First-time mothers who labour in water show reduced need for epidurals

First time mothers who immerse themselves in water during the first stage of labour can reduce the need for an epidural, according to University of Southampton researchers whose research will be published on bmj.com on Monday.

Dr Elizabeth Cluett at the University's School of Nursing and Midwifery set out to test the theory that labouring in water can relieve pain and anxiety, reducing the need for interventions to aid contractions.

They compared two groups of first-time mothers experiencing slow progress in labour. The women in the first group were immersed in a birth pool during the first stage of labour. Those in the second received standard care.

Fewer than half (47%) of the women in the water group needed an epidural, compared with almost two thirds (66%) in the other group.

The women who laboured in the water group were also less likely to need drugs to aid contractions (71% compared to 96%), and reported significantly lower pain scores and higher satisfaction with freedom of movement. The number of operative deliveries in the two groups was similar.

Before the trial, it has been assumed that the women in the water would undergo longer labours and need more assistance. However, 20% of the women in the water group did not require any intervention, and there was no evidence of longer labour.

"We believed that first-time mothers tend to get very stressed, a factor which causes hormonal changes and slow progress in labour," comments Dr Cluett. "Our study shows that by putting these women in water, we can relax them and ease the pain. We hope that our results will provide women with an option whereby they can give birth without the need for obstetric intervention."