WHO appropriate technology for birth revisited

Br J Obstet Gynaecol. 1992 Sep;99(9):709-10. doi: 10.1111/j.1471-0528.1992.tb13867.x.


PIP: The validity of WHO recommendations for childbirth care are examined. WHO recommendations were published in 2 places: the August 1985 Lancet article on "The Appropriate Technology for Birth" and in the WHO book, "Having a Baby in Europe." Questions have arisen since publication about how the information was derived, the representativeness of the information, the relation to research findings,. and the potential bias. The issue of appropriate birth practices and use of technology had been debated since the 1979 UN International Year of the Child. WHO established a 15-member multidisciplinary perinatal study group to review the literature and an academic and lay publication in 1985 were the result. Birth Conferences were also held nationally in countries applying the WHO birth recommendations. there have been 43 conferences conducted in 23 member states in addition to the US, Canada, Australia, and China; issues were debated and consensus reached. the recent publication by Chalmers et al. (1989) answered many questions. In the publication appendix perinatal technology is distinguished as that technology with 1) reduces the negative outcome of pregnancy and childbirth, 2) is promising but unproven, 3) has unknown effects and requires evaluation, and 4) is unnecessary based on available evidence. An example from the appendix on WHO recommendations for specific birth technology is given in table form for 13 practices recommended and a statement of research support. For example, the recommendations is that women participate in decisions about their birth experiences. Research states that failing to involve women in decisions about their care should be abandoned. Another recommendation is that the healthy newborn must remain with the mother whenever possible, and the research states that separating mothers and babies routinely should be abandoned. No assessment in the Chalmers et al. publication is concerned with perinatal health care policy or setting of policy. The recommendations were developed from survey research, discussion, debate, and carefully controlled and critically evaluated randomized control trials.

Publication types

  • Guideline

MeSH terms

  • Europe
  • Female
  • Humans
  • Labor, Obstetric / psychology*
  • Maternal Health Services
  • Perinatology
  • Pregnancy
  • World Health Organization*