For the one-in-three women who experience severe back pain during labour and birth, a safe, simple and effective treatment to ease the pain is here.

The solution?

Literally, water.

Sterile water injections (SWI) have been proven as an effective method for the relief of back pain in labour. The procedure involves a small amount of sterile water injected under the skin at four locations on the lower back.

SWI provides effective pain relief for up to 85 per cent of women with back pain in labour and the effect can last for up to two hours.

Up until now though, sterile water injections have been available in very few Australian maternity units, but thanks to a recent study, the treatment is about to become a whole lot easier to access.

“We found SWIs to be effective for  30, 60 and 90 minutes after administration – so simple and so effective – no longer midwifery voodoo,” says Professor Sue Kildea from Charles Darwin University, who lead the study in collaboration with UQ, the University of Skövde and the Oxford University Hospitals NHS Foundation Trust.

The study was the world’s largest of its kind, involving 15 hospitals in Australia and one in the UK

Professor Kildea says the simplicity and safety of the procedure made it of enormous value to women around both in Australia, and around the world.

“Water injections will not only be of benefit to women wanting to avoid pain relieving drugs during labour, but also where women have little or no access to pain relief during childbirth, such as home birth and countries with developing health systems,” Professor Kildea says.

The simple technique involves sterile water injections (SWI) into the lower back of pregnant woman in labour.

“Although we do not know exactly why it works it appears to be effective for many women,” says Professor Kildea.

“The injections have been likened to a brief wasp sting and the pain relief occurs almost immediately. 

“Some early research suggested that the injections may also reduce the likelihood of a woman needing a caesarean section during labour, but our trial did not find this.”

One of the major benefits of SWIs is that there is no effect on mother’s state of consciousness and zero effect on the baby.

The procedure doesn’t limit a mother’s mobility or adversely affect the labour progress.

“It a simple procedure and can be repeated as often as needed,” Prof Kildea said.

Dr Nigel Lee from the UQ School of Nursing, Midwifery and Social Work, says the injections were previously seen as controversial, but this study shows they are safe and effective.

“Some midwives have used this practice in order to provide pain relief for a number of years, however until now, there has always been limited research to suggest that it works,” says Dr Lee. 

“In fact, many hospitals refused to support the procedure, viewing it as ‘midwifery voodoo’.

“This research provides definitive evidence that water injections offer effective pain relief for the majority of women with labour back pain.”

The data was collected between 2012 and 2017 in one British and 15 Australian maternity units.

More than a thousand women in labour with severe back pain were given either water injections or a placebo of saline solution.

Twice as many of the women who received the water injections reported their pain reduced by at least half, for 90 minutes or longer.

“The implications of the results of our trial are huge,” says Dr Lee.

“Unlike normal labour pain, back labour pain is unpredictable and often continues between contractions with no break.

“Most drugs provided for labour pain are ineffective for back pain which may persist even after an epidural has been given.

“Water injections have been shown to be simple, effective and safe, and to have no effect on birth outcomes.”

Other benefits of water injections include:

• Often immediate effect.
• No effect on mother's state of consciousness.
• No effect on baby.
• Does not limit mobility.
• Does not adversely affect labour progress.
• A simple procedure that can be administered by your midwife.
• Can be repeated as needed

To read the full study in The Lancet journal visit https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30191-7/fulltext