Reports question safety of water births, citing risk of drowning in bathtub

Sunday, August 4th 2002, 12:00 am

By: News On 6

CHICAGO (AP) _ Delivering babies underwater in so-called water births could result in occasional near-drownings and deaths, reports suggest in the August issue of Pediatrics.

New Zealand doctors described four babies they say nearly drowned, and said more safety evidence is needed before water births are offered routinely.

A journal editorial suggests complications are rare but that several drownings have occurred during poorly managed water births. While some evidence suggests the death rate is comparable to conventional childbirth methods, data comparing nonfatal risks are scarce, Dr. Ruth Gilbert of the Institute of Health in London said in the editorial.

Proponents say childbirth in a warm-water bathtub is more comfortable for the mother and less traumatic for the baby because it simulates the uterine environment.

The New Zealand newborns all were transferred to National Women's Hospital in Auckland during an 18-month span, Dr. Sarah Nguyen and colleagues reported.

``All four infants presented in moderate to severe respiratory distress,'' but all improved quickly with treatment, and none suffered permanent damage, the doctors said.

Water births are more common in central and northern Europe than in the United States, though they are gaining ground and are available in about 200 hospitals, compared with three in 1991, said nurse Barbara Harper of the advocacy group Global Maternal/Child Health Association.

Supporters of the technique say primitive reflexes keep babies from taking a breath until they're removed from the water.

But babies who don't get enough oxygen during childbirth may gasp for air, risking allowing water to enter their lungs, said Dr. Joseph Gilhooly, a neonatologist at Oregon Health & Science University, which has a water birth program. Gilhooly said immersed babies should be removed from the water quickly to avoid that risk.

Water births have not been endorsed by the American College of Obstetricians and Gynecologists. Its obstetrics practice committee says there's not enough data to determine whether water births are safe.