Sunday, November 14, 2010


Thanks Carolyn (Thinkbirth)for this link: and yes Carolyn you are correct in saying every item could be a blog on its own......

The World Health Organization (WHO) definition of normal birth is: ‘Spontaneous in onset, low-risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex position between 37 and 42 completed weeks of pregnancy. After birth mother and infant are in good condition’.

It is a pity not every State and Territory in Australia adopts this policy TOWARDS NORMAL BIRTH: NSW is leading the way: the policy is aimed to increase normal birth and decrease surgical intervention. Western Australia needs to take a leaf out of the NSW book: I may even suggest it to our Minister of Health and our Chief Nurse and our Midwifery Advisor to see if we could not adopt this proactive lead to ensure that Normal Birth is the focus; even better I might give them Carolyn's 21 strategies to keep birth normal........

10 Steps
1. Have a written normal birth policy/guidelines, along with other
relevant policies, that are routinely communicated to all health care staff

2. Train all health care staff in skills necessary to
implement this policy

3. Provide or facilitate access to midwifery continuity of carer programs in collaboration with GPs and obstetricians for all women with appropriate consultation, referral and transfer guidelines in place

4. Inform all pregnant women about the benefits of normal birth and
factors that promote normal birth

5. Have a written policy on pain relief in labour that includes the use
of water immersion in labour and birth

6. Have a written postdates policy/guideline that is routinely
communicated to all health care staff (All women have an agreed due date of birth
documented in their health record)

7. Provide or facilitate access to vaginal birth after caesarean section
operation (VBAC) that is supported by a written vaginal birth after
caesarean section operation policy/guideline (develop statewide workshop of GPs, midwives and obstetricians to exchange views and skills regarding VBAC)

8. Provide or facilitate access to external cephalic version

9. Provide one to one care in labour for all women experiencing their
first labour or undertaking a vaginal birth after caesarean section
operation, vaginal breech or vaginal twin birth (implement local guidelines/protocols that discourage activities that separate midwives from the woman in labour. This includes the use of centralised monitoring systems as they discourage midwives from being with the woman in the labour room)

10. Provide formal debriefing in the immediate postpartum period for all women requiring primary caesarean section operation or instrumental birth with the opportunity for further discussion and information transfer

What I really like is Carolyn's inspirational and passionate list: this is how it should really plain simple language that everyone understands....

Carolyn's 21 Strategies to help keep birth Normal:

1. Avert the medical 'gaze'

2. Be powerful and able to negotiate as equals to doctors

3. Establish a "round table culture'

4. Dispel 'urban myths' about birth

5. Support women to choose upright positions in labour

6. Educate teenagers

7. Promote the use of positive images of birth

8. Look at system issues: promote and change to woman centred midwifery models

9. Discuss what normal birth means to us and ensure we are talking about the same things

10. Listen to women with respect - what does the woman want?

11. Encourage women in labour to stay home as long as possible

12. Establish and provide support structures to help women stay at home in early labour

13.Establish and provide support structures so women can choose to stay home to give birth if desired

14. Examine our own attitudes to 'being with woman' in pain and uncertainty

15. Seek to establish a relationship with each woman

16. Allay fear: let woman know what birth is really about

17. Address anxiety of support people and other health professionals

18. Pay attention to the language we use

19. Have confidence in women's ability to give birth

20. Pay attention to our body language as body language conveys meaning: what are we saying?

21. Set up birth space intentionally - find out what makes each woman feel safe and do that.

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