Aims: This study compares neonatal and maternal morbidity
and mortality between waterbirths and landbirths
(spontaneous singleton births in cephalic presentation,
vacuum extractions are excluded).
Methods: In this observational study covering nine
years, standardized questionnaires were used to document
9,518 spontaneous singleton cephalic presentation
births, of which 3,617 were waterbirths and 5,901
Results: Landbirths show higher rates of episiotomies as
well as third and fourth degree perineal lacerations.
Waterbirths show a higher rate of births “without injuries”,
first and second-degree perineal lacerations, vaginal
and labial tears. After a waterbirth, there is an average
loss of 5.26 g/l blood; this is significantly less than landbirths
where there is an 8.08 g/l blood loss on average.
In 69.7% waterbirths required no analgesic, compared to
58.0% for landbirths. Water and landbirths do not differ
with respect to maternal and neonatal infections. After
landbirths, there was a higher rate of newborn complications
with subsequent transfer to an external NICU.
During the study, there were neither maternal nor neonatal
deaths related to spontaneous labor.
Conclusions: Waterbirths are associated with low risks
for both mother and child when obstetrical guidelines are