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BIRTH IS NOT AN ILLNESS
16 Recommendations from the
World Health Organization
These 16 recommendations are based on the principle that each
woman has a fundamental right to receive proper prental care; that the woman
has a central role in all aspects of this care, including participation in
the planning, carrying out and evaluation of the care; and that social, emotional
and psychological factors are decisive in the understanding and implementation
of proper prental care.
1. The whole community should be informed about the various
procedures in birth care, to enable each woman to choose the type of birth
care she prefers.
2. The training of professional midwives or birth attendants should be promoted.
Care during normal pregnancy and birth, and following birth should be the
duty of this profession.
3. Information about birth practices in hospitals (rates of surgical birth,
etc.) should be given to the public served by the hospitals.
4. There is no justification in any specific geographic region to have more
than 10-15% cesarean section births (the current US surgical birth rate is
estimated to be about 23%).
5. There is no evidence that a cesarean section is required after a previous
transverse low segment cesarean section birth. Vaginal deliveries after cesarean
should normally be encouraged wherever emergency surgical capacity is
available.
6. There is no evidence that routine electronic fetal monitoring during labor
has a positive effect on the outcome of pregnancy.
7. There is no indication for pubic shaving or a pre-delivery enema.
8. Pregnant women should not be put in a lithotomy position (flat on the
back) during labor or delivery. They should be encouraged to walk during
labor and each woman must freely decide which position to adopt during
delivery.
9. The systematic use of episiotomy (incsion to enlarge vaginal opening)
is not justified.
10. Birth shoud not be induced (started artificially) for convenience, and
the induction of labor should be reserved for specific medical indications.
No geographic region should have rates of induced labor over 10%.
11.During delivery, the routine administration of analgesic or anesthetic
drugs, that are not specifically required to correct or prevent a complication
in delivery, should be avoided.
12. Artificial early rupture of the membranes, as a routine process, is not
scientifically justified.
13. The healthy newborn must remain with the mother, whenever both their
conditions permit it. No process of observation of the healthy newborn justifies
a separation from the mother.
14. The immediaate beginning of breastfeeding should be promoted, even before
the mother leaves the delivery room. (presuming she has given birth in a
facility)
15. Obstetric care services that have critical attitudes towards technology
and that have adopted an attitude of respoect for the eotional, psychological
and social aspects of birth should be identified. Such services should be
encouraged and the processes that have led them to their position must be
studied so that they can be used as models to foster similar attitudes in
other centers and to infuluence obsetetrical views nationwide.
16. Governments should consider developing regulations to permit the use
of new birth technology only after adequate evaluation.
These recommendations are taken from a report
on Appropriate Technology for Birth published by the WHO in April 1985.
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