WHO issues new guidelines to reduce birth interventions

By Julie Griffiths on 16 February 2018 Interventions Intrapartum care World Health Organisation

WHO has announced new recommendations to establish global care standards for healthy women and reduce unnecessary medical interventions.

The new WHO guideline includes 56 evidence-based recommendations on what care is needed throughout labour and immediately after for the woman and her baby.

The suggestions include having a companion of choice during labour and childbirth; ensuring respectful care and good communication between women and health providers; maintaining privacy and confidentiality; and allowing women to make decisions about their pain management, labour and birth positions and natural urge to push, among others.

According to WHO, the guideline recognises that every labour and childbirth is unique and that the duration of the active first stage of labour varies from one woman to another.

The guideline states that the previous benchmark for cervical dilation rate at 1cm/hr during the active first stage of labour (as assessed by a partograph or chart used to document the course of a normal labour) may be unrealistic for some women and is inaccurate in identifying women at risk of adverse birth outcomes.

The guideline emphasises that a slower cervical dilation rate alone should not be a routine indication for intervention to accelerate labour or expedite birth.

WHO assistant director-general for family, women, children and adolescents Dr Princess Nothemba Simelela said: ‘We want women to give birth in a safe environment with skilled birth attendants in well-equipped facilities. However, the increasing medicalisation of normal childbirth processes are undermining a woman’s own capability to give birth and negatively impacting her birth experience.’

She added: ‘If labour is progressing normally, and the woman and her baby are in good condition, they do not need to receive additional interventions to accelerate labour.’

WHO director of the department of reproductive health and research Ian Askew said: ‘Many women want a natural birth and prefer to rely on their bodies to give birth to their baby without the aid of medical intervention. Even when a medical intervention is wanted or needed, the inclusion of women in making decisions about the care they receive is important to ensure that they meet their goal of a positive childbirth experience.’

Access the new recommendations here.