Women to provide with more time during childbirth, says WHO

Women: the blessed being on land as they bore the fertility to give birth deserves better quality of care in health facilities with skilled health professionals and timely referrals.

Women should be given more time to give birth without medical interventions such as caesarean sections, and should be more involved in the decision-making, the World Health Organization (WHO) says.

The majority of women can give birth without complications, the WHO said in a set of 56 recommendations issued last week, yet a substantial portion undergo at least one medical intervention (such as being administered oxytocin to speed up labour, or having a caesarean section), and many are subjected to “needless and potentially harmful routine interventions.

Women should be allowed to choose their delivery position, including squatting or sitting, and be offered pain relief, said the doctor who presented the report. The guideline emphasizes that a slower cervical dilation rate alone should not be a routine indication for intervention to accelerate labor or expedite birth.

According to Ian Askew, the head of WHO Department of Reproductive Health and Research, when a medical intervention is wanted or needed, the inclusion of women in making decisions about the care they receive is important to ensure that they meet their goal of a positive childbirth experience.

World Health Organization anticipates that this new recommendation will help to substantially reduce the growing rate of unnecessary caesarean sections that has now reached an epidemic proportion.

The experiences of laboring women vary widely across the provinces and territories, with rates of inductions, epidurals, and episiotomies differing depending on where in the country you happen to live.

But research in the past 15 years, including a WHO study of 10,000 women in Nigeria and Uganda, has shown the rate can be slower without endangering the health of a woman or child.

To reduce unnecessary medical interventions, the World Health Organization guideline states that the previous benchmark for cervical dilation rate at 1 cm/hr during the active first stage of labor may be unrealistic for some women and is inaccurate in identifying women at risk of adverse birth outcomes.

NHS advice suggests that intervention should be considered if cervical dilation is less than 2cm in four hours – roughly half the “normal” rate.

“We want women to give birth in a safe environment with skilled birth attendants in well-equipped facilities”, said Dr Princess Nothemba Simelela, WHO assistant director-general for family, women, children and adolescents.

“Pregnancy is not a disease and child birth is a normal phenomenon, where you expect the woman to be able to accomplish that on her own without interventions”, Dr. Oladapo said.

Despite the risks, many women are opting for C-section deliveries nowadays, simply because they want to avoid labour pain or coincide with certain events, even though there are no complications with their pregnancies.

Medical staff and midwives should not intervene to speed up a woman’s labour unless there are real risks of complications, says the World Health Organisation (WHO).

For health care facilities, in addition to providing the clinical care specific to labour and childbirth, it also means making sure that women are treated with respect and that they have the very basics of oral fluids and food during labour and childbirth.

Sources reveal, according to 2015-2016 data from the Canadian Institute for Health Information, in Canada, 27 per cent of births were by C-section in 2010, up from 19 per cent in 1997, according to the Journal of Obstetrics and Gynaecology Canada. Women age 35 and older were more likely to have a primary C-section than younger women.

Rates of intervention in labour and birth showed considerable variation across Canada, suggesting that usage is not always evidence based.

Image Source: Shutterstock

by Israt Yasmin, The Blogging Connection

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