Gayiti 2015.

Methods	Random assignment to water or traditional birth.
Participants	Primiparous, singleton fetus, cephalic presentation, term pregnancy (37‐42 weeks).
Interventions	Immersion in water during first and second stages of labour. 120 women. Traditional delivery group received, enema, shave, artificial rupture of membranes, fetal monitoring and parenteral nutrition, education on breathing and pushing. Water delivery group; enema and shower before 3 cm cervical dilation, vaginal examination to confirm dilation of 4 cm, entered water bath, maintained at 35‐37 degrees Celsius, free to adopt any position in water, fetus monitored every 15 minutes.
Outcomes	Pain intensity on scale 1‐3 Total duration of labour Blood loss in 24 hours Perineal condition Apgar score
Notes	No mention of 1:1 care Medical model of care evident No description of 'bath' size or shape but refers to free movement Undertaken in 1 unit in China Dates of trial: June 2012 ‐ July 2013 Funding: not reported Declaration of interest: the authors declare that there are no conflicts of interest
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No indication of how randomisation achieved
Allocation concealment (selection bias)	Unclear risk	No information about concealment
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not possible
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants accounted for, no attrition
Selective reporting (reporting bias)	Unclear risk	Delivery data limited, but all intended outcomes reported on, but no differentiation by stages of labour
Other bias	Unclear risk	Medical module of care within study unit. No description of water bath intervention