Towards Normal Birth in NSW, a policy directive, with a requirement for mandatory compliance, was released earlier this year.
"This policy provides direction to NSW maternity services regarding actions to increase the vaginal birth rate in NSW and decrease the caesarean section operation rate; to develop, implement and evaluate strategies to support women and to ensure that midwives and doctors have the knowledge and skills necessary to implement this policy."
Carolyn Hastie has listed her 21 strategies to keep birth normal at her thinkbirth blog.
A NZ midwife, Sarah Stewart, has provided the link to the RCM list of ten top tips.
Midwives around the world have in recent years been promoting normal birth as a definitional duty of care, rather than a default position.
The policy directive Towards Normal Birth in NSW contains many parallels with the global Baby Friendly Hospital Initiative (BFHI), in the protection, promotion and support of breastfeeding. It is a simple step from BFHI to the protection, promotion and support of the normal physiological processes in the whole birthing continuum, rather than waiting until the baby has been born and needs food. The '10 steps to providing woman centred labour and birth care' (p8) parallels the BFHI '10 Steps'.
The NSW Health Department has taken a brave step in the right direction with this document. Time will tell whether 'mandatory' means just that, or something else. The implementation check list (Attachment 1) states that "All Area Health Services must achieve the measures by 2015."
We would love to hear from any readers in NSW. How's it going?