Talk:Water birth

NPOV again

This reads like an advert for waterbirth. I question the following statements, which require citation:

• The warm water is relaxing and eases labour by reducing the excretion of adrenaline caused by pain and fear. The water also stimulates the release of endorphins.

• The great majority of women who have experienced water birth say that they would never want to have a baby any other way.

• There are some concerns with regard to water births, though most objections are because the idea is unusual.

• Midwives and doctors experienced with water births have not noted an increase in infection rates for either mother or baby.

All of statements should be supported with citations from peer-reviewed journals, or removed.

129.186.205.228 15:30, 28 July 2006 (UTC)

I agree with the above, and seeing as it's been almost a year since that was posted with little or no change (that I noticed) I have marked the page npov. I'm interested in the topic, though, so I will be conducting some research and hope to contribute some major edits (with sources provided!) soon. Erich Blume 15:09, 2 March 2007 (UTC)

I agree with the NPOV tag. This article seems to be biased and written by a supporter of water birthing. I was particularly concerned with the inclusion of a Cochrane Database of Systematic Reviews article. Not by its inclusion, but at the blatant misreporting of the conclusions within that article. I have made some of the changes that I felt needed immediate correction. Misreporting the conclusions of a Cochrane Review is very poor form, confirms bias, and poses questions as to the motives of the author. Particularly considering the high regard given to Cochrane Reviews for their thoroughness and neutrality. I agree that this article requires a rewrite. Will see what I can do over time...just busy with my studies at the moment. Mtresillian 09:11, 12 March 2007 (UTC)

I agree that this needs extensive revision. In no way does it appear to be neutral or that it is trying to express any kind of scientific data. 70.171.13.185 (talk) 06:35, 10 November 2010 (UTC)

Agreed. This article would benefit enormously from a researched counterpoint. That the lead picture is titled "Normal Childbirth" is hardly an endorsement of neutrality. From my perspective, key improvements would include:

• A distinction between at-home delivery and the use of hospital facilities. Hospital support systems for childbirth are largely standardized. There's much more dramatic variation among individual waterbirth practitioners in the ability to respond to complications. The listed criticisms in the article are a small subset of these potential complications. Ignoring the rest to support a positive tone is very close to a straw man argument.
• Verification of the statistics cited in the article, both for numerical accuracy and inherent biases. Waterbirth literature (e.g., http://www.americanpregnancy.org/labornbirth/waterbirth.html) suggests a variety of risk factors that foreclose its use. If we assume that women will deliver conventionally in hospitals when complications are foreseeable, the remainder that choose water birth would be expected to have lower rates of complication or poor result (e.g., death) regardless of the birth method. The inclusion of mortality rates without any such discussion leaves the reader to chalk the difference to water birth itself, a potentially erroneous conclusion. Alexdi (talk) 12:06, 20 November 2010 (UTC)

I've gone back and changed a few things, particularly in the section on risks and concerns and in removing unsourced and erroneous statements. The medical establishment view is that there are no demonstrated benefits and many potential risks. To give an unbiased presentation, I've quoted the conclusions of the various reports presenting and summarizing water birth data. The citations are a mess (and there should be 'full cite necessary' tags added to the various 'Author, DATE' references throughout the article), but one PDF in particular contains most of the relevant journal articles.

http://www.neonatologie.ugent.be/waterbirth.pdf

The article on the whole still isn't anywhere near neutral. Earlier sections, and even the later ones in the Risks portion are still written as if in an advertorial. I'd also prefer a more neutral (at minimum, single-colored) article picture. The data exists in the PDF above to make it so for an author with time to spare. Alexdi (talk) 04:44, 4 October 2011 (UTC)

Offensive

The reference to "primitive races" is confusing and potentially offensive -- does this mean human cultures or other species?

I don't know the history of water birthing, so I'll leave the editing to someone more qualified.

