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CONFERENCE PROCEEDING
The UK pool study: Pattens of genital trauma and risk factors for severe genital trauma or neonatal morbidity following intrapartum water immersion
1
Cardiff University, School of Healthcare Sciences, Cardiff, United Kingdom
Eur J Midwifery 2026;10(Supplement 1):A184
ABSTRACT
BACKGROUND:
Warm water immersion during labour provides women with analgesia and comfort. The UK POOL study was the largest global study of waterbirth to date.
OBJECTIVES:
The presentation will present the primary outcomes of the study, describe patterns of genital trauma among women giving birth in or out of water, and explore risk factors for severe perineal trauma and additional neonatal treatments following intrapartum water immersion.
METHODS:
Cohort study with non-inferiority design. Setting – 26 UK NHS maternity services. Sample - 73,229 women without antenatal or intrapartum risk-factors, using intrapartum water immersion, between January 2015 and June 2022. Data source: Data captured in NHS maternity and neonatal information systems. Main outcome measures - Maternal primary outcome: obstetric anal sphincter injury (OASI) by parity; Neonatal composite primary outcome: Fetal or neonatal death, neonatal unit admission with respiratory support, or administration of antibiotics within 48 hours of birth. This project was funded by the National Institute for Health and Care Research (NIHR) (reference:16/149/01). The study is registered at ISRCTN.com, ISRCTN13315580 and received NHS ethical approval.
RESULTS:
Rates of OASI among nulliparous women (waterbirth: 730/15,176 [4.8%] vs. births out of water: 641/12,210 [5.3%]; adjusted odds ratio (aOR) 0.97, one-sided 95% confidence interval (CI), -∞ to 1.08). Rates of OASI among parous women (waterbirth:269/24,451 [1.1%] vs. births out of water 144/8,565 [1.7%]; aOR 0.64, one-sided 95% CI -∞ to 0.78). Rates of the composite adverse outcome among babies (waterbirth 263/9,868 [2.7%] vs. births out of water 224/5,078 [4.4%]; aOR 0.65, one-sided 95% CI -∞ to 0.79).
CONCLUSIONS:
Rates of the primary outcomes were no higher among waterbirths compared to births out of water.
KEY MESSAGE:
Among ‘low-risk’ women using water immersion during uncomplicated labour, remaining in the pool and giving birth in water was not associated with an increase in the incidence of adverse primary maternal or neonatal outcomes. Labour and birth - miscellaneous
Warm water immersion during labour provides women with analgesia and comfort. The UK POOL study was the largest global study of waterbirth to date.
OBJECTIVES:
The presentation will present the primary outcomes of the study, describe patterns of genital trauma among women giving birth in or out of water, and explore risk factors for severe perineal trauma and additional neonatal treatments following intrapartum water immersion.
METHODS:
Cohort study with non-inferiority design. Setting – 26 UK NHS maternity services. Sample - 73,229 women without antenatal or intrapartum risk-factors, using intrapartum water immersion, between January 2015 and June 2022. Data source: Data captured in NHS maternity and neonatal information systems. Main outcome measures - Maternal primary outcome: obstetric anal sphincter injury (OASI) by parity; Neonatal composite primary outcome: Fetal or neonatal death, neonatal unit admission with respiratory support, or administration of antibiotics within 48 hours of birth. This project was funded by the National Institute for Health and Care Research (NIHR) (reference:16/149/01). The study is registered at ISRCTN.com, ISRCTN13315580 and received NHS ethical approval.
RESULTS:
Rates of OASI among nulliparous women (waterbirth: 730/15,176 [4.8%] vs. births out of water: 641/12,210 [5.3%]; adjusted odds ratio (aOR) 0.97, one-sided 95% confidence interval (CI), -∞ to 1.08). Rates of OASI among parous women (waterbirth:269/24,451 [1.1%] vs. births out of water 144/8,565 [1.7%]; aOR 0.64, one-sided 95% CI -∞ to 0.78). Rates of the composite adverse outcome among babies (waterbirth 263/9,868 [2.7%] vs. births out of water 224/5,078 [4.4%]; aOR 0.65, one-sided 95% CI -∞ to 0.79).
CONCLUSIONS:
Rates of the primary outcomes were no higher among waterbirths compared to births out of water.
KEY MESSAGE:
Among ‘low-risk’ women using water immersion during uncomplicated labour, remaining in the pool and giving birth in water was not associated with an increase in the incidence of adverse primary maternal or neonatal outcomes. Labour and birth - miscellaneous
| eISSN: | 2585-2906 |
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