BIRTH IS NOT AN ILLNESS!

Publication Date: 
12/1988

15 RECOMMENDATIONS OF THE WORLD HEALTH ORGANIZATION

The following are some of the recommendations of a joint Interregional Conference for Birth, held in 1985 and arranged by the Regional Officers for Europe and the Americas of the World Health Organization (WHO).

The recommendations are based on the principle that each woman has a fundamental right to receive proper prenatal care; that the woman has a central role in all aspects of this care, including participation in the planning, carrying out and evaluation of the care; and that social, emotional and psychological factors are decisive in the understanding and implementation of proper prenatal care.

1. The whole community should be informed about the various procedures in birth care, to enable each woman to choose the type of birth care she prefers.

2. Information about birth practices in hospitals (rates of cesarean section, etc.) should be given to the public served by the hospitals.

3. There is no indication for pubic shaving or a predelivery enema.

4. Birth should not be induced for convenience. No geographic region should have rates of induced labor over 10 percent.

5. Artificial early rupture of the membranes, as a routine process, is not scientifically justified.

6. There is no evidence that routine intrapartum electronic fetal monitoring has a positive effect on the outcome of pregnancy. Electronic fetal monitoring should be carried out only in carefully selected medical cases (related to high perinatal mortality rates) and in induced labor. Countries should carry out investigations to select specific groups of pregnant women who might benefit from electronic fetal monitoring. Until results are known, national health care services should abstain from purchasing new monitoring equipment.

7. Pregnant women should not be put in a lithotomy position (lying flat on back) during labor or delivery. They should be encouraged to walk about during labor, and each woman must freely decide which position to adopt during delivery.

8. During delivery the routine administration of analgesic or anesthetic drugs, that are not specifically required to correct or prevent a complication in delivery, should be avoided.

9. The systematic use of episiotomy is not justified.

10. There is no justification in any specific geographic region to have more than 10-15% cesarean section births.

11. There is no evidence that a cesarean section is required after a previous transverse low segment cesarean section birth. Vaginal deliveries after a cesarean should normally be encouraged wherever emergency surgical capacity is available.

12. The immediate beginning of breastfeeding should be promoted, even before the mother leaves the delivery room.

13. The healthy newborn must remain with the mother whenever both their conditions permit it. No process of observation of the healthy newborn justifies a separation from the mother.

14. Governments should consider developing regulations to permit the use of new birth technology only after adequate evaluation.

15. Technology assessment should be multidisciplinary and involve all types of providers who use the technology. The women on whom the technology is used should be involved in planning the assessment as well as evaluating and disseminating the results. The results of the assessment should be fed back to all those involved in the research as well as to the communities where the research was conducted.

The full set of recommendations is published by the Regional Office for Europe of the WHO. Summary report on the Joint Interregional Conference on Appropriate Technology for Birth, Fortaleza, Brazil 22-26 April 1985. (ICP/NCH 102/m02s)

CONFERENCES

World Association for Infant Psychiatry and Allied Disciplines

4th World Congress, Lugano, Switzerland

September 20-24, 1989

For information contact:

Hiram E. Fitzgerald, Ph.D.

Department of Psychology

Psychology Research Building

Michigan State University

East Lansing, MI 48824-1117 U.S.A.

(517) 355-4599.

THE INFANT-PARENT INSTITUTE

Is a private teaching and clinical service institute specializing in disorders of attachment in infancy and problems of parenting. The Institute is free-standing and receives no government funds. To inquire further about services or to make a referral, call Michael Trout, Director, at the Institute in Champaign, Illinois at (217) 352-4060.

Traineeship applications due: Selection of the 1988-89 clinical trainee will take place this winter, for 10 months of intensive study, supervision and practicum experiences beginning in September (1988). Open to terminal-degree professionals from clinical or developmental psychology, social work, psychiatry, pediatrics, nursing, or related fields, the traineeship is designed to orient the student to clinical practices in infant mental health. Heavy emphasis is placed on supervised practica in assessment and treatment bolstered by a series of seminars on theory. Call Mr. Trout, Director of the Institute, at (217) 352-4060.

THE 9TH INTERNATIONAL CONGRESS ON PRE AND PERINATAL PSYCHOLOGY AND MEDICINE

March 26-31, 1989, Hilton Hotel, Jerusalem, Israel

MAIN TOPICS

Fetal memory; The experience of being born; Psychology of fertilization technologies; the role of antenatal diagnostic techniques; the cultural context of pre and perinatal experience; Encological and radiation hazards to the fetal environment; Aids and the unborn; Prenatal and neonatal ethics; Bonding-reality and fantasy; Cross-cultural perspectives of pre and perinatal psychology; Attitudes of perinatal psychology in various ethnic groups; Psychoneuroendocrinology of the fetus.

FOR FURTHER INFORMATION, PLEASE CONTACT:

ISPP Congress Secretariat

c/o International Ltd.

P.O. Box 29313

65121 Tel-Aviv, Israel

Tel: (03) 654541, Telex: 33554 Intur 11