Wednesday, February 06, 2008

Baby dies of freshwater drowning at waterbirth

According to Birth pool baby 'drowned' in the Independent of Ireland:
A baby died of "acute near drowning" three days after a natural water birth, an inquest heard yesterday.

Gina Eccles (24) gave birth to baby Harry in a birthing pool at Cavan General Hospital on February 26, 2006, helped by a midwife.

After birth, the baby boy was blue in colour, unresponsive to tactile stimulation and made no efforts to breath on his own, Dublin City Coroner's Court heard yesterday.

He was immediately ventilated and was transferred to the National Maternity Hospital, Holles Street, Dublin, later that day where he died on March 1.

Pathologist Dr Peter Kelehan told the court yesterday that baby Harry had died from an acute "near drowning" event after inhaling fresh water into his lungs.

He said the baby had exhibited hyponatremia or low sodium levels which is "a characteristic of freshwater drowning."

He added there was no evidence of disease which might have caused the baby's demise.

"I was not able to find any lesion which existed before this catastrophic event at the time of the baby's birth," he said.

Neuropathologist at Beaumont Hospital, Dr Michael Farrell, was also of the opinion that the event occurred at birth, Dr Kelehan told the court...
This tragic outcome is consistent with a study of water birth published in the BMJ in 1999, Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey which found that out of 4,030 deliveries in water, 35 babies suffered serious problems and 3 subsequently died. It is unclear if any of the deaths can be attributed to delivery in water. However, of the 32 survivors who were admitted to the NICU, 13 had significant respiratory problems including pneumonia, meconium aspiration, water aspiration, and drowning. Other complications attributable to water birth include 5 babies who had significant hemorrhage due to snapped umbilical cord. In all, 18 babies had serious complications directly attributable to waterbirth. The risk of serious complications necessitating prolonged NICU admissions was 4.5/1000.

The American Academy of Pediatrics Committee on the Fetus and Newborn released a comprehensive report in 2005 that waterbirth is not safe for babies. The report, Underwater Births, begins:
Throughout human existence, women have typically given birth to their offspring on land. Over the last 25 years, however, underwater birth has become more popular in certain parts of the world despite a paucity of data demonstrating that it is either beneficial or safe.1–22 Underwater birth occurs either intentionally or accidentally after water immersion for labor, a procedure promoted primarily as a means of decreasing maternal discomfort. A review of the available literature indicates that the risks of underwater birth to the newborn seem to outweigh the benefits, and caution is urged before widespread implementation.
After reviewing the existing scientific literature, the committee concludes:
The safety and efficacy of underwater birth for the newborn has not been established. There is no convincing evidence of benefit to the neonate but some concern for serious harm. Therefore, underwater birth should be considered an experimental procedure that should not be performed except within the context of an appropriately designed RCT after informed parental consent.


1 Old Comments:

In 1999, the neonatal death rate was around 5 deaths per 1000 live births, so it looks like water birth is safer if what you're saying is true. We should have expected over 20 deaths in the studies sample group.

By Anonymous Anonymous, at 7:16 PM