Water Aerobics may Decrease Pain of Childbirth

Pregnant women who perform water aerobics may experience less pain during delivery, a new study suggests.

Seventy-one pregnant women who did not exercise regularly participated in the study. Thirty-four women were randomly assigned to participate in moderate-intensity water aerobics for 50 minutes three times weekly. Treatment began at about 18 weeks of gestation until delivery. The remaining 37 women performed no exercise and served as the control. 

Throughout the study, all of the participants underwent several ergometric tests on a treadmill to measure their fitness.

The authors found that only 27.3 percent of women in the water aerobics group asked for pain medications during delivery, compared to 64.9 percent in the control group. According to these statistically significant findings, which are published in Reproductive Health, women who undergo water aerobics during pregnancy may require fewer pain medications during delivery.

Although more women in the control group (45.9 percent) underwent Caesarian sections than in the aerobics group (36.4 percent), the difference was not statistically significant. In addition, length of labor and average birth weight and age were similar in both groups.

"We've shown that the regular practice of moderate water aerobics during pregnancy is not detrimental to the health of the mother or the child," co-author Rosa Pereira said in a news release. "In fact, the reduction in analgesia requests suggests that it can get women into better psycho-physical condition."

However, this study is limited by its small sample size. About one-third of the women in the aerobics group dropped out of the study due to family, job and personal constraints.

Other types of water therapy, or hydrotherapy, have been used to treat pregnancy-related conditions, although evidence in this area is limited. For instance, early research suggests that giving birth in water may reduce labor pain, duration of labor, perineal damage to the mother and birth complications.

For more information about hydrotherapy, please visit Natural Standard’s Health & Wellness database.

Comments

[Kevin G.]

This is interesting. I wonder what the mechanism is that makes pregnant women who did water aerobics less likely to use pain medications during labor. Also, it is very interesting that the control group had more c-sections, even though it was deemed statistically insignificant. I still think it had to play a role in the results of the study.

[Ray A.]

I wonder why water aerobics was the chosen form of exercise. Is it the safest one? What about walking or yoga or Pilates? Or was it chosen because it seems like the most fun? Also, what are ergometric tests? And why did they have to be performed throughout the study?

[Julie]

From personal experience, I would say that water aerobics while pregnant is a wonderful way to exercise, and if it decreases labor pain, then even better! While pregnant with my first child, I took a pregnancy swimming class, which was basically water aerobics. There were three of us in class who all had our babies within a two-week time frame, and two of us did not use any pain relievers during labor and delivery.

This study is very interesting. I’m not sure if pain could actually be reduced though, rather the aerobics increased the power of the mind and belief in personal strength. During my classes, we focused and imagined various stages of labor while in the water. I think this helped mentally prepare us for labor and also boosted our confidence in our bodies and the amazing things they can do.

I also wonder if the group that partook in the classes discussed labor and delivery together, and therefore were able to relive some fears they may have had. There are so many factors that could have influenced the results, but I do agree that some type of water therapy while pregnant probably feels really good.

[Ruth]

Exercise releases endorphins, which are natural pain relievers. Both endorphins and opioid analgesics bind to the same opiate receptors in the CNS.

[Paula B]

The authors didn't indicate how long into pregnancy the women maintained the exercise program. Certainly, some women were able to exercise later than others. I hope the authors accounted for this in their results.

[Marie]

Even though the population size was small, its results are very interesting. I wonder how the water aerobics helped pain management after childbirth. I hope another study is done concerning this topic with more conclusive results!

[Eric]

Water aerobics is well-known for providing natural resistance with very light to no impact on joints. It is a great way to get your heart pumping without putting strain on joints! This is the first time, however, I have read anything about water aerobics to be associated with pain management. What an interesting article!

[Shaily]

I'm not sure about this, but I feel like water aerobics would be a safer form of exercise since it's performed in the water and that absorbs shock. I feel like getting on a treadmill or another type of intense exercise would be dangerous to do while pregnant.

[Philip]

Are there dangers to the mother and baby if you do take pain medications during child labor? I have always wondered about this because some people seem to discourage you from taking any pain relievers, while I haven't heard a lot about the negative effects. Anyone know more about this?

