When ACOG and AAP released the joint opinion paper in March “Ob-Gyns Weigh In: Laboring in Water is OK, Delivering in Water Has No Proven Benefit,” It was unclear what kind of effect such an opinion piece would have. After all, it wasn’t a policy statement with citations of all the research to support the new policy; it was an opinion piece that stated that “more research is needed.”
In the aftermath, hospitals and providers are walking back from allowing mothers to birth in tubs. Despite the fact that they have no proof of negative outcomes from the practice, suddenly this has become a good excuse to halt the option until…well, who knows. The rationale that’s being given is there’s more of a need to study waterbirths.
Rebecca Dekker over at Evidence Based Birth does a really good job talking about the evidence to support (or not support) the practice of allowing women to labor in a tub and to give birth in the tub. I’m not going to reinvent the wheel, so go read it on her website. The upshot? This isn’t an easy thing to study due to logistics and ethical standards, but it has been studied. It’s been studied enough that the practice is considered safe throughout much of Europe. And guess what? Their water works the same there as it does here.
Another really good explanation of the entire kerfuffle can be found over on Lamaze’s Science and Sensibility Blog. While it is written by Waterbirth International’s Barbara Harper, she has 24 footnotes of references to back up her information. One of the most stark parts of her post talks about the difficulty in setting up such a study. She writes:
A 2005 randomized trial which was set up in a Shanghai, China hospital was abandoned because the hospital director realized after only 45 births that the study was unethical. The original goal was to study 500 births, but the results of those first 45 were so good they abandoned the research project, yet continued their commitment to offering waterbirth to any woman who wanted one. The latest communication from the Changning Hospital in Shanghai indicates that they have facilitated well over 5000 waterbirths since then.
While I can’t locate information on the study she’s referring to, I did find a nice long list of studies on waterbirth that have been done in China.
Where are things headed? Truly, I don’t know. I am rather befuddled at this recent turn of events, given how quickly water birth access has expanded in the Twin Cities. In the end, as I always do, I encourage families to find out their options and vote with their feet. Want to have the option of a waterbirth? Then support those groups that still offer it. And let them know that there is plenty of research on the subject.
Off my soapbox.