Labour and birth - what the evidence shows

The National Institute for Health Research (NIHR) has brought together research on all aspects of labour and birth.

Woman in hospital ready to give birth.

Pregnancy news, 26/03/2019

The findings aim to help provide parents with some of the answers surrounding labour and the birth of their child.

Topics covered in the research include:

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The research found no evidence that being in labour in water increases the risk of a bad outcome for women or their newborn babies It also found that being in the water at the first stage of labour may reduce the chance of needing an epidural. 

What does this mean for a woman considering a waterbirth?

The NIHR says: “When considering immersion in water in the first or second stages of labour, it may be helpful to know that it does not appear to be risky and may help to avoid having an epidural.”

Labour and delivery 

For women with an epidural in place, lying down on their side as the baby is being delivered achieved more spontaneous vaginal births than in an upright position.

An upright position for women without an epidural may also bring benefits, such as a very small reduction in the duration of second stage of labour (around six minutes, mainly for first-time mothers), and assisted deliveries. However, there is an increased risk of blood loss.

What might this mean for a woman thinking about a preferred position during labour and for delivery?

The NIHR say: “You may want to include labouring and delivery position as part of your birth plan. Your midwife will be able to help you think about the options.

Pain management

First-time mothers in good health and not planning an elective caesarean found that attending two self-hypnosis groups (also known as hypnotherapy) and using a daily audio self-hypnosis CD did not reduce their use of epidural in labour, but did reduce their expected levels of anxiety and fear during the labour and birth.

What might this mean for a woman thinking about pain relief in labour?

The NIHR say: “You may want to consider using self-hypnosis during pregnancy as a way of relieving pain or anxiety during your labour. If so, you might need to investigate resources online or local sources of help. Your midwife will be able to tell you about the drugs that are used for pain relief in labour in the place where you are planning to give birth."

When to induce labour

For women whose pregnancy has gone beyond 41 week or more inducing labour after the due date slightly lowers the risk of stillbirth or infant death soon after the birth, although this risk is low.

Inducing labour at 39 weeks rather than waiting for it to start spontaneously did not significantly reduce the frequency of problems in newborn babies, but did significantly reduce the rate of a c- sections.


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