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

The aim of the care is to achieve a healthy mother and child with the least possible level of intervention that is compatible with safety. This approach implies that:

The tasks of the caregiver are fourfold:

· support of the woman, her partner and family during labour, at the moment of childbirth and in the period thereafter.

· observation of the labouring woman; monitoring of the fetal condition and of the condition of the infant after birth; assessment of risk factors; early detection of problems.

· performing minor interventions, if necessary, such as amniotomy and episiotomy; care of the infant after birth.

· referral to a higher level of care, if risk factors become apparent or complications develop that justify such referral.

This description assumes that referral to a higher level of care can be easily realized. In many countries that is not the case; special regulations are then necessary to enable primary caregivers to perform life saving tasks. This implies additional training, and adaptation of legislation to support the caregiver in these tasks. It also implies agreement amongst caregivers regarding their responsibilities (Kwast 1992, Fathalla 1992).