DOI: 10.38058/ijsl.1941274 ISSN: 2687-4733

The effects of water immersion and water birth on maternal and neonatal outcomes: a systematic review

Aleyna Yıldız, Tuğba Yılmaz Esencan
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Aim: The aim of this systematic review is to evaluate the effects of water birth on maternal and neonatal outcomes in the light of current evidence.Methods: This systematic review examines the current literature on maternal and neonatal outcomes of immersionband water birth. The literature search was conducted using Google Scholar, PubMed, Cochrane Library, and ScienceDirect databases. The systematic review included randomized controlled trials and prospective and retrospective cohort studies published in English or Turkish between 2012 and 2026. A total of 11 studies met the inclusion criteria and were included in the review.Results: The reviewed studies indicate that water birth enhances maternal relaxation through the effects of buoyancy and hydrostatic pressure, reduces pain perception, and supports the elasticity of perineal tissues, thereby contributing to the physiological progression of labour. This method has been reported to reduce the need for pharmacological analgesia, increase maternal satisfaction with childbirth, and encourage women’s active participation in the birth process. With regard to maternal outcomes, water birth appears to be associated with lower rates of third- and fourth-degree perineal tears, anal sphincter injuries, episiotomy, and postpartum haemorrhage. In terms of neonatal outcomes, no significant adverse differences have been identified between water birth and conventional birth methods with respect to Apgar scores, neonatal intensive care unit admissions, or the incidence of neonatal infections. However, the risk of umbilical cord avulsion during water birth remains controversial in the literature. Although rare cases have been reported, this complication is considered to have a low incidence.Conclusion: The available evidence suggests that there is no strong indication that water birth has adverse effects on maternal or neonatal outcomes. When appropriate candidate selection is ensured and evidence-based midwifery care is provided, water birth may be considered a safe birth option for both mothers and neonates.

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