Making normal birth a reality

AIMS Journal, 2007, Vol 19 No 4

National Childbirth Trust press release 15.11.07

The multi-disciplinary Maternity CareWorking Party (MCWP) has developed a consensus statement on normal birth. The statement is calling for a precise working definition of 'normal birth' across the UK to enable accurate comparisons to be made for similar women using different services and models of care.

The consensus statement includes discussion about why normal birth matters and recommendations for action to support normal birth. The statement also calls for all health trusts and boards across the UK to use the Information Centre definition of 'normal delivery' and to collect and publish normal birth statistics regularly.

The MCWP is concerned about rising inter vention rates and variations between different services in terms of planned and unplanned caesareans, and operative births, since these are associated with higher rates of illness.

The statement recommends that attention be paid to providing a comfortable and supportive environment to all women during labour to help them relax and feel secure. Also, medical procedures that are known to increase the likelihood of intervention should be avoided where possible.

Recent statistics for normal birth show that rates have fallen over the last two decades - figures for 2005 show that in England around 48% of women having their baby in hospital had a normal birth compared to 60% in 1990, using the definition adopted by the Department of Health, and in 2005 in Scotland 39.4% had a normal birth compared to 42% in 2001.

Gail Werkmeister, National Childbirth Trust (NCT) President and Chair of the Maternity Care Working Party, said; "This statement calls for a standard definition of normal labour and birth so that normal birth rates can be audited in all settings and compared with confidence.

"We want to encourage a positive focus on normal birth. With appropriate care and support the majority of women can have a normal birth, with a minimum of medical procedures. Most women prefer to avoid interventions provided their baby is safe and they feel they can cope."

Frances Day-Stirk, Director of Learning, Research and Practice Development at the Royal College of Midwives(RCM) said; "The RCM welcomes this whole-hear tedly as it helps put normal birth back on the agenda, and is in line with the RCM's own Campaign for Normal Birth. It is a concern that the number of women having a 'normal birth' is becoming the exception. This document is good and shows that women, midwives and other health care staff are working together."

Professor Sabaratam Arulkumaran, President of the Royal College of Obstetricians and Gynaecologists, said; "We support normality and informed choice for women, but for both to be a reality, appropriate systems need to be in place to provide the safest possible service. Complications in labour are often unpredictable and all women should receive one-to-one care from a midwife throughout childbirth so that warning signs are quickly detected. In order for maternity services to be as safe as possible staffing levels need to be addressed, an immediate increase in both midwives and obstetricians is required.

"The presence of consultant obstetricians in the labour ward will help reduce inter ventions and increase normal birth rate."

The statement recognises policies for maternity care are separate for each of the four countries of the UK, however it is committed to offering pregnant women more choice, with better access to normal birth across the UK.

Copies of the consensus statement are available to download from: http://www.appg-maternity.org.uk