Systematic Review of Hydrotherapy Research Does a Warm Bath in Labor Promote Normal Physiologic Childbirth?
DOI: 10.1097/JPN.0000000000000260 Continuing Education r r J Perinat Neonat Nurs Volume 31 Number 4, 303–316 Copyright C 2017 Wolters Kluwer Health, Inc. All rights reserved. Systematic Review of Hydrotherapy Research Does a Warm Bath in Labor Promote Normal Physiologic Childbirth? Jenna Shaw-Battista, PhD, RN, NP, CNM, FACNM ABSTRACT Key Words: bath, hydrotherapy, immersion, labor, Health sciences research was systematically reviewed to midwives, normal birth, pain, physiology assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional child- birth. Seven studies of 2615 women were included. Six his article describes a systematic review of re- trials examined hydrotherapy in midwifery care and found search on warm water immersion hydrotherapy an effect of pain relief; of these, 2 examined analgesia and Tduring labor, followed by standard care and con- found reduced use among women who bathed in labor. ventional childbirth. Use of nonpharmacologic comfort One study each found that hydrotherapy reduced maternal and pain relief methods remains limited in the United anxiety and fetal malpresentation, increased maternal satis- States where labor analgesia, anesthesia, and multiple faction with movement and privacy, and resulted in cervical obstetric procedures are routine.1 Higher international dilation progress equivalent to standard labor augmenta- utilization rates suggest a potential for increased US tion practices. Studies examined more than 30 fetal and hydrotherapy utilization and benefits that may include neonatal outcomes, and no benefit or harm of hydrother- support for labor physiology.1–3 Hydrotherapy promotes apy was identified. Two trials had anomalous findings of normal childbirth through reduced use of intrapartum increased newborn resuscitation or nursery admission after interventions due to neuroendocrine, circulatory, mus- hydrotherapy, which were not supported by additional re- culoskeletal and psychological effects of immersion.4 sults in the same or other studies.
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