Ghasemi 2013.

Methods	Participants randomly allocated to water birth or conventional birth groups
Participants	200 pregnant women,100 allocated to water birth, 100 to conventional (land) birth
Interventions	Immersion in water during second stage of labour Women in water were able to move about freely but pool not described Conventional care conducted on bed, no further information about care provided
Outcomes	Duration of labour; mode of delivery, Apgar at 1and 5 mins. No raw data provided ‐ only P values for outcomes.
Notes	Mean duration of first stage P < 0.344. mean duration of second stage P = 0.372; mean duration of third stage P = 0.523. caesarean section rate significantly higher in land group P = 0.018. Apgar scores were significantly higher for water birth group at 1 min P = 0.026, at 5 mins P < 0.001. No difference found for other variables Omolbanin hospital, Mashhad, Iran Dates of trial: 2008 and 2009 Funding: not reported Declaration of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Full paper in Iranian, so data based on English abstracts only, which did not provide this information
Allocation concealment (selection bias)	Unclear risk	Full paper in Iranian, so data based on English abstracts only, which did not provide this information
Blinding of participants and personnel (performance bias) All outcomes	High risk	Blinding of participants and carers not possible due to nature of intervention
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	High risk	Data implies attrition of 17 of 100 in the water group and 12 in the traditional care group but translation did not provide details
Selective reporting (reporting bias)	Unclear risk	Full paper in Iranian, so data based on English abstracts only, which did not provide this information
Other bias	Unclear risk	Full paper in Iranian, so data based on English abstracts only, which did not provide this information