Influence of Immersion in Water During Labor on the Request of Epidural Anesthesia by Pregnant Women

Influence of Immersion in Water During Labor on the Request of Epidural Anesthesia by Pregnant Women in Case of a Desire for Physiological Delivery

Women are showing a growing interest in less medicalized childbirth. According to the french 2021 perinatal survey, 52.2% of women want to limit medical procedures and 38.2% of women want childbirth without epidural anesthesia. Between 77 and 82% of deliveries nevertheless lead to an epidural anesthesia. The painful feeling seems to be the main motivation for using this mode of anesthesia.

Study Overview

• Status: Completed
• Conditions: Labor Pain; Delivery
• Intervention / Treatment: Other: General data; Other: Other data

Detailed Description

In the scientific literature, few data from clinical studies focus on the effects of immersion in water during childbirth. The analgesic effects of immersion in water to lessen the painful experience are yet to be proven. The opening of a physiological delivery room with a bathtub at the Saint-Etienne University Hospital since October 2020 provides data that has not been exploited yet and could make possible to answer the question of the analgesic effects of immersion in water during labour. The difficulties of analysis and the subjectivity of the painful feeling led us to consider the request of epidural anesthesia as the main analysis criterion.

• Study Type: Observational
• Enrollment (Actual): 249

Contacts and Locations

Study Locations

• France
  • Saint-Étienne, France, 42000
    • CHU Saint Etienne

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Pregnent women who used the physiological delivery room of the Saint-Etienne University Hospital between October 2020 and December 2022.

Description

Inclusion Criteria:

• All women who used the physiological delivery room of the Saint-Etienne University Hospital between October 2020 and December 2022.

Exclusion Criteria:

• Absence of physiological desire for childbirth.
• Medical indication for epidural anesthesia.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Experimental group; Women who wish to give birth without epidural anesthesia and have benefited of water immersion during labor	Other: General data; General data will be collected to ensure that both groups are comparable : maternal age, maternal BMI, gestational age, parity, number of children in current pregnancy, history of caesarian section, newborn child weight; Other: Other data; Other data collected will be used to estimate primary and secondary outcomes : request for an epidural anesthesia by the parturient, medical indication for peridural anesthesia, duration of childbirth, delivery methods, occurrence of maternal or neonatal complications.
Control group; Women who wish to give birth without epidural anesthesia and have not benefited of water immersion during labor	Other: General data; General data will be collected to ensure that both groups are comparable : maternal age, maternal BMI, gestational age, parity, number of children in current pregnancy, history of caesarian section, newborn child weight; Other: Other data; Other data collected will be used to estimate primary and secondary outcomes : request for an epidural anesthesia by the parturient, medical indication for peridural anesthesia, duration of childbirth, delivery methods, occurrence of maternal or neonatal complications.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of requests for epidural anesthesia by parturients	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of the first stage of childbirth	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Duration of the second stage of childbirth	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Duration of the third stage of childbirth	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Number of instrumental extractions	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Number of caesareans	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Number and degree of perineal tear	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Use of episiotomy by the obstetrical team	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Estimated postpartum hemorrhagic volume and occurrence of postpartum hemorrhage	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Apgar score (Appearance, Pulse, Grimace, Activity, Respiration) from 0 to 10 of the child at birth	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center. At 5 minutes a score of 7 to 10 is considered normal; a score of 4 to 6 is intermediate and a score of 0 to 3 is low.	Day 0
Arterial pH measured at the umbilical cord	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0
Number of neonatal resuscitation	Retrospective collection of medical data from the computer software Easily in Saint-Etienne university hospital center.	Day 0

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Saint Etienne
• Investigators: Principal Investigator: Tiphaine BARJAT, MD PhD, CHU Saint Etienne

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2023
• Primary Completion (Actual): June 30, 2023
• Study Completion (Actual): June 30, 2023

Study Registration Dates

• First Submitted: August 21, 2023
• First Submitted That Met QC Criteria: September 12, 2023
• First Posted (Actual): September 13, 2023

Study Record Updates

• Last Update Posted (Actual): September 13, 2023
• Last Update Submitted That Met QC Criteria: September 12, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Labor pain; Childbirth; Epidural anesthesia; Pregnant women; Water immersion; Waterbirth; Physiological delivery; General medicine
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Labor Pain
• Other Study ID Numbers: IRBN702023/CHUSTE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No