Appropriate technology for birth.
The European regional office of the World Health Organization (WHO), the Pan American Health Organization, and the WHO regional office of the Americas held a conference in April on appropriate technology for birth. Held in Fortaleza, Brazil, the conference was attended by over 50 participants representing midwifery, obstetrics, pediatrics, epidemiology, sociology, psychology, economics, health administration, and mothers. Careful review of the knowledge of birth technology led to unanimous adoption of the recommendations which follow. WHO believes these recommendations to be relevant to perinatal services worldwide. Every woman has the right to proper prenatal care, and she has a central role in all aspects of this care, including participation in the planning, carrying out, and evaluation of the care. Social, emotional, and psychological factors are fundamental in understanding how to provide proper prenatal care. Although birth is a natural and normal process, even "no risk pregnancies" can result in complications. Sometimes intervention is necessary to obtain the best result. For the recommendations to be viable, a thorough transformation of the structure of health services is required together with modification of staff attitudes and the redistribution of human and physical resources. General recommendations include the following: health ministries should establish specific policies about appropriate birth technology for the private and nationalized health services; countries should carry out joint surveys to evaluate birth care technologies; and the whole community should be informed of the various procedures in birth care in order to enable each woman to choose the type of birth care she prefers. Specific recommendations include the following: The well-being of the new mother must be ensured through free access of a chosen member of her family during birth and throughout the postnatal period; women who give birth in an institution must retain their right to decide about clothing, food, disposal of the placenta, and other culturally significant practices; and the healthy newborn must remain with the mother whenever possible. The recommendations acknowledge differences between regions and countries. Implementation must be adapted to these special situations.