Towards Evidence Based Practice for Low Risk Women
The relative benefits and risks for healthy mothers and babies of giving birth outside an obstetric unit have been widely debated in Western countries since the latter part of the 20th century.
Conditions conducive to spontaneous birth in low-risk women
From an extensive review of recent research on birth outcomes in different settings, the National Institute for Clinical Excellence (NICE) has concluded that giving birth outside an obstetric unit is the optimal choice for low-risk women. Consistent evidence shows that for women at low risk of complications giving birth in an obstetric unit is associated with a higher incidence of interventions that carry increased risk of morbidity, compared with planning birth at home or in a midwifery-led unit.
In its efforts to oblige professionals to understand the risks and benefits of routine interventions and procedures that have become synonymous with intrapartum obstetric led care, the report uses current evidence to recommend judicious practices that minimise interference and promote appropriate use of all interventions deemed necessary for mother and baby.
The report provides sufficient evidence for parents to make informed choices about obstetric procedures, pharmacological agents used during and after birth, and routine practices that disrupt maternal-infant contact following birth. The report also reviews available evidence on the safety and effectiveness of non-pharmacological methods of pain relief in labour, including massage. Here, available evidence shows that breathing and relaxation techniques or massage by birth partners may significantly reduce perceived pain and anxiety in labour and do not adversely affect maternal or neonatal outcomes (NICE 2014)
National Collaborating Centre for Women's and Children's Health, Intrapartum Care: Care of healthy women and their babies during childbirth, Clinical guideline 160: Final version December 2014, Commissioned by the National Institute for Clinical Excellence (NICE).