Case Report of Haemophilus parainfluenzae Sepsis in a Newborn Infant Following Water Birth and a Review of Literature

Abstract

Water birth has become an increasingly popular alternative to hospital delivery as it is thought to provide maternal benefits, including less discomfort, decreased need for analgesics or anesthesia, and decreased perineal trauma. 1,2 Immersion in water during the first stage of labor has some beneficial effects for the mother, but water immersion during the second stage of labor has not been adequately studied for safety and efficacy. 3,4 Water birth has been deemed safe for infants in a few studies, but these have been mostly retrospective reports or studies with a small sample size. 5 Bacterial colonization of infants does not seem to differ between normal births and water births. 6 Despite putative physical and emotional benefits for mothers, underwater delivery has been linked to rare but serious adverse effects for newborns. These include respiratory distress and drowning from tub-water aspiration, pneumonia, sepsis, seizures, and perinatal asphyxia. 7,8 There have been many small sample size reports but no randomized controlled trials on this subject. 9 It is notable that there is no mention of this mode of birth in the medical, health, and newborn sections of the 2003 U.S. Standard Certificate of Live Birth. 10