Journal Article


Predictors of obstetric anal sphincter injury during waterbirth: A secondary analysis of a prospective observational study

Abstract

Introduction and Hypothesis: Obstetric Anal Sphincter Injury (OASI) during childbirth is associated with urino-genital pain and dysfunction. Waterbirth is a popular birth choice for women, but controversy remains around the risk of OASI during waterbirth. This study reports on the incidence of OASI, and factors associated with OASI, for a cohort of women who gave birth in water. Methods: This secondary analysis used prospectively collected data from 2,908 women who gave birth in water in the hospital setting. Incidence of OASI was calculated. Univariable and multivariable logistic regression analysis evaluated factors associated with OASI. Results: The incidence of OASI was 1.9% (95% CI 1.4, 2.4) for all women. In nulliparae it was higher (3.2%, 95% CI 2.3, 4.3), than for multiparae (0.9%, 95% CI 0.5, 1.4). In the multivariable analysis two variables were associated with OASI; multiparity was negatively associated with OASI (aOR 0.24, 95% CI 0.12, 0.50, p < 0.001), and birth weight was positively associated with OASI (aOR 1.001, 95% CI 1.000, 1.002, p = 0.02). A ‘hands-on’ technique was used during only 13% of births. Birth position supporting a flexible sacrum did not influence OASI risk. Conclusions: A low incidence of OASI was found for this cohort of women. The low proportion of midwives using a hands-on technique suggests that it may not be required in waterbirth. 

Attached files

Authors

Burns, Ethel
Price, Laura
Carpenter, Jane
Smith, Lesley

Oxford Brookes departments

Department of Nursing

Dates

Year of publication: 2019
Date of RADAR deposit: 2019-10-21


Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License


Related resources

This RADAR resource is the Accepted Manuscript of Predictors of obstetric anal sphincter injury during waterbirth: A secondary analysis of a prospective observational study

Details

  • Owner: Joseph Ripp
  • Collection: Outputs
  • Version: 1 (show all)
  • Status: Live