Warm tub bathing during labor: maternal and neonatal effects

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Neonatal Care

Background:

• Maternal preference for water immersion during labor is common.
• Concerns exist regarding potential adverse effects of labor bathing on maternal and neonatal outcomes.
• Evidence on the safety of labor immersion is limited.

Purpose of the Study:

• To investigate the safety of warm water immersion during the first stage of labor.
• To assess potential detrimental maternal and neonatal effects associated with labor bathing.
• To provide evidence-based guidance for women desiring to bathe during labor.

Main Methods:

• Prospective randomized controlled trial comparing labor bathing versus no bathing.
• Inclusion criteria: singleton pregnancy, gestational age >= 35 weeks, planned vaginal delivery, normal admission tests, regular contractions, cervical dilation >= 3-4 cm.
• Exclusion criteria: intrauterine growth retardation, meconium-stained amniotic fluid, occupied bath. Primary endpoint: neonatal intensive care unit (NICU) referral.

Main Results:

• No significant difference in NICU referral rates between the bathing group (612) and control group (625) (OR 0.8; 95% CI 0.2, 3.1).
• No significant differences observed in rates of perineal tears (OR 1.3), instrumental delivery (OR 1.1), cesarean section (OR 1.8), or maternal postpartum stay.
• Neonatal outcomes, including Apgar scores <7 at 5 minutes, neonatal distress, and tachypnea, showed no significant differences between groups.

Conclusions:

• Warm water immersion during labor does not appear to cause negative maternal or neonatal effects.
• Women desiring to bathe during labor can do so without compromising their or their newborns' well-being.
• The study supports the safety of labor bathing as an option for expectant mothers.