• 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.
• There is no justification in any specific geographic region to have more than 10-15% cesarean births (the current US rate is around 23%)
• 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.
• There is no evidence that routine electronic fetal monitoring during labor has a positive effect on the outcome of pregnancy.
• Pregnant women should not be put in a lithotomy (flat on the back) position during labor or delivery. They should be encouraged to walk during labor and each woman must freely decide which position to adopt during delivery.
• The systematic use of episiotomy (incision to enlarge the vaginal opening) is not justified.
• Birth should not be induced (started artificially) for convenience and the induction of labor should be reserved for specific medical indications. No geographic region should have rates of induced labor over 10%
• During delivery, the routine administration of analgesic drugs, that are not specifically required to correct or prevent a complication in delivery, should be avoided.
• Artificial early rupture of the membranes, as a routine process, is not scientifically justified.
  **Not all the recommendations were listed. Only those that corresponded to the US birth stats were listed. Please visit WHO's website for complete list.

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In the United States...
 

• 27.6% of women have cesareans*
   
• 44% of mothers get induced
   
• 63% of mothers have epidurals
   
• 93% of mothers have electronic fetal heart monitoring
   
• 53% of mothers are given synthetic oxytocin to augment (stimulate) labor.
   
• 52% of mothers are given a bladder catheter
   
• 85% of mothers are connected to an IV line during labor
   
• 58% of mothers have a gloved hand inserted into their uterus after birth
   
• 35% of mothers have an episiotomy
   
• 74% of mothers who give birth vaginally are on their backs while giving birth. Even though research shows this is the worst position for a woman to be in!
   
• 58% of mothers with a previous cesarean were denied a VBAC (Vaginal Birth After Cesarean)
   
• 12% of mothers were permitted to eat during labor
  *source: Centers for Disease Control, 2003

  The figures above (except for cesareans) are taken from the Maternity Center Association's 2002 "Listening to Mothers" survey in collaboration with Harris Interactive (the Harris Poll group). This is the first national U.S. survey of women's childbearing experiences. Information was gathered from 1,583 women having babies between 2000 and 2002.

  This is not what we call 'normal birth' even though these procedures are becoming the 'norm'.

  The US spends the most money on maternal and infant care in the world but has yet to improve its outcomes. Many of the procedures listed above were implemented to do just that but they haven't improved anything. According to the World Health Organization** there are on average 21 other countries in the world whose infant and maternal mortality rates are better than ours. If we would implement the WHO's recommendations we could dramatically cut insurance premiums and the cost of health care! That would amount to between 10 to 15 BILLION dollars saved each year!

  ** Refer to the WHO's website.