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The use of warm water immersion during labour (including birth) for relaxation and
pain relief has a long history. It is commonly used both in lay and clinical care and
has also been advocated as part of the general health and exercise in pregnancy. This
care option is gaining popularity especially among advocates of woman-centred approach
to care in developed countries.
Key messages
􀃎 There are enthusiasts and sceptics regarding immersion in water during labour
and birth.
􀃎 There is low quality of evidence that water immersion during the first stage of
labour reduces the use of analgesia and reported maternal pain.
􀃎 The early immersion in water during first stage of labour may increase the use of
oxytocin and analgesia or paracervical block.
􀃎 There is need for a large (and rigorously conducted) randomised trials with sample
sizes sufficient to assess the effects of immersion in water on other outcomes
such as (postpartum haemorrhage, rate of caesarean); other subgroups (e.g. nulliparous
and multiparous) and use of co-interventions. Trials should be conducted
in low-middle and high income settings.


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