Printer Friendly
The Free Library
6,673,945 articles and books
Member login
User name  
Password 
 
Join us Forgot password?

For labor progressing too slowly, immersion in water may be effective alternative to obstetric intervention.


For women who are having their first birth and whose labor is progressing more slowly than expected, immersion in water may reduce the need for standard methods of augmentation, according to according to
prep.
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

3.
 results of a study conducted in a British hospital. (1) A group of women who labored in water were significantly less likely to require obstetric ob·stet·ric or ob·stet·ri·cal
adj.
Of or relating to the profession of obstetrics or the care of women during and after pregnancy.



obstetrical, obstetric

pertaining to or emanating from obstetrics.
 intervention than were a comparable group whose labor was managed with standard augmentation; those in the immersion group also reported less pain and greater satisfaction with some aspects of the approach.

The study, conducted in 1999-2000, included 99 nulliparous women with a diagnosis of dystocia dystocia /dys·to·cia/ (dis-to´se-ah) abnormal labor or childbirth.

dys·to·ci·a
n.
A slow or difficult labor or delivery.
 (i.e., cervical dilation during active, spontaneous labor was occurring at a rate of less than 1 cm per hour). All participants were at low risk of complications and had received reformation about the study during pregnancy. They were randomly assigned to receive standard care for dystocia (amniotomy and intravenous oxytocin oxytocin (ŏksĭtō`sĭn), hormone released from the posterior lobe of the pituitary gland that facilitates uterine contractions and the milk-ejection reflex.  as needed as needed prn. See prn order. ) or to labor in an acrylic pool filled with tap water. Care for both groups of women was managed by midwives, who administered analgesia analgesia /an·al·ge·sia/ (an?al-je´ze-ah)
1. absence of sensibility to pain.

2. the relief of pain without loss of consciousness.
 and monitored the progress of labor. If labor was not progressing satisfactorily, the midwives administered additional oxytocin to women in the augmentation group and advised women in the immersion group to consider augmentation.

Half of women in each group were married, and the women's average age was about 25-26 years. The two groups were similar with respect to mean gestational age ges·ta·tion·al age
n.
See estimated gestational age.


Gestational age
The estimated age of a fetus expressed in weeks, calculated from the first day of the last normal menstrual period.
 at the start of labor and mean cervical dilation both at the beginning of labor and when dystocia was diagnosed. On average, the birth weights of their infants also were about the same.

Forty-seven percent of women who labored in water and 66% of those receiving standard augmentation required epidural epidural /epi·du·ral/ (-dur´il) situated upon or outside the dura mater.

ep·i·du·ral
adj.
Located on or over the dura mater.

n.
 analgesia at some point; the difference, assessed through chi-square testing, was not statistically significant. Likewise, the rate of operative delivery did not differ between groups (49 50%). However, the proportion who had labor augmented by amniotomy, oxytocin or both was significantly lower in the immersion group than in the augmentation group--71% vs. 96%. (For two women assigned to the augmentation group, labor progressed before augmentation began.) And the proportion who had any of these interventions was significantly lower among women who labored in water (80%) than among those who received standard augmentation (98%).

In postpartum interviews, women who had labored in water rated their pain 30 minutes after the start of the intervention significantly lower level than those in the augmentation group did. Furthermore, women in the immersion group reported a reduction in pain over the following half hour, while those in the augmentation group said that their pain had increased. Overall, about nine in 10 women in each group were satisfied with the labor management approach, but higher proportions in the immersion group than in the augmentation group were satisfied with the freedom of movement (91% vs. 63%) and privacy (96% vs. 81%) it afforded.

Finally, indicators of maternal and infant well-being showed little difference by approach to management of labor. Rates of both maternal and infant infections were similar in the two groups, as were infants' Apgar scores and blood gas levels. Twelve percent of infants born to mothers in the immersion group, but none of the others, were admitted to the neonatal unit within 10 days; most were released within 48 hours and had no subsequent problems.

The researchers conclude that standard augmentation is not "inevitable" for nulliparous women with dystocia, and that laboring in water under the care of a midwife may reduce the need for obstetric intervention and offer an effective alternative for managing pain. Given these outcomes, they add, the immersion approach may have benefits for women's physiological and psychological health.

REFERENCE

(1.) Cluett ER et al., Randomised Adj. 1. randomised - set up or distributed in a deliberately random way
randomized

irregular - contrary to rule or accepted order or general practice; "irregular hiring practices"
 controlled trial controlled trial Clinical research A clinical study in which one group of participants receives an experimental drug while the other receives either a placebo or an approved–'gold standard' therapy. See Blinding, Double-blinded.  of labouring in water compared with standard augmentation for management of dystocia in first stage of labour, British Medical Journal The British Medical Journal, or BMJ, is one of the most popular and widely-read peer-reviewed general medical journals in the world.[2] It is published by the BMJ Publishing Group Ltd (owned by the British Medical Association), whose other , 2004, 328(7435):314-319.
COPYRIGHT 2004 The Alan Guttmacher Institute
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

 Reader Opinion

Title:

Comment:



 

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Digests
Author:Hollander, D.
Publication:Perspectives on Sexual and Reproductive Health
Geographic Code:1USA
Date:Jul 1, 2004
Words:649
Previous Article:Teenagers who abstain from sex cite similar reasons regardless of whether they have ever had intercourse.(Digests)
Next Article:Three-year program helps male adolescents establish, maintain sexual limits.(Digests)
Topics:



Related Articles
Emotional aid delivers labor-saving results. (emotional support reduces rates of pregnancy complications)
Birthing trauma linked to diminished IQ. (long, unproductive labor may reduce a child's intellectual prowess)
Posterior labor - a pain in the back! It's prevention and cure.
Water Immersion.(natural childbirth technique)
Question of the Quarter.(Safety Issues Concerning the Use of Glycoprotein IIb-IIIa Inhibitors in the Management of Acute Coronary Syndromes.)
Baby Is Breech, Now What?
Keys to reducing maternal mortality: circumstances of maternal deaths are investigated in Indonesia.
Risk factors for anal tears.(Brief article)

Terms of use | Copyright © 2009 Farlex, Inc. | Feedback | For webmasters | Submit articles