I agree. I've rewritten the paragraph. —Caesura 22:22, 26 Mar 2005 (UTC)

I think the assertion in the History section that 'water birthing has been used by many past cultures' needs a reference. Which cultures, where, at what time etc? Gamsarah 11:51, 20 January 2006 (UTC)

Needs a complete rewrite.

I'm new to wikipedia and not sure what the best way to go about getting the right people to look at this is. From what I have read, this article is clearly written entirley by a proponent of of waterbirth and is extremely POV. Quotes like "Some have thought that the baby can drown, but that fear has been shown to be groundless." are ridiculous. Who has thought the baby can drown? Who has shown this fear to be groundless? When? How?

Not being a doctor or an expert on this subject, there's not much I can really add myself. I simply assert that for any article that might influence a person's medical decisions must be completely NPOV.

Please sign your posts with four tildes. I think you are being rather critical and that if you are concerned you can be a little more polite about it and preferably do the research to improve the article yourself. Many people when introduced to the notion of waterbirth are concerned that the baby will drown, because they do not understand that the baby's breathing reflex is started by exposure to air. I'll attempt to improve the article. Maustrauser 23:02, 17 March 2006 (UTC)

Righto. I have done a major re-write and removed the NPOV tag. Clearly some more references could be found and I'll do that over the next few days. I'll also attempt to write articles on all the redlinks. But that will have to wait a few more days. I've gotta have a life. Please make further improvements to this article. Maustrauser 23:37, 17 March 2006 (UTC)

Re: Karil Daniels film "Water Baby"

As I just explained to Karil Daniels on her user talk page, the material she added doesn't really belong in the "Research" section, and also should be rewritten to conform with WP guidelines re "conflict of interest" (Wikipedia:Conflict of interest) so it isn't perceived as "self-promotion". I told her I would move it here for the time being, so it can be redone and moved back to a more appropriate spot in the article -- perhaps a new section/heading for films, does anybody have a better suggestion?

Here's the material I removed from the article:

In the USA, Karil Daniels produced a multiple award-winning documentary, "WATER BABY: Experiences of Waterbirth" which first brought waterbirth to the attention of many hospitals and birth centers and popularized the waterbirth method in the USA and Europe. "WATER BABY" was the first film to document waterbirth and shows 4 actual waterbirths in home, hospital and birth center settings. It was made in France with Dr. Odent, in Russia with Igor Charkovsky, and in the USA with Dr. Rosenthal. An excerpt from this film can be seen at the Waterbirth Website. [[2]]

Cgingold 15:56, 20 November 2006 (UTC)

Material re Water Baby removed, again

Even in a toned-down, less promotional version, this still doesn't belong in the "Research" section. However, after checking out the website, I confirmed that it IS an award-winning film that deserves mention in the article. (In fact, it probably merits an article of its own.) So I created a new section for "Resources", and moved 3 book listings there, as well. Cgingold 11:43, 18 December 2006 (UTC)

Under the Advantages to the Babys section this article states, "Water eases the transition from the birth canal to the outside world, because the warm liquid resembles the familiar intra-uterine environment, and softens light, colors and noises." I was under the impression that newborns cannot detect colors. --Yoap 14:44, 5 June 2007 (UTC)

NPOV again

This article is seriously an advocacy piece. The purpose of these articles should be to give facts about the procedure that are cited by reliable sources, not to overcome objections. ⟳ausa کui ^× 15:51, 26 June 2007 (UTC)

---

It is not a "procedure". That term implies treatment of a medical condition. Childbirth is a physical process not a medical condition. There is no set procedure. There are no rules. If women want to do it in water then why all this angst? Why not spend your energies on stopping unnecessary cesareans instead?

