OBJECTIVE:

To assess neonatal intensive care unit (NICU) admissions and neonatal outcomes after water birth or land birth in an alternative birthing center.

METHODS:

We conducted a prospective observational study of preselected low-risk parturients separated into three groups depending on their location for labor and delivery: land–land, water–land, and water–water. Delivery outcomes, labor length, maternal pain assessment, need for newborn resuscitation, and NICU admission and diagnoses were collected. The primary outcome was admission to the NICU.

RESULTS:

There were 2,077 total deliveries from April 2015 to December 2019, consisting of 458 land–land deliveries, 730 water–land deliveries, and 889 water–water deliveries. The rate of NICU admission was 2.8% (95% CI 1.5–4.8%) for land–land deliveries, 4.1% (2.8–5.8%) for water–land deliveries, and 2.0% (1.2–3.2%) for water–water deliveries. A post hoc power analysis revealed a 70% power to detect a 2.1% difference in NICU admissions between the water–land and water–water groups.

CONCLUSION:

In this cohort of low-risk pregnant women, births in water and on land were associated with similar rates of admission to the NICU.

doi: 10.1097/AOG.0000000000004545