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Needs of Healthy Childbearing WomenWhat proportion of pregnant women are at low risk for problems? Do low-risk pregnant women receive appropriate maternity care? What do healthy childbearing women need? What kind of maternity care is appropriate if I'm healthy and low-risk? Why should I avoid routine interventions if I'm healthy and low-risk? What proportion of pregnant women are at low risk for problems?The great majority of pregnant women in the U.S. are well and healthy. Healthy People 2020 describes health goals for the nation. According to the Healthy People definition, nearly 85 percent of pregnant women in the U.S. — about 3 1/2 million woman every year — enter labor at "low risk" for problems. These women, together with their infants and other family members, have distinct health and social needs.Do low-risk pregnant women receive appropriate maternity care?Low-risk pregnant women have good reason to expect to an uncomplicated birth and a healthy newborn. Unfortunately, contemporary maternity care systems often treat pregnancy and birth in healthy women as medical conditions or disease states, rather than normal life processes. Childbirth care in U.S. hospitals is intervention-intensive, even for low-risk women. Six of the ten most common hospital procedures in the country are maternity-related, and the most common operating room procedure is cesarean section.Many programs address the important needs of the minority of pregnant women who have medical problems, or are at a high risk for developing them. But, limited attention is given to ensure that the millions of healthy women who give birth every year receive the appropriate care. Childbirth Connection and this website address the needs of this group. What do healthy childbearing women need?If you are in good health, your medical needs may be limited, but you can benefit greatly from information and other support to help you maintain and enhance your health. Attentive care and reliable information can help you understand what is happening to your body, identify potential concerns, and make informed decisions about your care. The transition to parenthood is a major life change, and you may welcome and benefit from guidance and support at this time.What kind of maternity care is appropriate if I'm healthy and low-risk?Pregnancy, labor and birth, and the postpartum period involve innate processes of women and their fetuses/newborns that are regulated by powerful hormones. When we support these processes and avoid interfering with them, labor, birth, attachment, and breastfeeding reflect these processes, and the need for medical intervention is limited. It is important to find caregivers and places for giving birth that understand, respect, and work with these inborn processes.Maternity care that is supportive and respectful, and that reflects the best available research about safe and effective care, has the best potential to lead to:
Why should I avoid routine interventions if I'm healthy and low-risk?Many hospitals and health professionals use maternity interventions liberally or routinely, even when there is no clear need for them. This may happen because of standard practice in that community, health professionals’ education and training, pressure to hasten the labor and birth, or for other reasons. The national Listening to Mothers survey found high rates of intervention among women giving birth in U.S. hospitals. Examples of commonly used interventions include: inducing labor, using continuous electronic fetal monitoring, giving intravenous fluids, and cutting an episiotomy. Women themselves may also request interventions that are not medically needed, such as labor induction for convenient scheduling.Although select women in specific situations may benefit from such maternity interventions, the best research finds that many interventions do not offer benefits to healthy women but do increase their risk for potentially harmful side effects. If there is no clear, well-supported justification for use, it is wise to avoid interventions because they may:
The chain of unintended effects of maternity interventions has been called a "cascade of intervention." Many women feel that their bodies have failed them, and are unaware that things that have gone wrong were triggered by maternity practices themselves. Moreover, the use of unnecessary interventions compromises the quality of maternity care and wastes resources of the employers, governments and families who pay for this care. Most recent page update: 7/11/2011
© 2013 Childbirth Connection. All rights reserved.
Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality and value of maternity care through consumer engagement and health system transformation. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families. |
News and Features
Listening to MothersSM III is the third national
survey exploring women’s experiences in pregnancy and childbirth.
Commissioned by Childbirth Connection, conducted by Harris Interactive, and
funded by the W.K. Kellogg Foundation, the survey polled 2,400 women who gave
birth in U.S. hospitals from 2011 to 2012. Results show that medically
intensive experiences are typical, and evidence-based practices are
underutilized. Childbearing women need better support and knowledge to
navigate their maternity care.
Access the full report and supplementary materials  New Report: Maternity Care and Liability Go to report and supporting materials New Report: The Cost of Having a Baby in the United States Go to report and supporting materials New Cesarean Resources: Go to Best Evidence Report Go to web pages and booklet for women 
For 95 years, Childbirth Connection has been dedicated to improving the
quality and value of maternity care for all women and their families. Learn
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Childbirth Connection works to ensure that all women and babies get the best
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The Transforming
Maternity Care website focuses on maternity care
system improvements designed to engage diverse stakeholders in quality
improvement efforts. The site offers full access to the landmark reports 2020 Vision and
Blueprint for
Action, features a Blog, and other
resources such as an Action Center, a
database of
quality improvement projects, an interactive data
center, and many more tools
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