“Most women, in every country across the world, would prefer to give birth as physiologically as possible. For most women and babies, this is also the safest way to give birth, and to be born, wherever the birth setting. If routine interventions are eliminated for healthy women and babies, resources will be freed up for the extra staff, treatments and interventions that are needed when a labouring woman and her baby actually need help. This will ensure optimal outcomes for all women and babies, and sustainable maternity care provision overall.” (Professor Soo Downe, Professor in Midwifery Studies, 2014)

Defining and measuring normal births

What affects levels of interventions?

As with all types of birth, whether it is vaginal or by caesarean section, it is only through retrospective analysis of the data that you can measure the number of interventions and the potential for unwarranted variation. The systems in place to support women and families to make informed choices about their care with access […]

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Retrospective analysis of the data

The routine data being collected should enable services to describe the nature and prevalence of interventions in labour and birth for births recorded as normal or spontaneous or physiological, for women and babies with or without known complications at labour onset. It is through the regular scrutiny of the statistics, the nature of the births […]

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Measurement: Patterns of maternity care in English NHS trusts

This is the second report published by RCOG (2016) describing patterns of maternity care practice and outcomes using data routinely collected by English NHS Hospitals.   Even though normal births were part of the suite of indicators for analysis, these results were excluded from the analysis due to data quality issues. Also excluded from this […]

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Measurement: Interventions in Normal Labour and Birth

The Royal College of Midwives have worked in collaboration with the University of Central Lancashire (UCLAN) to pilot a survey tool and report (UCLAN/RCM, 2016)that is available for 7 trusts in England. The simple two page survey tool can be completed prospectively or retrospectively and is comprised of a simple, two page instrument with tick […]

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The necessary statistics

In order to be able to undertake analysis of the data on trends in normal births, it is important to ensure that there is a detailed account of the interventions for women and babies with or without known complications at labour onset. Although these may be available in the clinical notes, it needs to be […]

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Technical definition of normal birth

This section is based on the Consensus Statement from the Maternity Care Working Party (2007) to be used for data collection and measurement. The ‘normal delivery’ group includes • women whose labour starts spontaneously, progresses spontaneously without drugs, and who give birth spontaneously; • and women who experience any of the following provided they do […]

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Defining normal births

The definition for normal birth is specifically applied to vaginal births without the use of technology or medical interventions. This excludes the onset of labour using induction methods, pain management such as epidural or spinal anaesthetic, and the use of forceps or ventouse. Normal birth is a technical definition put forward for use as part […]

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Supporting women in labour