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Poster Session 3

Category: Labor

Poster Session 3

(990) Maternal and Neonatal Outcomes in Low-Risk Women at term after Waterbirth

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Yael Reichman, MD (she/her/hers)

Resident
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
Tel Aviv, Tel Aviv, Israel

Coauthor(s)

Omri Dominsky, MD, MPH (he/him/his)

OB\GYN resident
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, HaMerkaz, Israel
Roza Shperling-Berkovitz, MD, MPH

Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
ichilov, HaMerkaz, Israel
Ayelet Dangot, MD, MSc (she/her/hers)

Obstetric and Gynecology Resident
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, HaMerkaz, Israel
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Yariv Yogev, MD

Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center Gray Faculty of Medicine, Tel Aviv University, Israel
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
AL

Anat Lavie, MD

Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Objective:
To compare maternal and neonatal outcomes after waterbirth versus natural birth in a contemporary low-risk cohort.

Study Design:
Retrospective cohort of singleton, cephalic, term (37–42 wk) vaginal deliveries without regional analgesia at a single university hospital (~13 000 births/yr, June 2024–June 2025). Eligibility: estimated fetal weight 2 500–4 000 g, normal anatomy scan, no uterine scar or major comorbidity, reassuring intrapartum monitoring. Women electing birth in the hospital birthing center were grouped by intended setting (water vs land). The primary outcomes were perineal tears (intact perineum, 1st, 2nd, 3rd/4th), episiotomy, postpartum haemorrhage (defined as estimated blood loss ≥ 1 000 mL), need for manual removal of the placenta and duration of the second and third stage of labor. Secondary outcomes were 5-min Apgar < 7, neonatal resuscitation, NICU admission and need for sepsis work-up.

Results:

1. Overall, 10,236 vaginal deliveries occurred during the study period, of which 232 (2.3 %) met inclusion; 87 (37.5 %) delivered in water and 145 (62.5 %) delivered in the natural birth center without water immersion. Among 95 women who planned waterbirth, 87 (91.6%) completed delivery in water.
2.  Second-degree tears were less frequent after waterbirth overall (13.8 % vs 24.8 %; P = 0.046) and in primiparas specifically (23.1 % vs 48.7 %; P = 0.043).
3.  Rates of intact perineum (54 % vs 48.3 %), first-degree tears (31 % vs 24.1 %), 3rd/4th-degree tears (0 vs 0.7 %), episiotomy (0 vs 3.4 %), PPH (2.3 % vs 3.4 %), manual removal of the placenta (1.1 % vs 2.8 %), and labor durations were similar between groups (all P >  0.095).
4.  Neonatal outcomes were comparable between groups (all P >  0.30).

Conclusion:
In our cohort, more than 90 % of women who planned waterbirth achieved it. Waterbirth was associated with a significantly lower rate of second‑degree perineal tears without adversely affecting other maternal or neonatal outcomes or changing labor and delivery duration.