First of all, please sign your comments with four tildes. Second, Wikipedia is not the place to "spend your energies" starting, stopping, or advocating anything! Wikipedia is not a soapbox (this is one of Wikipedia's rules, which you should probably read). The argument on this page is not about whether the subject of the article is "good" or "bad", it is about whether the article takes a position on that question one way or the other. It shouldn't. Your opinionating here is inappropriate. I agree that this is an advocacy piece and should be deleted or rewritten. Wikipedia is for neutral encyclopedic articles, and the presence of anything other than that (regardless of whether it's "right" or "wrong", whatever the hell those mean) must be viewed as a defacement of Wikipedia. And it may interest you to learn that "procedure" (the word you dislike) is in fact a synonym for "process" (the word you used). Xezlec 03:56, 19 August 2007 (UTC)

Introductory paragraph

I've rewritten the introductory paragraph to make it more encyclopedic. One thing which might be added to the introduction is some very basic (non-political) statistics; for example, the approximate number of water births that occur every year. (I'd avoid mortality statistics, as article introductions in particular should be as uncontroversial as possible.) I was unable to find said statistics after a quick Google search. Also, if I have mischaracterized the pro and con positions, I apologize. --ScottAlanHill 05:27, 2 September 2007 (UTC)

Episiotomy

There is a phrase that reads "decrease the need for episiotomy". This conflicts with the general consensus that episiotomy is rarely or never "necessary" and in fact is detrimental...see the episiotomy page. I'm going to rephrase this. Cazort (talk) 02:15, 11 February 2008 (UTC)

Research or further reading?

I moved the following (boxed) text to here, because it doesn't seem useful to have a section named research without further specification (see Wikipedia:Research sections). It may rather seem like a Further reading section.Mikael Häggström (talk) 16:19, 16 March 2010 (UTC)

Research Considerable research has been undertaken into the safety of water birth. Two of the most prolific researchers have been Michel Odent and the American obstetrician Michael Rosenthal. Dianne Garland, a midwife in the UK, has focused on gathering research through the National Health Service system, and has published a book called, Waterbirth: An Attitude to Care. In the US, Barbara Harper, a nurse and childbirth educator, has explored waterbirth throughout the world, and chronicled the history and current use of waterbirth in dozens of countries in her book, Gentle Birth Choices. Harper has compiled an extensive bibliography of research on the subject, which can be seen at the website for Waterbirth International.

References

Again, NPOV

This reads like a pamphlet promoting water birth. Major cite issues, lack of coverage of negative consequences. No rebuttal to positive comments. Ronk01 talk 15:55, 12 October 2010 (UTC)

There are still significant issues with lack of WP:NPOV from what I can see. The whole style is pretty jarring to read as well with "proponents" and "critics" throughout. A more even-handed narrative is needed I feel, along with more citations. Lineslarge (talk) 23:22, 9 June 2012 (UTC)

I have now updated the lead so rather than containing arguments, it simply explains what water birth is and gives a single sentence summarising each of the opposing views. This ought to do for now, but can be expanded once the rest of the article is more balanced. Lineslarge (talk) 16:50, 10 June 2012 (UTC)

References

I am doing a bit of cleanup on this article and have fixed the numerous references to Sprague that were not using the correct markup. However, I have not checked that they are all actually in that source. Perhaps someone could verify this? Lineslarge (talk) 20:56, 9 June 2012 (UTC)

Now I've cleaned up the rest of the references there are several that still aren't linked to inline citations. I think the article could do with a full fact check as well as someone trying to marry up those orphaned references. Lineslarge (talk) 23:19, 9 June 2012 (UTC)

After trawling through the page history is seems the following references supported material that has since been removed from the article. I have therefore removed them from the reference section:

• Odent M. Birth under water. Lancet 1983:1476-1477.
• Siegel, P. (1960). Does bath water enter the vagina? Journal of Obstet and Gynecol 15: 660-1.
• Eriksson, M., et al. (1996, Aug.). Warm tub bath during labor. A study of 1385 women with prelabor rupture of the membranes after 34 weeks of gestation. Acta Obstet et Gynecol Scand 75 (7): 642-644.
• Fewell, J.E., Johnson, P. (1983). Upper airway dynamics during breathing and during apnea in fetal lambs. J of Physiol 339: 495-504.
• Harding, R., Johnson, P., McClelland, M. (1978) Liquid sensitive laryngeal receptors in the developing sheep, cat, and monkey. J of Physiol 277: 409-22.
• Office of National Statistics. 2007. "Mortality Statistics: Childhood, infant and perinatal - Review of the Registrar General on deaths in England and Wales, 2005." Series DH3 No. 38. London.

