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J Psychosom Obstet Gynaecol. 2005 Jun;26(2):127-33.

Experience of pain and analgesia with water and land births.

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Department of Obstetrics and Gynaecology, Cantonal Hospital, Frauenfeld, Switzerland.


Labor is one of the most painful experiences in a woman's life. Does water birth influence the pain experienced? Data from an ongoing, longitudinal, prospective observational study that spans 9 years and includes questionnaires from 12,040 births were used to evaluate pain perception (visual analogue scale (VAS)) and analgesic use. Three birthing methods were compared: water birth, bed birth and Maia stool birth. Based on the VAS, the data show that the different birthing methods do not influence the intensity of pain throughout the different stages of labor. The only significant difference noted was that bed births are more painful in the early first stage, and less painful at the end of the second stage. This later difference may be due to increased use of epidural anesthesia in women choosing a bed birth. Women who choose bed births are significantly less likely than others to have an analgesic-free birth. For primiparas, there is also a small but significant difference showing that water births are less likely to require analgesics compared to Maia stool births. No such difference is seen in women who have given birth previously. We conclude that women who choose bed births perceive more pain in the early first stage of labor, leading them to be more likely to choose an epidural anesthesia in the late first stage, or to use other types of analgesics. Women who choose water births or Maia stool births are more likely to get through labor without using any analgesics.

[Indexed for MEDLINE]

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