The Soothing Touch of Water: Maternal Comfort and Neonatal Outcomes in Hydrotherapy-Assisted Labor

This study aims to evaluate the impact of hydrotherapy-assisted labor on maternal and neonatal outcomes compared to conventional vaginal delivery.

A retrospective cohort study was conducted at Bilkent City Hospital between 2019 and 2024, including 408 women divided into four groups: 102 primiparous and 102 multiparous women in the hydrotherapy group and 102 primiparous and 102 multiparous women in the conventional delivery group. Maternal outcomes included labor pain (VAS scores), labor duration, perineal trauma, and postpartum complications, while neonatal outcomes included Apgar scores, NICU admission rates, and birth weights. Systemic inflammatory markers (NLR, PLR) were analyzed for their association with cesarean delivery risk. Statistical analyses were performed using SPSS 25.0, with a significance level of p < 0.05.

Hydrotherapy-assisted labor was associated with significantly higher vaginal delivery rates in both primiparous (85.29% vs. 80.39%, p = 0.04) and multiparous women (85.29% vs. 81.37%, p = 0.04). VAS pain scores at 6 cm cervical dilation and at 6 h postpartum were significantly lower in the hydrotherapy groups across both parity strata (all p = 0.01). The incidence of third- and fourth-degree perineal tears and postpartum infection-related hospitalization was significantly reduced in the hydrotherapy groups. Neonatal outcomes were favorable, with higher Apgar scores at 1 and 5 min and lower NICU admission rates among women undergoing hydrotherapy-assisted labor. Within the hydrotherapy cohort, women who required cesarean delivery exhibited significantly higher PLR and WBC/neutrophil ratio values and distinct NLR patterns compared with those who achieved vaginal birth. ROC analyses demonstrated moderate discriminatory performance of NLR, PLR, and WBC/neutrophil ratio for predicting cesarean delivery.

Hydrotherapy-assisted labor provides significant maternal pain relief, reduced perineal trauma, and improved neonatal outcomes, with no increased risks. The association between systemic inflammatory markers and labor progression highlights the need for further research. Hydrotherapy should be considered a safe and effective alternative for labor management in properly selected cases.