Birth
Conditions
Keywords
waterbirth, landbirth, epidural use, birth outcomes
Brief summary
Evaluate maternal perinatal outcomes in adult low-risk laboring people randomized to waterbirth compared to those randomized to birth on land.
Detailed description
The proposed randomized control trial will be approached as a pilot study to explore or test (if sample size permits) our hypotheses. Primary outcome: Use of epidural anesthesia during labor and vaginal birth. Secondary outcomes: Use of IV narcotics in labor, duration of active labor, mode of delivery, composite maternal adverse outcomes (see below), use of intermittent auscultation (IA), composite neonatal adverse outcomes (see below), United States Birth Satisfaction Scale-Revised (US-BSS-R), use of epidural analgesia during labor (full intention-to-treat analysis).
Interventions
PROCEDUREWaterbirth
Those who remain eligible will have an inflatable birthing tub set up in their room and available for them to use as desired. Waterbirth will be performed in adherence to the following protocol endorsed by the American College of Nurse Midwives.
Sponsors
University of New Mexico
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria based on A model practice template for hydrotherapy in labor and birth (2016): Prenatal inclusion criteria (to be assessed at the time of enrollment): * ≥18 years of age * Able to speak and understand English or Spanish * Singleton gestation * Vertex presentation * Able to ambulate with no mobility restrictions (i.e., no difficulty getting from seated to standing) * Less than class III obesity (BMI \<40 kg/m2) at initiation of prenatal care Labor inclusion criteria (to be assessed at time of admission): * Greater than 37 weeks 0 days through and less than 412 completed weeks 6 days gestation with fetus in vertex presentation * Normal blood pressure and normal temperature (obstetric criteria for exclusion: two blood pressures 140/90 four hours apart; two fevers of over 100.4 one hour apart)
Exclusion criteria
based on A model practice template for hydrotherapy in labor and birth (2016): Prenatal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Epidural Anesthesia | Labor and delivery | Evaluate the epidural anesthesia rate in adult low-risk laboring people randomized to have the option of waterbirth compared to those randomized to birth on land. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| IV Narcotic Use | Labor and delivery | Use of IV narcotics in labor |
| Active Labor Duration | Labor and delivery | duration of active labor |
| Delivery Mode | Labor and delivery | Mode of delivery |
| Maternal Adverse Outcomes | Up to 2 weeks postpartum | Composite maternal adverse outcomes |
| Intermittent Auscultation (IA) | Labor and delivery | Use of intermittent auscultation (IA) |
| Neonatal Adverse Outcomes | Up to 2 weeks postpartum | Composite neonatal adverse outcomes |
| United States Birth Satisfaction Scale-Revised (US-BSS-R) | 3 days to 2 weeks postpartum | Satisfaction with birth experience |
Countries
United States
Contacts
CONTACTFamily Planning Research
PRINCIPAL_INVESTIGATORKatrina Nardini
University of New Mexico
Outcome results
None listed