BMJ  2004;328:767-768 (27 March), doi:10.1136/bmj.328.7442.767-c

Letter

Labouring in water

Findings do not fully support conclusions

The first 150 words of the full text of this article appear below.

EDITOR—The study by Cluett et al, comparing labour in water with standard augmentation for dystocia, tackles an important area.¹ Too often modern obstetrics concentrates on major medical interventions and neglects the low tech solutions that many women would prefer.²

Despite the study's robust design the findings do not fully support the conclusions. Neither of the primary outcomes (epidural rates and assisted delivery rates) differed significantly between the two groups: only by combining all outcome measures was there a significant difference in medical intervention overall. One conclusion not emphasised is that labour in the pool is associated with significantly more neonatal morbidity, with six babies from this group admitted to special care and none from the standard augmentation group (P = 0.013).

Inadequate numbers may be responsible for the absence of a significant difference in epidural rates. As discussed by Cluett et al, recruitment to randomised controlled trials of . . . [Full text of this article]

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Rotherham General Hospital, Rotherham, South Yorkshire h.d.bradshaw@sheffield.ac.uk

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Related Article

Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour

Elizabeth R Cluett, Ruth M Pickering, Kathryn Getliffe, and Nigel James St George Saunders
BMJ 2004 328: 314. [Abstract] [Full Text] [PDF]

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