Abstract
Abstract Objectives: to describe the perineal outcomes of women who had delivered in water and out of water. Methods: a cross-sectional and quantitative study developed in a public hospital in Setúbal, Portugal. The population was of women who participated in the "Water Birth Project" in the period from 2011 to 2014, which gave birth in water and out of water. 104 women were selected according to established inclusion criteria. The groups were compared according to the following variables: demographics, obstetric information, delivery care and perineal outcomes. The data were analyzed in the Stata(r) software, with descriptive and bivariate statistics (chi-square and Fisher's test). Results: the medical records of 73 women who gave birth in water and 31 women who gave birth out of water were studied. Water deliveries were significantly associated with fewer perineal lacerations, lower rates of episiotomy, and shorter delivery time. Conclusions: the results of the study suggest that childbirth in water has a protective effect against severe third or fourth degree perineal tears, during fetal expulsion in water.
Highlights
Perineal trauma is a frequent event in women who are giving birth for the first time.[1]
The population was of women who participated in the "Water Birth Project" in the period from 2011 to 2014, which gave birth in water and out of water. 104 women were selected according to established inclusion criteria
The perineal trauma classification that has gained more acceptance is that of the United Kingdom Obstetrics and Gynaecology Real College, which is adopted by the National Institute for Health and Care Exceller (NICE)[3] and classifies as first degree those spontaneous lacerations when the wound is limited to the skin and/or the connective tissue without any bleeding or minimal bleeding
Summary
Perineal trauma is a frequent event in women who are giving birth for the first time.[1]. Spontaneous trauma to the perineum, called laceration, has its own classification, and can range from first to fourth degrees according to the adopted classification and the damaged perineal tissue.[2]. The perineal trauma classification that has gained more acceptance is that of the United Kingdom Obstetrics and Gynaecology Real College, which is adopted by the National Institute for Health and Care Exceller (NICE)[3] and classifies as first degree those spontaneous lacerations when the wound is limited to the skin and/or the connective tissue without any bleeding or minimal bleeding. A second-degree laceration reaches perineal muscles, preserving the anal sphincter. Severe perineal traumas are classified in third and fourth degrees. The fourth degree occurs when the perineal trauma reaches the rectal mucous membrane
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