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Five ACOG Recommendations for Limiting Intervention during Birth

Five ACOG Recommendations for Limiting Intervention during Birth


5 ACOG Recommendations for Limiting Intervention during Birth

The American Congress of Obstetricians and Gynecologists recently updated their recommendations to limit intervention during birth. Since these recommendations were released, natural birth advocates have been talking about the impact these changes will have on women’s experiences in birth. While many hospitals and healthcare professional already follow some of these practices, we’re thrilled with the expected changes and wanted to share our five favorite recommendations.

What they said:

“Admission to labor and delivery may be delayed for women in the latent phase of labor when their status and their fetuses’ status are reassuring. The women can be offered frequent contact and support, as well as nonpharmacologic pain management measures.”

What it means: Moms who haven’t be determined at risk for complications during delivery can spend the first phase of labor in the comfort of their own homes, waiting until they’ve moved to “active labor” to head to the hospital.

Why we love it: Staying at home during this phase of labor can help moms relax, which allows labor to progress more quickly. Sometimes labor can stall when a mom goes to the hospital this early. This is also a great time to rest, eat, and drink plenty of fluids.

What they said:

“For women with normally progressing labor and no evidence of fetal compromise, routine amniotomy need not be undertaken unless required to facilitate monitoring.”

What it means: If everything is proceeding naturally, and mom & baby are both doing well, the medical staff won’t break mom’s water for her.

Why we love it: This allows mom to labor as long as she needs to provided she and baby are doing well. Once the bag of waters is broken it is recommended that the baby is delivered within 24 hours. Breaking water unnecessarily puts mom and baby “on the clock.”

What they said:

“To facilitate the option of intermittent auscultation, obstetrician–gynecologists and other obstetric care providers and facilities should consider adopting protocols and training staff to use a hand-held Doppler device for low-risk women who desire such monitoring during labor.”

“Frequent position changes during labor to enhance maternal comfort and promote optimal fetal positioning can be supported as long as adopted positions allow appropriate maternal and fetal monitoring and treatments and are not contraindicated by maternal medical or obstetric complications.”

What it means: Rather than be hooked up to fetal heart rate monitors, baby will be monitored by a Doppler, allowing mom greater freedom of movement

Why we love it: This helps mom labor in whatever position she feels comfortable in rather than in bed on her back. Moms will be encouraged to labor on a birthing ball, walk around, be on their hands and knees, or any other position works for them.

What they said:

“Use of the coping scale in conjunction with different nonpharmacologic and pharmacologic pain management techniques can help obstetrician–gynecologists and other obstetric care providers tailor interventions to best meet the needs of each woman.”

What it means: This method, which uses a list of questions to determine how well the mom is coping, allows for more personalization of care.

Why we love it: Every mom will be treated as an individual rather than all laboring women being treated the same, it may also allow moms to focus on how their bodies are working rather than on the negative aspect of “pain.”

What they said:

“In the absence of an indication for expeditious delivery, women (particularly those who are nulliparous with epidural analgesia) may be offered a period of rest of 1–2 hours (unless the woman has an urge to bear down sooner) at the onset of the second stage of labor.”

What it means: After her cervix has fully dilated, moms who DON’T feel the need to push will be offered a chance to rest for a few hours (laboring down) before trying to push.

Why we love it: Since new moms are often exhausted from labor, this gives them a chance to rally/conserve some energy for the next leg of labor. This will also allow moms to work with their bodies’ natural urges rather than try to “force” something to start happening.

We want to hear from you!

Did your labor & delivery team follow practices like this? Might your delivery have been different if they had? Are you excited to see hospitals implement these recommendations? 

Additional Resources:

ACOG Recommendations for Limiting Intervention during Birth




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