both in the first minute (mean of 9.4) and in the fifth minute of life (mean of 9.9). CONCLUSION: These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women.