The World Health Organization, already in 1985 with the Declaration of Strength and later with the guidelines of 1996 and 2001 published its recommendations on the attention to the normal childbirth. Many of them have been fortunately included in the Strategy for Normal Childbirth Care recently promoted by the Spanish Ministry of Health.
The O.M.S considers a "normal birth" this: "Spontaneous onset, low risk at the start of labor and thus remain during labor and birth. The baby is born spontaneously in a cephalic presentation between 37 and 42 full weeks of pregnancy. After birth the mother and baby are in good conditions."
However, the scope of these recommendations is not completely known to women and their families. Many of the practices that WHO advised against They have continued to be carried out during these years and I believe that there is no record of their total abandonment at present, although surely the delivery care will gradually be humanized and improved.
The medical practices that the WHO considers useless and even harmful in normal deliveries have seemed to me to be obligatory for pregnant women. These are:
Acts that are clearly harmful or ineffective and should be eliminated.
1) Routine use of enemas 2) Routine use of pubic hair removal 3) Routine use of intravenous infusions 4) Prophylactic insertion of intravenous routes 5) Rectal examinations 6) Routine use of the supine position during delivery 7) Use of radiological pelvimetries 8) Administration of oxytocics at any time during delivery, so that their effect cannot be controlled. 9) Routine use of the lithotomy position 10) Sustained and constant thrusts (Valsalva maneuver) during the expulsion. 11) Massage and stretching of the perineum during the expulsion. 12) Use of oral Ergometrine tablets in delivery, to prevent or control bleeding. 13) Routine use of parenteral Ergometrine in delivery. 14) Routine uterine lavage after delivery. 15) Routine manual exploration of the uterus after delivery.
