Baths may lower intensity of active labor pain.(Obstetrics)

SAN FRANCISCO -- Taking a bath can decrease the pain of active labor and reduce the use of analgesics, but don't draw the water if the mother is less than 5 cm dilated or you may prolong labor, Tekoa L. King said at a meeting on antepartum and intrapartum management sponsored by the University of California, San Francisco.

Data on bathing during labor are mixed but tend to support the usefulness of baths, said Ms. King, a certified nurse-midwife on the ob.gyn. faculty at the University of California, San Francisco.

Until 2002, two out of three well-designed randomized, controlled trials found that women randomized to baths during labor reported less pain, greater comfort, and improved satisfaction rates, compared with women who did not bathe. The third study showed no differences between groups. Baths did not affect the likelihood of cesarean section, low Apgar scores, or infection, she said.

"It appears to be safe in terms of infection rates" regardless of whether the patient has ruptured or nonruptured membranes, "so I think we can just lay that worry to rest," Ms. King said.

One of these trials also found a significant decrease in the incidence of abnormal fetal positioning in the bath group, compared with controls (1% vs. 5%), but these results need to be confirmed, she said.

One study suggested that the positive effects of bathing may have been underestimated, because a significant number of women in the control group switched to baths.

Three other randomized, controlled studies were too small or poorly designed for their results to be considered valuable, Ms. King said.