Care in Normal Birth (WHO, 1996, 60 p.): BACK COVER

Care in Normal Birth (WHO, 1996, 60 p.)

(introduction...)

ACKNOWLEDGEMENTS

1. INTRODUCTION

1.1 Preamble

1.2 Background

1.3 Risk Approach in Maternity Care

1.4 Definition of Normal Birth

1.5 Aim of the Care in Normal Birth, Tasks of the Caregiver

1.6 The Caregiver in Normal Birth

2. GENERAL ASPECTS OF CARE IN LABOUR

2.1 Assessing the Well-being of the Woman during Labour

2.2 Routine Procedures

2.3 Nutrition

2.4 Place of Birth

2.5 Support in Childbirth

2.6 Labour Pain

(introduction...)

2.6.1 Non-pharmacological methods of pain relief

2.6.2 Pharmacological pain relief in labour

2.7 Monitoring the Fetus during Labour

(introduction...)

2.7.1 Assessment of amniotic fluid

2.7.2 Monitoring the fetal heart rate

2.7.3 Fetal scalp blood examination

2.7.4 Comparison of auscultation and electronic fetal monitoring

2.8 Cleanliness

3. CARE DURING THE FIRST STAGE OF LABOUR

3.1 Assessing the Start of Labour

3.2 Position and Movement during the First Stage of Labour

3.3 Vaginal Examination

3.4 Monitoring the Progress of Labour

3.5 Prevention of Prolonged Labour

(introduction...)

3.5.1 Early amniotomy

3.5.2 Intravenous infusion of oxytocin

3.5.3 Intramuscular oxytocin administration

4. CARE DURING THE SECOND STAGE OF LABOUR

4.1 Physiological Background

4.2 The Onset of the Second Stage

4.3 The Onset of Pushing during the Second Stage

4.4 The Procedure of Pushing during the Second Stage

4.5 Duration of the Second Stage

4.6 Maternal Position during the Second Stage

4.7 Care of the Perineum

(introduction...)

4.7.1 “Guarding the perineum” during delivery

4.7.2 Perineal tear and episiotomy

5. CARE DURING THE THIRD STAGE OF LABOUR

5.1 Background

5.2 Prophylactic use of Oxytocics

5.3 Controlled Cord Traction

5.4 Active Versus Expectant Management of the Third Stage

5.5 Timing of Cord Clamping

5.6 Immediate Care of the Newborn

5.7 Care of the Mother Immediately after Delivery of the Placenta

6. CLASSIFICATION OF PRACTICES IN NORMAL BIRTH

(introduction...)

6.1 Practices which are Demonstrably Useful and Should be Encouraged

6.2 Practices which are Clearly Harmful or Ineffective and Should be Eliminated

6.3 Practices for which Insufficient Evidence Exists to Support a Clear Recommendation and which Should be Used with Caution while Further Research Clarifies the Issue

6.4 Practices which are Frequently Used Inappropriately

7. REFERENCES

8. LIST OF PARTICIPANTS

SAFE MOTHERHOOD RESOURCE LIST

BACK COVER

BACK COVER

Complications arising during pregnancy and childbirth cause the deaths of hall a million women every year, the vast majority in the developing world. Over 4 million newborn babies die each year, most of them as a result of poorly managed pregnancies and deliveries. Millions more women and babies suffer debilitating and life-long consequences of ill-health.

The World Health Organization seeks to alleviate the burden of suffering borne by women, children and families, through its Maternal Health and Safe Motherhood Programme which seeks to reduce levels of maternal and neonatal mortality and ill-health significantly by the year 2000,

The Organization’s activities fall into four main areas:

· technical cooperation with countries in planning, implementing, managing and evaluating national safe motherhood and newborn care programmes;
· epidemiological research into levels and causes of maternal and neonatal mortality and operational research on cost-effective ways of reducing deaths and disabilities;
· strengthening human resources for the provision of essential obstetric care, including development of standard treatment and management protocols, programme planning guidelines and training materials;
· production of advocacy materials and collection, analysis and dissemination of information to provide scientifically sound data on the nature and dimensions of maternal and newborn mortality and morbidity and how change can be brought about,

If you would like to know more about the WHO Maternal and Newborn Health/Safe Motherhood Unit, write to:

Maternal and Newborn Health/Safe Motherhood
Division of Reproductive Health (Technical Support)
World Health Organization
1211 Geneva 27
Switzerland