[Joselyn]

I think exercise during pregnancy is a great idea, but I think you should definitely consult a doctor before starting any exercise program while pregnant. You have to be especially careful of not becoming dehydrated or overheated.

[S.k.]

I'm not sure if the results of this study are conclusive enough to conclude that water aerobics can directly affect labor pain. There definitely needs to be more research with a bigger subject pool, but I guess exercise never hurts anyone!

[Georgia Peters]

I’ve got news that may not make the front page, but it’s just as important. Childbirth uses muscles. It’s no coincidence that women who exercise and have practice and control with their muscles have less issues giving childbirth. It was interesting to note that they also required less pain medications and C-sections, which could easily follow from an increased muscle tone and a boost in general health.

[Tamara]

I think any type of light exercise will benefit pregnant women. Studies show that water aerobics can reduce some of the edema cause by fluid-retention during pregnancy. Women report having less overall physical discomfort, better sleep and improved mobility.

[Robert D.]

It would be interesting to see these women also have child birth in water to see if there is a synergistic or additive benefit from combining it with water aerobics. Also, subsequent studies need to increase the subject pool (and not the one with water).

[Edward N.]

Ruth,

Do endorphins have the same effects as opioids? If they bind to the same receptors, then why can athletes still feel pain during exercise? Do marathon runners feel no pain? If someone breaks his/her leg, would running a few miles relieve the pain as effectively as hydrocodone? Is this really the mechanism that water aerobics decreased pain medication use during labor?

[shantelle]

I have always been a big fan of water exercises! It’s a great way to work out and not put much strain on one’s joints. I think exercising throughout pregnancy has many benefits, and this study proves so!

[Myrna Marx]

As a follow up to Joselyn's post, the authors note absolute and relative contraindications to exercise during pregnancy as follows: multiple gestation, higher risk of premature labor, incompetent cervix, bleeding during pregnancy, severe heart diseases, fetal growth restriction and others.

[Mike]

I found it surprising that throughout the pregnancy, the indicators of maternal cardiovascular capacity (e.g., VO2 max, cardiac output) were similar in the two groups. At the same time, they state that the women were exercising at 70 percent of their maximal heart rate. My question is this: how long does it typically take to see an exercise-induced increase in CV capacity?

[UncleTony]

Hold the phone! What if the water aerobics women were just used to doing things, so they were able to not need pain medication since they were used to "taking the hard road" or just used to being active. My nephew sits on the couch eating sugar-coated butter sticks and does not take out the trash. My other nephew is active in sports, and he does take out the trash without a problem. I think it’s the same idea.

[Reese]

Georgia, you bring up a great point. It makes sense that exercise would help something as intense on the body as childbirth. I didn't think that exercise could decrease C-sections and pain medications. Hopefully, more research will be done on this.

[K.K.]

It is great to finally have something besides deep breathing that is not a drug to help reduce delivery pain! Regardless of how beneficial water aerobics is, there must also be significant care to train the mothers to recognize water breakage during these exercises. My pregnant niece unknown to her, broke water during her morning shower which led to a complicated delivery and her infant requiring an antibiotic drip through the cranial soft tissue. Thankfully, both survived a potentially dangerous situation.

[Becca]

I believe that in general, non-vigorous exercise will benefit pregnant women. Studies do show that women who participate in water aerobics for 50 minutes, three times per week during pregnancy are significantly less likely to ask for pain meds during labor.

Water aerobics is safer for pregnant women than conventional exercise because it decrease edema, prevents an increase in skin temperature and does not overload the musculoskeletal system. Overall, studies show that water aerobics does not negatively affect the mother or her baby’s health and could have some wonderful benefits.

[SUMA]

I agree with S.K. that the results of this study are not conclusive enough to state that water aerobics helps decrease pain of childbirth. The authors stated “there was no effect on the cardiovascular capacity or on the duration of labor or the type of delivery” between the two groups. I guess I am not clear how they made the association that water aerobics specifically had an effect on analgesia requests. I think there are many confounders that could come into play; for example, pain tolerance, personal views toward delivery, knowledge of the laboring experience and what to expect. (Did they attend childbirth classes?)

