AAP, ACOG Issue Statement Addressing Underwater Labor and Delivery

There is no evidence that immersion in water during delivery provides maternal or fetal benefit, and underwater delivery may put newborns at risk for complications, according to a statement released by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) that was published online March 20, 2014, in Pediatrics. Although using a birthing pool during the early stages of labor can alleviate pain and reduce the need for anesthesia among expectant mothers, the report states that this practice has not been shown to improve perinatal outcomes and should not be allowed to prevent or inhibit other elements of care. The report recommends that facilities planning to offer immersion during the first stage of labor establish rigorous protocols for candidate selection, maintenance and cleaning of tubs and immersion pools, infection control procedures, monitoring of mothers and fetuses at appropriate intervals while immersed, and immediately and safely moving women out of tubs if maternal or fetal concerns develop.