Physiologically-sound practices to promote spontaneous labor & birth at term:

Definition of physiological: “ accord with, or characteristic of, the normal functioning of a living organism

(Stedman’s Medical Dictionary – 1995)

1. Continuity of care
2. Patience with nature
3. Social and emotional support
4. Full-time presence or immediate availability to laboring woman by the primary caregiver or birth attendant during active labor
5. Mother-controlled environment (place) for labor and birth
6. Provision for appropriate psychological privacy (persons present)
7. Mother-directed activities, positions & postures for labor & birth
8. Opportunity for an upright and mobile mother during active labor
9. Recognition of the non-erotic but none-the-less sexual nature of spontaneous labor & normal birth
10. Non-pharmaceutical pain management such as walking, one-to-one care, touch relaxation, showers & deep water tubs, other physiological care strategies
11. Judicious use of drugs and anesthesia when needed (for hospitalized women)
12. Absence of arbitrary time limits as long adequate progress, mom & babe OK
13. Vertical postures, pelvic mobility and the right use of gravity for pushing
14. Birth position by maternal choice unless medical factors require otherwise
15. Mother-Directed Pushing – NO prolonged breath-holding (Valsalva Maneuver)
16. Physiological clamping/cutting of umbilical cord – after circulation between baby and placenta has stopped (average 3-6 minutes)
17. Immediate possession and control of healthy newborn by mother and father
18. On-going & unified maternity care and support of the mother-baby during the postpartum/postnatal period

These evidence-based practices should standard care for healthy women with normal pregnancies, regardless of the category of maternity care provider (physician or midwife) or setting for labor and birth (hospital, home or birth center).

American College of Community Midwives ~ Copyright 2006