NCT believes that birth is a normal physiological process and most pregnant women are fit and healthy, so there are potential benefits of giving birth in a social setting, such as at home or in a freestanding or alongside midwifery unit or birth centre.
Penny Simkin, a leading American childbirth educator and author, describes her roadmap of labour, a teaching aid to guide parents through normal childbirth and variations on normal.
Trixie McAree, consultant midwife and supervisor of midwives at North West London Hospitals NHS Trust, looks at how we can reduce the rate of caesarean sections and increase the number of normal births.
The Normal Birth Consensus Statement from the Maternity Care Working Party includes discussion about why normal birth matters, the NHS Information Centre definition of 'normal delivery' and recommendations for action to support normal birth.
National policy in England promotes normal birth. Maternity Matters states that midwives should have the skills and confidence to promote normal birth.
The Welsh NSF states that all maternity units use the All Wales Clinical Pathway for Normal Labour, which was written by midwives for midwives to help promote normal birth, and undertake regular audit of its implementation.
The Scottish programme Keeping Childbirth Natural and Dynamic (KCND) launched in 2009 promotes mutliprofessional working and implementation of care pathways. Pathway to normal maternity care, part of the KCND programme, sees pregnancy and childbirth as a normal physiological process. More details on the KCND programme and documents are available to download from the website.
NCT's Normal birth as a measure of the quality of care: Evidence on safety, effectiveness and women’s experiences considers whether normal birth rates can be used as a measure of the quality of midwifery care. NCT policy briefing on protecting and promoting opportunities for normal birth below sets out NCT's policy in this area and actions that can be taken within maternity services, drawing on evidence of what seems to have an impact with regard to promoting and protecting opportunities for normal birth. An article on developments in East Lancashire provides an example of positive action for change. An NCT research networker and researcher at BirthChoiceUK analyses normal birth rates for England from 2012.
Relevant overviews of evidence look at working with pain in labour and self-hypnosis for labour and birth. There is also a review of a paper looking at psychoprophylaxis during pregnancy and whether it helps women cope with pain in labour.
NCT research networkers critique new research studies to assess their quality and significance. For example, two NCT authors concluded that a Scandinavian study of psychoprophylaxis as preparation for coping with pain in labour provided too little information about the intervention, the comparison group and the cultural context in which the women were giving birth, so that the findings were difficult to interpret and potentially misleading. In particular, the study findings could not be applied to NCT antenatal preparation.