1ST CITY CLINICAL HOSPITAL

On February 15, 2018, the World Health Organization released new guidelines to set global standards for health care for healthy pregnant women.

Around the world, almost 140 million births occur annually, and most of them occur without any risks to the mother and child, both at the beginning and during labor. Despite this, childbirth is a critical period for the survival of mother and child. In accordance with the WHO Global Strategy for the Health of Women, Children and Adolescents (2016–2030), the health priority is not only the prevention of deaths due to obstructed childbirth, but also the successful subsequent development of the child .

The last 20 years have seen a significant increase in the number of procedures aimed at regulating and monitoring the physiological process of childbirth, designed to improve the prognosis for mother and child . Active medical intervention can have a negative impact on the subjective experience of women in labor. However, creating a positive birth experience through high-quality care and respect for the birthing woman's preferences is a central idea and not an adjunct to standard clinical practices.

A “positive birth experience” is defined as a desired outcome for all birthing women that meets or exceeds their personal and sociocultural expectations and perceptions. This experience includes the birth of a healthy baby in a safe environment , as well as physical and emotional support, including from birth partners and friendly, competent medical personnel. The idea is based on the premise that women generally prefer a physiological birth that provides a sense of personal achievement , and want to actively participate in decision-making, even if medical intervention is required.

WHO guidelines provide recommendations on the health care needed during and immediately after birth for a woman and her baby. They include the possibility of the presence, at the request of the woman, of a loved one during labor and childbirth; ensuring respectful care and appropriate communication between women and health care providers; respect for personal space and confidentiality; giving women the right to make decisions regarding, among other things, pain management, labor and birth positions, and natural pushing.

The main objective of the obstetric service of the 1st City Clinical Hospital is to provide the most accessible, highly qualified care to pregnant women, women in labor and postpartum women.

Every birth is unique and progresses at different speeds!

Taking into account the uniqueness of each contraction and birth for different women, in our daily practice we adhere to the model of intrapartum care recommended by world experts to create a positive birth experience, ensuring that childbirth takes place in a safe environment in the presence of qualified obstetric specialists.

A list of some recommendations for intrapartum care to ensure a positive birth experience:

• Treating women during labor with respect, preserving her dignity, privacy and confidentiality, and ensuring opportunities for informed choice and ongoing support throughout labor
• Effective communication between the birthing mother and her caregivers using simple, culturally appropriate rules
• Presence of a birth partner if desired by the woman.
• Awareness of women in labor both about the accepted duration of labor and about the individuality of this parameter
• The use of regional methods of labor analgesia to relieve pain in healthy pregnant women (taking into account the preferences of the woman in labor)
• Encouraging mobility and upright posture in women at low risk of complications during childbirth
• Ensuring that infants born without complications have direct skin-to-skin contact with their mother for the first hour after birth to prevent hypothermia and promote breastfeeding
• Ensuring that babies born without complications stay in the same room with their mother around the clock

According to WHO, the foundation of a positive birth experience is supportive medical care based on an individual approach

It is also important to recognize that childbirth can be an unpredictable and risky event. Therefore, careful monitoring and sometimes medical intervention are necessary.

Even when interventions are desired or necessary, women must maintain a sense of personal achievement and control, which is also possible through their participation in decision-making. Cooperation with medical workers in the provision of medical care and implementation of recommendations necessary for the implementation of the chosen treatment tactics are, in our opinion, the basis for ensuring a comfortable birth.

The obstetric service of the 1st City Clinical Hospital strives to implement the model of care during the intrapartum period recommended by WHO in order to provide women with childbirth according to their individual needs and ideas, and also to lay the foundation for the provision of medical services in accordance with the principles of respect for human rights.