GENEVA - The World Health Organization (WHO) warns healthy pregnant women are undergoing unnecessary medical interventions at an alarming rate. Given the trend, WHO is launching new recommendations aimed at reducing potentially harmful interventions.
The organization reports most of the estimated 140 million annual births occur without complications. Yet, it says over the past 20 years there has been a significant rise in medical interventions previously used to avoid risks. These include oxytocin infusion to speed up labor and caesarean sections.
WHO says health providers tend to intervene medically when the rate of labor appears to be slower than what is considered normal. This is based on a long-held benchmark for cervical dilation to occur at a rate of one centimeter per hour.
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.
He says WHO has set another boundary for cervical dilation of up to five centimeters per hour during the first stage of labor until the woman is ready to push out the baby.
“It should not be longer than 12 hours in first-time mothers. And it should not be longer than 10 hours in subsequent labors…. So, as long as a woman is making some progress within that time frame, and the condition of the mother as well as the baby are reassuring, then there should be no reason for intervening,” Oladapo said.
WHO warns unnecessary labor and potentially harmful routine medical interventions are rampant in all parts of the world - in poor and rich countries alike. WHO’s new guidelines include 56 evidence-based recommendations on best care for mother and baby during labor and immediately after.
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.