The American Academy of Pediatrics (AAP) and the American
College of Obstetricians and Gynecologists (ACOG) released new
recommendations on laboring and delivering in water in the April 2014 print
issue of Pediatrics. In a joint clinical report published online on Thursday,
March 20, “Immersion in Water for Labor and Delivery,” both the AAP and ACOG
determine that undergoing the first stage of labor in a birthing pool may offer
some advantages, such as decreased pain and shorter labors. However, immersion
in water during the second stage (underwater birth) has no proven benefit to
mother or baby, and can pose serious and sometimes fatal health risks. The AAP
and ACOG conclude that there may be some benefits of water immersion for
healthy women with uncomplicated pregnancies during the early stages of labor,
but there is no evidence this practice improves perinatal outcomes. The safety
and efficacy of underwater birth has not been established, and it should be
considered an experimental procedure that should not be performed unless under
the context of an appropriately designed clinical trial with informed consent.
Immersion during labor and delivery should not prevent or inhibit necessary
equipment such as maternal or fetal monitoring from being used.
The American Academy of Pediatrics is an organization of 62,000 primary
care pediatricians, pediatric medical subspecialists and pediatric surgical
specialists dedicated to the health, safety and well-being of infants, children,
adolescents and young adults. For more information, visit www.aap.org.