The World Health Organization released new guidelines that state women should have more say in the labor and delivery room.
The guidelines emphasize that a slower cervical dilation rate alone should not be a routine indication for intervention to accelerate labor or expedite birth. These include oxytocin infusion to speed up labor and caesarean sections.
The WHO, among 26 recommendations, rejected a traditional benchmark in labour wards worldwide for the dilation of a woman's cervix at the rate of 1 centimeter per hour, saying it was "unrealistic" and often led to excessive caesarean sections.
"However, the increasing medicalization of normal childbirth processes are undermining a woman's own capability to give birth and negatively impacting her birth experience", said Princess Nothemba Simelela, the Assistant Director-General at the UN World Health Organization (WHO) for Family, Women, Children and Adolescents.
Olufemi Oladapo, a medical officer in WHO's department of Reproductive Health and Research, says every labor and childbirth is unique, and it is perfectly normal for some women to be slower than the prescribed rate of cervical dilation. About 830 women die from pregnancy- or childbirth-related complications around the world every day - the majority could be prevented with high-quality care in pregnancy and during childbirth. Studies show that a substantial proportion of healthy pregnant women undergo at least one clinical intervention during labour and birth. In subsequent labours it usually does not extend beyond 10 hours. These are all essential elements of good quality labour and childbirth care that every woman and her baby should receive.
Cesarean rates of more than 10-15 percent do not appear to lead to any significant drop in mortality rates of mother or child, said WHO's Metin Gülmezoglu.
Among middle-income economies, Latin America, Turkey, China, and Iran have high cesarean rates, but so do some hospitals in sub-Saharan Africa, "and often not for the right reasons", he said.
While these interventions are meant to help women and their babies, they can have negative effects, the United Nations health agency says in its guidelines that were presented on Thursday in Geneva. Adopting a woman-centred philosophy and a human-rights based approach opens the door to numerous care options that women want such as the right to have a companion of choice with them throughout the labour and birth as well as the freedom to move around during the early stages of labour and to choose their position for birth.
These include permitting a woman to have a companion of choice present during labor and childbirth; ensuring good communication between women and health providers; and allowing women to make decisions about their pain management, labor and birth positions.
Episiotomy, a cut made to the woman's outer genital area to widen the birth canal, is not recommended routinely.
Worldwide, an estimated 140 million births take place every year and most of these occur without complications for women and their babies, the World Health Organisation (WHO) has said.
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