How the Use of Water Impacts Perineal Trauma during Childbirth

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Authors

Richards, Emma
Gragg, Courtney

Date of Issue

2025-04-25

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Presentation

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en_US

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Abstract

Perineal trauma is a frequent complication in vaginal childbirth, affecting a large majority of women. These injuries range from minor tears of the vaginal mucosa to severe obstetric anal sphincter injuries (OASIS) involving the anal sphincter complex and the area between the vagina and anus, including the vaginal wall and vulva. Perineal trauma may cause lasting issues like pain, infection, incontinence, and painful intercourse, significantly impacting a woman's recovery and well-being after childbirth. An emerging area of interest in preventing perineal trauma is the use of warm water immersion (WWI) or water birth (WB) during labor and delivery. Immersion in water—typically in a birthing tub—has been shown to enhance blood flow, relax perineal muscles, and stimulate oxytocin release, potentially leading to more effective contractions and reduced stress. This method may ease labor and decrease the need of interventions linked to perineal trauma, while creating a calming environment that supports maternal comfort. The purpose of this evidence-based practice review is to examine the effectiveness of WWI/WB in reducing perineal trauma compared to standard land birthing practices. While findings suggest WB/WII may enhance birthing experience, impact on perineal trauma remains inconclusive. The results of this research, allows nurses to educate patients on WB/WWI and assist in implementing these interventions, if they so choose.

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