Ethel Burns1, Laura Price2, Jane Carpenter3, Lesley Smith4. 1. Oxford School of Nursing and Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Marston Road, Oxford, OX3 0FL, UK. 2. Royal United Hospitals Bath NHS Foundation Trust, Patient Safety Department, Mary Ward, Combe Park, Bath, BA1 3NG, UK. 3. Oxford School of Nursing and Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Marston Road, Oxford, OX3 0FL, UK. jane.carpenter@brookes.ac.uk. 4. Institute of Clinical and Applied Health Research, Faculty of Health Sciences, University of Hull, Hull, HU6 7RX, UK.
Abstract
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injury (OASI) during childbirth is associated with urino-genital pain and dysfunction. Waterbirth is a popular birth choice for women, but controversy remains around the risk of OASI during waterbirth. This study reports on the incidence of OASI, and factors associated with OASI, for a cohort of women who gave birth in water. METHODS: This secondary analysis used prospectively collected data from 2,908 women who gave birth in water in a hospital setting. The incidence of OASI was calculated. Univariable and multivariable logistic regression analysis evaluated factors associated with OASI. RESULTS: The incidence of OASI was 1.9% (95% confidence interval (CI) 1.4, 2.4) for all women. In nulliparae it was higher (3.2%, 95% CI 2.3, 4.3) than in multiparae (0.9%, 95% CI 0.5, 1.4). In the multivariable analysis, two variables were associated with OASI; multiparity was negatively associated with OASI (adjusted odds ratio [aOR] 0.24, 95% CI 0.12, 0.50, p < 0.001), and birth weight was positively associated with OASI (aOR 1.001, 95% CI 1.000, 1.002, p = 0.02). A "hands-on" technique was used during only 13% of births. A birth position supporting a flexible sacrum did not influence OASI risk. CONCLUSIONS: A low incidence of OASI was found for this cohort of women. The low proportion of midwives using a hands-on technique suggests that it may not be required in waterbirth.
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injury (OASI) during childbirth is associated with urino-genital pain and dysfunction. Waterbirth is a popular birth choice for women, but controversy remains around the risk of OASI during waterbirth. This study reports on the incidence of OASI, and factors associated with OASI, for a cohort of women who gave birth in water. METHODS: This secondary analysis used prospectively collected data from 2,908 women who gave birth in water in a hospital setting. The incidence of OASI was calculated. Univariable and multivariable logistic regression analysis evaluated factors associated with OASI. RESULTS: The incidence of OASI was 1.9% (95% confidence interval (CI) 1.4, 2.4) for all women. In nulliparae it was higher (3.2%, 95% CI 2.3, 4.3) than in multiparae (0.9%, 95% CI 0.5, 1.4). In the multivariable analysis, two variables were associated with OASI; multiparity was negatively associated with OASI (adjusted odds ratio [aOR] 0.24, 95% CI 0.12, 0.50, p < 0.001), and birth weight was positively associated with OASI (aOR 1.001, 95% CI 1.000, 1.002, p = 0.02). A "hands-on" technique was used during only 13% of births. A birth position supporting a flexible sacrum did not influence OASI risk. CONCLUSIONS: A low incidence of OASI was found for this cohort of women. The low proportion of midwives using a hands-on technique suggests that it may not be required in waterbirth.
Entities:
Keywords:
Birthing pool; OASI; Perineal trauma; Severe perineal trauma; Waterbirth
Authors: I Gurol-Urganci; D A Cromwell; L C Edozien; T A Mahmood; E J Adams; D H Richmond; A Templeton; J H van der Meulen Journal: BJOG Date: 2013-07-03 Impact factor: 6.531
Authors: Diane Borello-France; Kathryn L Burgio; Holly E Richter; Halina Zyczynski; Mary Pat Fitzgerald; William Whitehead; Paul Fine; Ingrid Nygaard; Victoria L Handa; Anthony G Visco; Anne M Weber; Morton B Brown Journal: Obstet Gynecol Date: 2006-10 Impact factor: 7.661
Authors: Helain J Landy; S Katherine Laughon; Jennifer L Bailit; Michelle A Kominiarek; Victor Hugo Gonzalez-Quintero; Mildred Ramirez; Shoshana Haberman; Judith Hibbard; Isabelle Wilkins; D Ware Branch; Ronald T Burkman; Kimberly Gregory; Matthew K Hoffman; Lee A Learman; Christos Hatjis; Paul C VanVeldhuisen; Uma M Reddy; James Troendle; Liping Sun; Jun Zhang Journal: Obstet Gynecol Date: 2011-03 Impact factor: 7.661
Authors: H Aughey; J Jardine; N Moitt; K Fearon; J Hawdon; D Pasupathy; I Urganci; T Harris Journal: BMC Pregnancy Childbirth Date: 2021-03-26 Impact factor: 3.007