Lineslarge (talk) 20:07, 10 June 2012 (UTC)

I've matched up a few references that were never marked up correctly and there are now only two references left in the article (Flade and Geburtsberichte) that are not linked as inline citations. These two are in German and are from when the page was originally created. I've left them there as I can't read them and they may well still be relevant. Lineslarge (talk) 22:39, 10 June 2012 (UTC)

Epidural

The text currently states:

Epidural anesthesia may be associated with a higher incidence of instrumental delivery with forceps[citation needed]. However, epidural anesthesia does not increase the incidence of cesarean section and has been shown to be a safe alternative for labor analgesia[citation needed].

Previously it said the opposite with respect to cesarian section and was supported by the following reference:

• Ros, Andrea, Ricardo Felberbaum, Iris Jahnke, Klaus Diedrich, Peter Schmucker, and Michael Huppe. 2007 "Epidural anaethesia for labour: does it influence the mode of delivery?" In Archives of Gynecology and Obstetrics. V. 275(4):269-274(6)

I am removing the reference from the references section as it no longer supports the text and have added the citation needed tags. Lineslarge (talk) 22:00, 10 June 2012 (UTC)

NPOV, weasel words, fact, who, when, et cetera.

This article is a shambles. Just glanced at it (not a topic of interest, but saw it mentioned and wanted to look at the wiki article for more info), it reads as propaganda for pro-water birth. I don't know whether there's such a thing as pro or con for it, I can only assume there is, but the citations backing up some really sporadic claims are all non-medical non-peer reviewed sources, usually vanity published books by proponents of the act writing books on mid-wifery.

These aren't valid sources, in the slightest. Also there's a lot of 'some people / some clinics' and ambiguous time frames, et cetera in the article. I started to mark it up with {{fact}}'s but then realised it was just too out of hand to bother with or it'd be littered with citation requests.

So, I've flagged it as NPOV and containing weasel words, perhaps someone with more knowledge (and less agenda than the current editors) could fix this mess up? BaSH PR0MPT (talk) 11:51, 13 July 2012 (UTC)

I've tidied up the notices with the {{Multiple issues}} tag, removed the NPOV check as it's now flagged, and added {{Peacock}}. Lineslarge (talk) 20:12, 13 July 2012 (UTC)

I've gutted the page, most of it was sourced to a book by Annie Sprague, published by Annie Sprague Ltd. Not a WP:MEDRS. In fact, most of the page was not MEDRS-ed, so I've trimmed it down to actual secondary, reliable sources. Amazingly, there's very few on pubmed despite there apparently being no small share of research. Though for some reason very few have abstracts. I'm wondering if it's due to low-impact publications? WLU (t) (c) Wikipedia's rules:^simple/_complex 23:25, 29 August 2012 (UTC)

Sources

• [3] AAP consensus statement?

Merge Birth Pool

A new article has been created, Birth Pool, which appears as if it could be merged into this article. Are there any opinions about whether it should stay as it's own article or integrated with this article?--CaroleHenson (talk) 16:11, 2 April 2015 (UTC)

Agree, noting that the Water Birth page also includes a discussion of the use of such pools during labor, not just for delivery. So,  Done Klbrain (talk) 10:15, 27 August 2017 (UTC)

Mistaken citation - immersion versus delivery benefits

This article repeats the statement throughout that "immersion during the first stage of childbirth can reduce the pain of labor". This is not actually a benefit of giving birth under water. This is a pain management option for women in the first stage of labor.

