Controversial Issue in Water Birth to Reduce Perineal Trauma

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

Author
1. Adly N Al Fattah
2. Ali Sungkar
3. Budi I Santoso
4. Surahman Hakim
ISSN
0974-8938
DOI
10.5005/jp-journals-10006-1688
Volume
11
Issue
3
Publishing Year
2019
Pages
5
Author Affiliations
    1. Department of Obstetrics and Gynecology, Dr Cipto Mangunkusumo Hospital, Jakarta/Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
    1. Department of Obstetrics and Gynecology, Universitas Indonesia, Jakarta, DKI Jakarta, Indonesia
    1. Department of Obstetrics and Gynecology, Dr Cipto Mangunkusumo Hospital, Jakarta/Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
    1. Department of Obstetrics and Gynecology, Dr Cipto Mangunkusumo Hospital, Jakarta/Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Article keywords
    Episiotomy, Perineal trauma, Water birth

    Abstract

    Introduction: Perineal trauma becomes a concern during childbirth. One method to reduce perineal trauma is through water birth; however, there is still a lack of publication about water birth. This study aims to appraise the benefit of water birth to reduce the perineal trauma. Materials and methods: Searching was conducted on Pubmed®, Cochrane Library®, and Medline® using keywords or MeSH. There were 4 eligible articles consisting of 1 case-control, 1 clinical trial, and 2 systematic reviews. Appraisal determining the validity, importance, and applicability (VIA) was conducted by two independent authors guided by British Medical Journal (BMJ) Evidence-based Medicine Toolkit. Results: There were no difference percentage of intact perineum (RR 1.16; 95% CI 0.99–1.35), episiotomy (RR 0.93; 95% CI 0.80–1.08), second degree tear (RR 0.94; 95% CI 0.74–1.20), and third/fourth degree tear (RR 1.37; 95% CI 0.86–2.17) between water birth and conventional birth in a systematic review. Another review showed that water birth decreased the use of episiotomy and the severity of perineal laceration. A prospective trial study concluded that water birth caused less requirement for obstetric intervention; however, it impacted to more perineal laceration. Another study showed lower episiotomy and higher intact perineum rates in water birth group. Conclusion: There is still inconsistency of water birth in reducing perineal trauma.

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