Individualized, supportive care key to positive childbirth experience: WHO

Kolkata: The World Health Organisation (WHO) has issued new recommendations to establish global care standards for healthy pregnant women and reduce unnecessary medical interventions.

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.

“We want women to give birth in a safe environment with skilled birth attendants in well-equipped facilities. However, the increasing medicalization of normal childbirth processes are undermining a woman’s own capability to give birth and negatively impacting her birth experience,” WHO Assistant Director-General for Family, Women, Children and Adolescents Dr Princess Nothemba Simelela said.

“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 said.

Today, there is a massive discrepancy in the support provided to women around childbirth. At one end of the spectrum, they are offered too many medical interventions too soon. At the other, they get too little support too late - or none at all. At neither end, do women have the positive childbirth experience they desire and deserve, Dr Simelela said.

She said a normal uncomplicated pregnancy should result in the birth of a healthy child. — Unfortunately, this natural process is too often treated as a high-risk event for fear of adverse birth outcomes. This results in an intense global focus on good clinical outcomes, which, although desirable, can over-ride women’s own preferences, and lead to their subjection to unnecessary interventions.

Women are also reporting high levels of disrespect and abusive care during facility-based childbirth in all regions and cultures. This can totally overshadow one of the most pivotal moments in a woman’s life – the day she welcomes her baby into the world, she said.

Undoubtedly, encouraging women to give birth in health facilities, where there are skilled birth attendants, is essential and has helped reduced global newborn and maternal mortality rates for decades. However, there is room for improvement on the quality of care provided in these facilities, Dr Simelela said.

To meet Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all at all ages, we cannot keep our focus solely on survival. High quality care for all pregnant women and their newborns, throughout pregnancy, childbirth and the postnatal periods, is essential to ensure that mothers and children both survive and thrive, she added.