The cited study states this distinction (see: Background section):

Water immersion during the labor refers to immersion in water during only the first stage of labor; the delivery is not performed in the water. Water immersion may provide the advantages described above without the potential risks associated with water birth.

Given this study doesn't focus on or support water birth, I will go ahead and remove this citation, maybe someone can provide a better citation supporting actual delivery underwater.

Dfebb (talk) 07:37, 6 April 2016 (UTC)

Well done Dfebb. Hopefully someone will find some excellent source to replace it. Sgerbic (talk) 15:19, 6 April 2016 (UTC)

I have returned the deleted information as I see no problem with it. Dfebb states, "This article repeats the statement throughout that "immersion during the first stage of childbirth can reduce the pain of labor". This is not actually a benefit of giving birth under water. This is a pain management option for women in the first stage of labor." This first stage of labor is part of the birth process, not a distinct process. See our article: "The process of normal childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and birth of the infant, and the expulsion of the placenta.[1]" Gandydancer (talk) 16:15, 6 April 2016 (UTC)

The title of this article is "Water Birth". The first line clearly states the intent of the article: "Water birth is childbirth that occurs in water." The word childbirth here is hyperlinked to the Childbirth Wikipedia page where the first line states:

"Childbirth, also known as labour and delivery, is the ending of a pregnancy by one or more babies leaving a woman's uterus."

Therefore, childbirth here is being framed as the ending of a pregnancy. Indeed, the graphic depicting a baby that appears to have been delivered underwater also lends support to this.

Given this framing, using a study that explicitly states that it is not looking into delivery under water as the predominant support for the 'Benefits' section of this Water Birth article is incorrect. It would be fine if the source was indeed a study whose findings actually did support underwater delivery.

Dfebb (talk) 04:49, 24 November 2016 (UTC)

References

References

• Liu et al. (2014),

"A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery", BioMed Central (BioMed Central Ltd unless otherwise stated. Part of Springer Science+Business Media), retrieved 2016-04-06

Multiples births section

I have removed this newly added section for discussion:

Water Birth with Multiples

There is an increased risk and concern with women who are giving birth to multiples via water birth. There is a higher chance for premature births and added complications and therefore studies have shown a water birth may be more risky for these deliveries. Although 40% of women expecting twins delivery vaginally a water birth is not recommended because of added risk and inability to perform an emergency cesarean section if needed.

I don't believe that the American Pregnancy Association is adequate for medical information. The second ref seems OK but multiple births is not even mentioned at that source. Thoughts? Gandydancer (talk) 03:26, 4 August 2020 (UTC)

I do not have the expertise to comment on The American Pregnancy Association. I briefly reviewed this article a week or so ago and also noted the low-quality sources and strong claims shared. Today I also noticed the section that says, "WEBMD suggests" under Water birth#Water Birth Criteria. JenOttawa (talk) 14:59, 4 August 2020 (UTC)

@Mariac12345: I noticed that you are here to help improve this article as part of your class project. Would you be able to find a WP:MEDRS source for adding information about "criteria" for a water birth? I feel that this section should be deleted unless we can use a recent high quality secondary source to share a list of people who may be considered for having a water birth. @Mariac12345: also, thank you for helping to improve this article! JenOttawa (talk) 15:03, 4 August 2020 (UTC)

Jen, I questioned it also and decided that MEDRS would be sufficient, though I certainly could be wrong because I am hardly a source expert. I have done extensive work on the Breastfeeding article and I know how hard it can be to find such information, for example I tried to put the fact that holding your hands or arms to your breasts can help to stop an unexpected milk letdown which I knew from my own experience. But the info was from a blog and while an excellent blog, written by a nurse, it was still just a blog. Another woman that works on the article who is very good with sources said it was not acceptable. In fact, come to think of it I'll ask her to take a look at this. Gandydancer (talk) 15:20, 4 August 2020 (UTC)

