
- maternal and neonatal infections, particularly with ruptured membranes;
- umbilical cord avulsion or rupture, leading to serious hemorrhage and shock;
- neonatal respiratory distress, near-drowning, or drowning that results from tub-water aspiration; and
- seizures and perinatal asphyxia.
Although it had been claimed that neonates delivered into water do not breathe-in or swallow water because of a protective "diving reflex"; the report found cases showing that in compromised neonates, the diving reflex is overridden, which may lead to gasping and aspiration of the surrounding water. Although rare, the report found a case of aspiration of contaminated water that led to a pseudomonas aeruginosa, a serious bacterial infection, and death.
The report noted the absence of peer-reviewed studies with rigorous protocols, making it difficult to know exactly what all the benefits and complications are, and encouraged more studies on the efficacy and safety of water deliveries.
[1] "Immersion in Water During Labor and Delivery," Pediatrics, published online March 20, 2014; DOI: 10.1542/peds.2013-3794.