Natural birth practices from evidence to fact in the light of 2023 ICM theme
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Department of Midwifery, Institute of Health Sciences, Amasya University, Amasya, Turkey
Publication date: 2023-10-24
Corresponding author
Seher Arık   

Department of Midwifery, Institute of Health Sciences, Amasya University, Amasya, Turkey
Eur J Midwifery 2023;7(Supplement 1):A158
Birth and delivery methods are one of the most discussed topics today. Recently, increasing cesarean rates have caused us to re-question our delivery methods. The World Health Organization advocates that acceptable cesarean rates should be 15 percent. In many European countries, these rates vary between 20-30 percent. These countries are working to bring down these high rates. However, when we look at Turkey, the cesarean section rate is given as 54.4%, according to the data in the Turkey Health Statistics 2019 Report. This ratio is an unbelievable and unacceptable figure and an indication that we are doing something wrong. Every cesarean section performed without medical reasons brings with it many negativities for both the mother and the baby. We see that birth is approached as a medical event that needs to be managed and intervened. Births are now remembered with drugs and medical interventions. However, birth is a physiological event that takes place under the control of the hormones secreted by our body. All kinds of unnecessary interventions to the birth will disrupt the functioning of the birth. If the pregnant women are provided with a safe environment for birth, many births will occur spontaneously. All we have to do is trust the baby and the mother's body. The basic approach to pregnancy and childbirth today is that birth is a physiological process and requires little medical intervention. Natural childbirth is the birth where the woman actively participates in the birth with her instincts, the health professionals are the spectators, without any anesthesia or intervention as much as possible, except for the health checks. The International Confederation of Midwives (ICM) emphasizes that childbirth is a physiological process, that the primary decision maker in matters related to childbirth is women, and that midwives should contribute to the development of normal births and the prevention of complications by implementing non-intervention-free interventions that increase women's self-confidence. More than 95% of women in the world are capable of giving birth naturally. In this case, the hormones active at birth prepare the baby and mother for birth in the healthiest way possible. Every unnecessary intervention disrupts the natural flow of birth, making this process more risky. However, birth is as natural a process as getting pregnant. Evidence suggests that only support without intervention during labor increases spontaneous vaginal delivery, decreases the rates of cesarean and invasive delivery, and less need for analgesia in labor. For a woman who believes in the instinctive rhythm of her own body and actively participates in her own birth, childbirth becomes something that is enjoyed rather than feared. Supporting natural childbirth should not be perceived as rejecting or opposing modern medicine. Because pregnancy and childbirth are physiological events, not diseases. It is known that natural birth has benefits in terms of being discharged from the hospital in a shorter time, bonding with the baby in a shorter time, and reducing the risk of infection and bleeding. The World Health Organization (WHO) and Lamaze International have published six evidence-based guidelines for health professionals to increase natural births and to perform birth safely with the least possible intervention. These evidence-based recommendations are; • Birth should start on its own, • There should be freedom of movement during birth, other positions should be supported instead of supine, • Emotional and physical support should be given to the pregnant woman throughout the birth, • Any unnecessary intervention should be avoided, • Natural and active pushing techniques should be preferred at birth. • After birth, mother and baby should stay together. Today, important organizations such as ACOG, RCOG, NICE also recommend these evidence-based practices. The International Confederation of Midwives (ICM) has set its 2023 theme as “together again: from evidence to truth”. This theme draws attention to the importance of evidence-based practices in midwifery practices and can be interpreted as midwives should adapt evidence-based practices to midwifery practice. From this point of view, practices for natural birth are discussed in line with evidence-based practice recommendations.
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