Dr Princess Nothemba Simelela
The World Health Organisation (WHO) has issued new recommendations to establish global care standards for healthy pregnant 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.
These 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.
“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,” Dr Princess Nothemba Simelela, WHO Assistant Director-General for Family, Women, Children & Adolescents, indicated.
“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,” she added.
The new WHO guideline recognises every labour and childbirth as unique and that the duration of the active first stage of labour varies from one woman to another.
The guideline stated that the previous benchmark for cervical dilation rate at 1 cm/hr during the active first stage of labour may be unrealistic for some women and is inaccurate in identifying women at risk of adverse birth outcomes.
It, therefore, emphasized that a slower cervical dilation rate alone should not be a routine indication for intervention to accelerate labour or expedite birth.
“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,” Ian Askew, WHO Director, Department of Reproductive Health & Research pointed out.
Worldwide, an estimated 140 million births take place every year. Most of these occur without complications for women and their babies. Yet, over the past 20 years, practitioners have increased the use of interventions that were previously only used to avoid risks or treat complications such as oxytocin infusion to speed up labour or caesarean sections.
Childbirth is a normal physiological process that can be accomplished without complications for the majority of women and babies. However, studies show a substantial proportion of healthy pregnant women undergo at least one clinical intervention during labour and birth. They are also often subjected to needless and potentially harmful routine interventions.
By Jamila Akweley Okertchiri