Aims Giving birth in water has potential benefits for mothers in terms of maternal comfort, pain relief, and increased rates of normal delivery. Concerns have been raised, however, about possible adverse effects on the baby, including hypothermia and respiratory distress. We examined routinely collected hospital data over a twelve month period to assess the safety of water birth for lowrisk deliveries in a UK District General Hospital.

Methods Neonatal outcomes were examined in 1878 babies born by normal vaginal delivery following spontaneous onset of labour at full-term, between 1 April 2014 and 31 March 2015. Prespecified outcomes included need for neonatal unit admission, Apgar scores and temperature following delivery, with comparisons made between those born in water and those born on land.

Results In the studied period there were 323 water births and 1555 non-water births. There was no significant difference in maternal age or sex of baby. The majority of water births occurred in the midwife-led birthing centre, while non-water births were split more evenly between the midwife-led unit and main delivery suite. Mothers delivering in water were less likely to have had 2 or more previous pregnancies. There was no significant difference in rates of neonatal unit admission between those born in water and those not (2/323 [0.6%] vs 14/1555 [0.9%]; p=0.62). There was some evidence of better one-minute Apgar scores in the water birth group, although this did not reach statistical significance (p=0.06). This difference was attenuated by 5 min of age. Mean temperature following delivery did not differ between groups (water births 36.7 degrees vs non-water births 36.8 degrees; p=0.10).

Conclusion An evaluation of the safety of water birth in a District General Hospital found no significant differences in rates of neonatal unit admission, 5 min Apgar scores, and temperature following delivery when compared with babies born on land. Research is needed to assess whether this finding can be generalised to other District General Hospitals, and whether the apparent safety of water birth is maintained when examining later outcomes.