A recent Cochrane review of 11 randomized trials evaluated the safety and efficacy of water immersion during the first stage of labor. Water immersion, which involves complete abdominal submersion in a bath or pool, reduced both maternal pain and epidural and spinal analgesia requirements (level 1 [likely reliable] evidence). Analgesia/anesthesia use was significantly lower for immersion groups compared to controls in a meta-analysis of 6 trials with 2,499 women (38.1% vs. 42.1%, p = 0.025, NNT 25). One high quality trial with 120 women found that significantly fewer women in the immersion group experienced moderate to severe pain (67.8% vs. 90.2%, p = 0.004, NNT 5). There were no significant differences in labor duration, operative delivery rates or neonatal outcomes (Cochrane Database Syst Rev 2009 Apr 15;(2):CD000111). For more information, see the Overview of labor and delivery topic in DynaMed.
