A respected or humanized birth is one in which the wishes and needs of the woman giving birth are taken into account, her rights and those of the baby are respected, as well as the physiological process of childbirth itself, avoiding unnecessary interventions.
More and more hospitals, following WHO recommendations, offer women a positive, respectful and humanized birth experience. These are the main points to consider in order to have a respected delivery .
Be treated with respect
We start with the first fundamental premise that brings together all the following: pregnant women should be treated with respect , as anyone deserves.
For some years now, the WHO has made its position on disrespect and abuse during childbirth clear: they must be eradicated, since all women have the right to dignified and respectful care during pregnancy and childbirth, and the right not to suffer physical or verbal violence, or discrimination.
Listen and take into account the wishes of the mother
The birth plan is a written document prepared by the pregnant woman where her preferences, needs, wishes and expectations regarding the moment of delivery and birth of her baby are reflected. Any woman has the right to develop a birth plan and change her preferences at any time during pregnancy or delivery, depending on her condition and the development of events.
This document must be taken into account by the health professionals who care for the woman at the time of delivery, although some of the points contemplated could be modified if unforeseeable circumstances arise that require it.
- To develop a birth plan, see here.
- To develop a cesarean delivery plan, see here.
Right to be accompanied
The woman who gives birth has the right to be accompanied throughout the labor process (phases of labor, delivery and postpartum) by the person she chooses, whether it is a natural birth or a cesarean section, provided that the circumstances do not advise against it.
And it is that the fact that the woman can be accompanied by a person of her choice , favors a positive birth experience, improves the emotional state of the mother and facilitates the realization of skin to skin with her child.
The woman must be informed at all times
The woman is the owner of her body, of her pregnancy and of her delivery , so she has the right to know at all times what procedures are going to be performed on her or her baby. Likewise, any procedure, intervention or use of medication during labor and postpartum must be justified, avoiding unnecessary procedures.
Do not perform interventions without consent
In line with the above, if it is necessary to carry out a procedure on the woman , this should not only be informed in a clear and accessible language, but the mother should have the opportunity to ask and clarify all her doubts before giving or deny your consent.
Among the interventions that must have the consent of the woman would be vaginal examinations, the Hamilton maneuver or rupture of membranes, bladder catheterization, episiotomy at the time of delivery and, in general, any invasive diagnostic and therapeutic procedure.
Allow time for labor to begin and do not accelerate dilation
Childbirth is a natural process that should not be forced. Everything is synchronized so that the hormones do their job when the right moment arrives, therefore, and except for duly justified exceptions (which in no case should be greater than 10% of deliveries), inductions should not be carried out.
Likewise, when dilation has begun, it is important to allow time for the body to do its work and not to accelerate this process with medical interventions such as oxytocin stimulation or cesarean section, as long as the good conditions of the baby and the mother are ensured.
Avoid unnecessary and / or not recommended practices
Little by little, hospitals are banishing unnecessary practices for the correct course of delivery, as well as at the time of birth.
According to the WHO, some of these unnecessary practices would be performing vaginal examinations at intervals of less than four hours when labor has started, routine pubic or perineal shaving before vaginal delivery (a practice that is not without risks and that is not has shown benefits), the prepartum enema, or episiotomy during delivery by default.
As for the baby , routine nasal or oral aspiration after birth would be considered not recommended practices according to the WHO. Nor should the baby be bathed or cleaned immediately after birth, as the vernix caseosa with which they are born has important benefits for their health.
Special mention should be made of the issue of caesarean sections , a major abdominal surgery that should only be performed with justification when the health of the mother and / or the baby so advises. If the practice of cesarean section is justified, except in special situations, it should not be scheduled before week 39 and in twin pregnancies at week 38.
Freedom of movement during dilation
Whenever she wishes and is possible, the woman has the right to be able to move freely during the dilation process, since the mother’s movements favor the descent and fit of the baby, which with its own weight helps to soften the cervix to favor the birth.
More and more hospitals offer women resources to facilitate this freedom of movement (balls, lianas, bathtubs, design and functional furniture in the room …), as well as analgesic methods that relieve pain without impeding movement
Freedom to choose the position to give birth
Likewise, when it is time for the expulsion, the woman should be able to choose the position with which she feels most comfortable to give birth (lying down, standing, squatting, on all fours …). There is no more appropriate posture than another, but this will be chosen by the woman naturally following her own instinct.
In this sense, many hospitals already have vertical delivery stools or chairs so that the woman can give birth sitting down if she wishes.
Late cord cutting
At the time of delivery, a respected delivery would also go through waiting two to three minutes before cutting the cord . And it is that it has been shown that the late cutting of the umbilical cord allows more blood to reach the baby, which translates into more iron, more hemoglobin, a greater antioxidant effect and a decrease in inflammation in cases of induced labor.
Skin to skin at birth
Whenever the situation allows it, as soon as the baby is born, skin-to-skin contact between mother and baby should be facilitated -also in the case of caesarean sections-, allowing her to take him in her arms and place him on her chest. This practice carried out early has been shown to have innumerable benefits for mother and baby, in addition to strengthening the bond and favoring the establishment of breastfeeding.
The baby should not be separated from his mother’s breast unless his health conditions so indicate. In this way, face down on his mother’s body, he can be evaluated, dried, identified and even the Apgar test can be performed without the need to separate them. The rest of the routine tests and procedures can be postponed until later or carried out at the moment but always in the presence of the mother.
If for some reason the mother cannot be in skin-to-skin contact with her baby, this practice should be encouraged with the father or companion of the woman at the time of delivery.
Do not separate mother and baby
During the time that the mother and the baby remain in the hospital, skin-to-skin contact and non-separation of both must be guaranteed at all times. Certain medical examinations and examinations can be done in the room with the parents or on the mother’s breast, to minimize pain and stress for the baby.
If the baby has any health condition for which he or she needs to be admitted to a Neonatal Intensive Care Unit, whenever possible the kangaroo method and breastfeeding without schedules should be favored. In fact, there are already several hospitals that have projects that facilitate the cohabitation of the baby and his parents while the admission lasts, since being together is a right of both the child and the parents.
Encourage and support breastfeeding
It is important that, from the delivery room, the mother can count on informed health professionals who advise her on breastfeeding, support her in making decisions and solve any doubts or difficulties that may arise in those first moments. And it is that it has been shown that having support in breastfeeding from the moment the baby is born, favors its success and enhances the attachment relationship between mother and baby.
In the case of women who decide not to breastfeed their babies , their decision should be respected and not feel judged by it, although it is important that health professionals make sure that this decision has been made with information.
In Babies and More | “It is time to put an end to obstetric violence”, the petition and sentence of a UN committee to Spain, Respected childbirth is a reality in the Torrejón Hospital, also in times of COVID, How long does delivery last, phase to phase?
