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Birth Is Not An Illness
Recommendations made by the
World Health Organization
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MOONDRAGON ARTICLES
Birth Is Not An Illness
Recommendations made by the
World Health Organization
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 Information about birth practices in hospitals (rates of cesarean section, etc.) should be given to the public served by the hospitals. There is no indication for pubic shaving or a pre-delivery enema. Birth should not be induced for convenience. No geographic region should have rates of induced labor over 10%.> Artificial early rupture of the membranes, as a routine process, is not scientifically justified. There is no evidence that routine intrapartum electronic fetal monitoring has a positive effect on the outcome of pregnancy. Electronic fetal monitoring should be carried out only in carefully selected medical cases (related to high perinatal mortality rates) and in induced labor. Countries should carry out investigations to select specific groups of pregnant women who might benefit from electronic fetal monitoring. Until such time as results are known, national health care services should abstain from purchasing new monitoring equipment. Pregnant women should not be in the lithotomy position during labor or delivery. They should be encouraged to walk about during labor and each woman must freely decide which position to adopt during delivery. 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. There is no justification in any specific geographic region to have more than 10-15% cesarean section births. There is no evidence that a cesarean section is required after a previous transverse low segment cesarean section birth. Vaginal deliveries after a cesarean should normally be encouraged wherever emergency surgical capacity is available. The immediate beginning of breast-feeding should be promoted, even before the mother leaves the delivery room. The healthy newborn must remain with the mother, whenever both their conditions permit. No process of observation of the healthy newborn justifies a separation from the mother. Governments should consider developing regulations to permit the use of new birth technology only after adequate evaluation.