Thank you for all your work maintaining these articles Gandydancer! That would be great to get someone in the field to help with this. I think that a high-quality OB or midwifery text book would suffice for some of these sections, and perhaps for your paragraph in the Breastfeeding article. Not many systematic reviews have been done and so many websites (too many to list) are not necessarily evidence based nor peer reviewed. I do not edit regularly in this area nor do I have text books myself.JenOttawa (talk) 16:15, 4 August 2020 (UTC)

Circling back to the Water birth article, evidence and recommendations shared in clinical guidelines may a good approach. For example, the AGCO 2016 guideline could be considered: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/11/immersion-in-water-during-labor-and-delivery JenOttawa (talk) 16:20, 4 August 2020 (UTC)

I just added a sentence in to the lead to get started and cleaned up the lead. This could be used in a few other places in the article. Please do feel free to adjust what I have added!JenOttawa (talk) 16:29, 4 August 2020 (UTC)

Hi everyone. I agree that MEDRS sources should be used for all claims about whether water birth is safe or helpful. MEDRS is our highest standard of sourcing for biomedical information. I'm concerned about the use of old sources, e.g. a source that talks about lack of scientific proof of safety, but is from 2004.

@Mariac12345: thanks for choosing to work on this article! If anyone is looking for high-quality sources, there are some excellent MEDRS-compliant sources referenced and summarized in this article from evidencebasedbirth.com. Take care, Clayoquot (talk | contribs) 01:07, 6 August 2020 (UTC) Re-pinging @Mariac12345: as pings only work if you add a signature in the same edit. Clayoquot (talk | contribs) 02:04, 6 August 2020 (UTC)

Thanks Clayoquot. Actually I'm feeling a little embarrassed as that site is not at all what I thought it was--I just now looked at it and it really is quite awful. I would not object if it were removed now as we wait for the student to reply (since it is entirely possible that they may not, at least in my experience). BTW, Clayoquot, that's a great source you mentioned. I don't have time to work on this right now but plan to later. It is of some interest to me since my daughter Jane gave birth to her first in a children's plastic pool and then by the time she had the second their small local hospital had a pool so that was the plan. But as it turned out the baby was born on the couch with her three-year-old acting as midwife while the real midwife was racing for her home and her husband was racing around gathering supplies for what was clearly going to be an unexpected home birth. Her husband Ken recalls how he was racing upstairs and there was John Gunner with a "sick smile" on his face and his hand on his sister's head and he said, "Daddy, the baby's here". Ken was an army-trained EMT so he knew how to help the baby out. It all happened, from first twinge of labor pains, in just 42 minutes flat. Gandydancer (talk) 17:00, 6 August 2020 (UTC)

Wow, that is an incredible experience. I am so glad it worked out alright and your family sounds amazing! Another consideration is to use background info from the 2018 Cochrane Review to expand the article. Yes, I am the WiR for Cochrane, but this is just an idea and not related to my WiR activities!! It is great to see these articles improved to ensure that people are getting evidence based information. Dr. Google is scary in this field!JenOttawa (talk) 17:31, 6 August 2020 (UTC)

Awesome story, Gandydancer! Congratulations to everyone involved! Clayoquot (talk | contribs) 18:24, 6 August 2020 (UTC)

Yes, it is a good story. Jane told me that when she could feel the baby's head coming out she told John, "Don't worry if Mommy screams when the baby comes out--that is just normal". Now this all happened in a small town in Maine and they got a full page story with photographs and an interview of John, the midwife, in the local weekly. Upon reading the story the men cheered and the women wept with joy. . Gandydancer (talk) 18:44, 6 August 2020 (UTC)

I deleted the student's section per the above discussion. Gandydancer (talk) 13:47, 17 August 2020 (UTC)

References