CCM for edit — Introductory content – Physiologic Management Defined

Introductory Section

TITLED –> Science-based principles of physiologically-based care for spontaneous labor and normal birth in healthy women with normal pregnancies

Characteristics of Physiological Management of Normal Pregnancy, Labor & Birth

1. Continuity of care
2. Patience with nature
3. Social and emotional support
4. Mother-controlled environment (place) for labor and birth
5. Provision for appropriate psychological privacy (persons present)
6. Full-time presence of primary caregiver during all active stages of labor & immediate PP-NN
7. Opportunity for an upright and mobile mother during active labor
8. Mother-directed activities, positions, and postures for labor and birth
9. Recognition of the non-erotic but nonetheless sexual nature of spontaneous labor and normal birth
10. Use of non-pharmaceutical pain management such as walking, one-to-one care, touch relaxation, showers and access to deep water tubs, other traditional coping strategies
11. Judicious use of drugs and anesthesia when needed for hospitalized labor patients
12. Absence of arbitrary time limits as long as some progress, mother and baby OK
13. Vertical postures, pelvic mobility and the right use of gravity for pushing
14. Birth position by maternal choice unless clinically significant medical factors require otherwise
15. Mother-directed pushing –no prolonged breath-holding (i.e., the Valsalva maneuver)
16. Physiological clamping/cutting of umbilical cord– after circulation between baby and placenta has stopped (approximately 3-5 minutes)
17. Immediate possession and control of newborn by mother and father unless clinically-significant medical factors require otherwise
18. On-going and unified care and support of the mother-baby during the postpartum/postnatal period.

Physiological management is the science-based model of normal maternity care. As such it should be the foremost standard of care for all healthy women with normal pregnancies, regardless of the category of maternity care provider and regardless of the setting for labor and birth (hospital, home or birth center).

 

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