I do agree that exercising helps to increase muscle tone which may improve the laboring experience. Water aerobics allows a person to exercise every muscle at the same time. It enhances muscular endurance and improves cardiovascular fitness. The water causes your body to be buoyant, causing less stress on joints and muscles and provides a great deal of resistance in all directions for your muscles to work against. It would be interesting to repeat this study comparing it to other forms of exercise (safe for pregnant women) to determine if the same result is obtained.

[liz]

I Googled benefits of giving birth in water, and it states that water soothes muscle and stimulates natural pain inhibitors, resulting in less pain/stress or anxiety in the mother. It also mentions that it is less traumatizing for baby since the environment is similar to the womb.

[Anna H.]

Although well conceived and depicting a hardcore reality of labor pain, this study fails to yield its findings in a sound and scientific manner due to the large number of irregularities in data collection, which was not at all uniform. The high percentage of Caesarian cases in patients who were not subjected to aerobic exercises is a clear indication of their request for analgesics. The results depicted in this study do not indicate scientifically that water aerobics could decrease labor pains.

[uwak]

Good news for my wife. Thanks for information

[RZD]

I've heard about women giving birth in water and that it is supposed to be less painful with possibly fewer complications. However, what is it about water aerobics that would increase the threshold of pain during labor? Is it the form of exercise and how it tones or sculpts one's muscle's or is it the resistance that water provides?

[Luce]

This is very interesting. I have heard of water aerobics to be effective in patients with arthritis, but not during pregnancy to prevent labor pains. However, exercise during pregnancy does increase the strength of the mother and thus enhance muscle contraction during labor and delivery with less pain.

[sandra]

Very Interesting! I never knew that. I have heard of the benefits of pelvic tilts prior to pregnancy to help strengthen the uterine muscle, but water aerobics is a first for me. It also sounds fun!! I like how you took into consideration the limitations to the study, such as sample size. I would definitely consider water aerobics in the future!

[v.n.]

They state that one group did water aerobics and the control was not exercising at all. I think that strengthening the muscles and becoming more flexible is what may have helped the women deal with the pain of labor.

Also, there was a high percentage of women in the control group who had caesarian sections. Obviously, they would need pain medication for that procedure. I think those percentages, and the fact that the control group didn't exercise at all, plays with the validity of the study.

[Erika]

Very Interesting and fun!! I wonder if this also applies to other forms of low-intensity workouts. I can’t wait to spread the word to friends, especially since many pregnant women would like to work out but feel very limited. This is at least something fun because it can be done in a group. I would personally consider this in the near future. Thanks for sharing!!

[Monique]

Isn’t it possible that the control group requested analgesia because psychologically they knew without exercise they will need the medication anyway? Also, the aerobic exercise group might have held back their pain, thinking pain tolerance during labor is expected from them. Does any of this have an impact on the result or could it have played a role? The researchers did not state if the study participants were questioned after labor if they had the intentions to request for analgesia during labor.

[LT]

There are multiple benefits of water aerobics. It doesn't cause any kind of stress or jerk on the joints and is extremely safe. As compared to the exercises done on the land, water aerobic exercises are more effective and lead to a loss of about 450-700 calories per hour. I highly recommend it.

[Jess]

The study reports that those women in the exercise group had a lower heart rate at the end of the study than they did at the baseline measurement. This indicates that the women may have merely improved their overall fitness by incorporating regular exercise, and therefore, were more fit for childbirth.

[Michaela]

Although the authors stated that the number of caesarian sections were not significant, those results most surely impact the number of patients who requested analgesics.

[Michelle Duong]

This is great news for women like me, who haven't had their first child yet! My only concern with this study is that the sample size is so small. It mentions that throughout the study, 18 women dropped out because of outside factors. That does not leave a very large N to evaluate. However, I still think the findings are significant despite an N = 53.

Could it be that the water aerobics are helping because physical activity decreases pain in labor? Or is it the water itself that has this effect on labor? If anything, the water aerobics must be safer for pregnant women, as it provides the same amount of resistance without the additional strain or possible injury of gravity-based exercises.