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Mellado-García E, Díaz-Rodríguez L, Cortés-Martín J, Sánchez-García JC, Piqueras-Sola B, Higuero Macías JC, Rodríguez-Blanque R. Systematic Reviews and Synthesis without Meta-Analysis on Hydrotherapy for Pain Control in Labor. Healthcare (Basel) 2024; 12:373. [PMID: 38338258 PMCID: PMC10855539 DOI: 10.3390/healthcare12030373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Although there is scientific evidence regarding the use of water immersion during labor, this evidence is primarily focused on the first stage of labor. There is limited scientific evidence on water immersion during the second stage of labor. OBJECTIVE The objective of this study was to conduct a comprehensive systematic review and synthesis of contemporary evidence related to water birth, with a specific focus on the second stage of labor. METHODS A systematic review of the scientific literature published between January 2018 and October 2023 was carried out. A synthesis of the results was conducted following the Synthesis without Meta-Analysis (SWiM) guidelines. PubMed, Scopus, and the Cochrane Library were utilized as information sources. The search strategy was designed using the keywords "immersion" and "parturition", along with their relevant synonyms. Inclusion criteria encompassed studies employing randomized controlled trials (RCTs), systematic reviews, and quantitative and qualitative approaches focusing on pregnant women undergoing water immersion at any stage of the labor process. RESULTS Eleven articles were selected: two systematic reviews (one quantitative and one qualitative), five cohort studies, one case-control study, one cross-sectional observational study, and two qualitative studies. A thorough assessment of the methodology was performed using several specific tools: the Cochrane RoB 2 (Risk of Bias 2) tool for systematic reviews, JBI Critical Appraisal Checklist for Qualitative Research for qualitative studies, STROBE for observational descriptive studies, and CASPe for qualitative studies. The results provided fundamental insights that will contribute to conceptual standardization regarding the effects of water birth on maternal and fetal health. Additionally, a synthesis of the results was performed concerning types of delivery, analgesia use, pain perception, and maternal satisfaction with the water birth experience. CONCLUSIONS In this study, we conclude that the results regarding delivery types, labor durations, and analgesia use found in the literature, along with statistically significant maternal/fetal effects, are crucial for making recommendations regarding the use of water during labor in any of its stages if the woman desires it safely.
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Affiliation(s)
- Elena Mellado-García
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Costa del Sol Health District, Servicio Andaluz de Salud, Junta de Andalucía, 29640 Fuengirola, Spain
| | - Lourdes Díaz-Rodríguez
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Jonathan Cortés-Martín
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Juan Carlos Sánchez-García
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Beatriz Piqueras-Sola
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Virgen de las Nieves University Hospital, Servicio Andaluz de Salud, Junta de Andalucía, 18014 Granada, Spain
| | | | - Raquel Rodríguez-Blanque
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- San Cecilio University Hospital, Servicio Andaluz de Salud, Junta de Andalucía, 18016 Granada, Spain
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