WORLD HEALTH ORGANIZATION: Care in Normal Birth: A Practical Guide (1996)
Category A: Birth Practices Which Are Demonstrably Useful and Should Be Encouraged

In 1996, the World Health Organization (WHO) assembled birth experts from around the world to identify common practices in normal birth that were justified, that improved birth outcomes, and that ought to be encouraged for sound care in normal birth.¹ At the same time, WHO identified common birth practices that are known to be harmful, unnecessary, underused as well as those interventions that required further study to determine their merit in the care of child bearing families. In a way, as presented, the listing of intervention by category serves as a “sort of” report card for birthing facilities in that either the intervention is or is not currently practiced. This article “speaks to” the first of the four categories of common birth practices and the rationale of those interventions WHO identified seventeen years ago. The practices to be encouraged are in bold type and listed below.

Category A: Practices which are demonstrably useful and should be encouraged

1. The acceptance of a woman’s personal plan (her wishes) for her birth is important.¹  Some would say that birth defies planning, as indeed it does. No one can predict the course a labor will take; that can be known only retrospectively. However, what is known is that the childbirth experience impacts “long term physical and psychological health, breastfeeding, mother-infant attachment and parenting” (Goer, p. 3).²  Birth becomes part and parcel of a woman’s sense of self and her life history. Consequently, it is imperative that a mother be allowed to make her own birth choices, the consequences of which later define who she is as a woman and mother. Birth wishes are the expressed desires of childbearing parents that outline their birth preferences for the healthcare provider. The essence of birth wishes ask that the mother be treated with respect, that she is has the right to make choices as an autonomous individual, and that no interventions in the birth occur without her consent. Birth wishes should be developed during the prenatal period and shared with the healthcare provider before labor begins.

We didn't plan a trip to West End on Monday, but when we got a call that morning about someone killing puppies in a horrific manner, we had to go.

We could find no evidence or willing witnesses, but the police have promised to speak strongly to the supposed offender. (The only witnesses were children.)

We were determined to get every puppy in that area we could find.

Between Monday and Tuesday's two trips, we ended up with 21 puppies and 4 adults - pretty good for a two door Ford Explorer; currently our only duty-paid vehicle.

The puppies are all very young, but not much used to handling. There was a lot of pulling puppies out from under cars, boat trailers and other objects, in addition to some interesting scary dirty forays into very thick bush, with some very vehement objection on the part of some of the pups; but all were captured safely and with only minor injuries to the humans!

Thanks to everyone who supported our Car & Dog Wash & No Fleas Market last Saturday!  We were thrilled to have a plethora of volunteers - a group of Ross University students, and 20 police cadets came out to help, which meant that in addition to the paying customers, almost every puppy in the shelter got a nice bath!

We are grateful also to Caraline Holding, Tracy Jervis and Penny Richards for the great flea market. Barbara Stollery, Beth Hatfield, Vicki Stafford, Nancie Pollard, and Tip Burrows for the baked goods. Bahamian Brewery for the loan of the tent, and Crown Ice for ice and water.

Thanks to all the volunteers, and everyone who patronized the event. Almost $900 was raised for our animals!

Big thanks also to Madeleine Buzzi who makes amazing tote bags out of recycled materials.  To our delight and surprise on Saturday, she brought us a lovely donation of the proceeds of the bag sales!  

Thank you Madeleine, and thanks to everyone who has bought a tote and helped our animals in the process.  For more info on the tote bags, email us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it and we'll put you in touch.

Remember our 5th Pub Quiz is this Saturday at RedBeards Pub - registration starts at 7 p.m. and the quiz will start promptly at 8.  Teams of up to six are invited to play for bragging rights and their name on the plaque that resides at the pub for all to see.  It's a really fun night to test your intellect and trivia knowledge, don't miss it! See poster below.

Birth is a normal, natural, safe and healthy event. On average, 80%-85% of pregnant women are low-risk both through their prenatal months and during the process of birth. The World Health Organization (WHO), the global public health arm of the United Nations, defines normal birth as “spontaneous in onset, low-risk at the start of labor and remaining so throughout labor and delivery. The infant is born spontaneously in the vertex (head first) position between 37 and 42 completed weeks of pregnancy. After birth the mother and infant are in good condition.” (WHO, 1996, p. 4).  

In the late 1990s, concerned about the increasing labor inducing (forcing), augmenting (stimulating), managing (controlling) and monitoring (interpreting) of the physiological processes of labor with less than optimal outcomes, the WHO convened a meeting of  childbearing experts from the WHO global regions worldwide. In that congregation of experts, WHO expressed the belief that the ”medicalization” of birth denies women the “freedom to experience the birth of their children in their own way” and turns the “normal physiologic event [of birth] into a medical procedure” (WHO, 1996, p. 2).

Addressing the “there is a temptation to treat all births (of which 80 % are uncomplicated) routinely (standardized protocols) with the same high level of intervention required by those who experience complications (20%), WHO maintains that “women and their babies can be harmed by unnecessary practices” (WHO, 1996, p. 2). Hence, the purpose of the 1996 gathering was to identify common practices in normal birth that were justified, that improved birth outcomes, and that ought to be encouraged for sound care in normal birth. At the same time, WHO hoped to identify which common birth practices were harmful, which were unnecessary, which were underused and which required further study to determine their merit in care of child bearing families.