10 steps to a normal birth

Every maternity unit should seek to promote normality in childbirth by:

1. Providing care from a small group of midwives and others who are kind, sensitive and skilled in their work.
   
   
2. Using as a basis for all policies, guidelines, and clinical decision-making a profound understanding of the anatomy, physiology and psychology of pregnancy, birth and breastfeeding.
    
3. Offering to women only those interventions for which clear evidence exists that they do more good than harm.
    
4. Creating a therapeutic physical environment which protects and promotes the natural hormonal releases which are needed for normal labour and birth.
    
5. Supporting a woman’s preference for place of birth and birth companion, and ensuring she has skilled, one-to-one support during labour.
    
6. Adopting the Ten Steps to Successful Breastfeeding.
    
7. Recognising the wider context of women’s lives and aiming for equity in the way care is offered. Seeking, through partnership with support groups and other agencies, to acknowledge and address problems such as a history of abuse, violent relationships, poverty, mental illness, drug and alcohol abuse and poor housing.
    
8. Explaining clearly and honestly to women the advantages and disadvantages of the available screening tests, and being equally respectful of the acceptance or refusal of such tests.
    
9. Encouraging and providing a range of minimally-invasive measures to support women through the pain of labour, such as; birth pools, TENS, birth balls, massage and so on, to reduce the woman’s use of epidurals and pethidine, which are inconsistent with physiological birth.
   
   
10. Offering antenatal and postnatal programmes which are empowering and which prepare women for the physical, mental and spiritual dimensions of birth and parenthood.

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