Objective To compare maternal and obstetrical outcomes of water birth and land birth. Methods We searched PubMed, EMbase, SCI, The Cochrane Library, Chinese Biomedical Literature Database, China Journal Full Text Database, Chinese Scientific Journals Full Text Database, conference proceedings, and references of the included studies to identify randomized controlled trials (RCTs) comparing water birth and land birth. The methodological quality was evaluated and the data was extracted by two reviewers independently using a designed extraction form. The Cochrane Collaboration’s RevMan 5.0 software was used to carry out meta-analyses. Results Eleven RCTs involving 3963 lying-in women were included. The results of meta-analysis showed that the rate of episiotomy (OR=0.09, 95%CI 0.01 to -0.59) and estimated blood loss (MD= -36.02, 95% -55.24 to -16.79) in the immersion group were significantly lower than those in the non-immersion group. There were no significant differences between the two groups on the other sides of the study. Conclusion Water birth can reduce the rate of episiotomy and estimated blood loss during the duration of labor. And there is no more risk of maternal and neonatal infection. More high-quality randomized controlled trials are required.
