1. The entire community should be informed on the different procedures that constitute pregnancy and childbirth care, to facilitate a woman’s ability to choose the type of care that suits her.
2. The training and professional development of midwifes must be encouraged and supported. Midwifes should be in charge of the care provided during normal pregnancy, labour or puerperium.
3. Hospitals should provide the public information on their practices regarding childbirth (birth protocols, care data, caesarean rates, etc.).
4. There is no justification regardless of the geographical setting for a caesarean birth rate higher than 10 to 15%.
5. There is no proof that a caesarean is required after a previous transverse Caesarean of the low segment. As a general rule, vaginal births must be encouraged after a caesarean as long as an emergency surgical service is available.
6. There is no existing proof on the positive effects of electronic foetal monitoring during normal labour.
7. Routine use of enemas or pubic shaving is not advised and should be eliminated. Pregnant women should not be placed in the lithotomy position during labour and childbirth. They must be encouraged to walk during labour and they should be free to decide their desired position for labour and birth.
8. Routine use of episiotomy (surgical incision through the perineum made to enlarge the vagina) is not justified.
9. Programmed inductions (inducing labour through artificial means) should be avoided. The induction of birth should be limited to medical advice. There is no geographical justifications for an induction rate higher than 10%.
10. Routine administration of analgesic or anaesthetic drugs during labour must be avoided unless specifically required to avoid or treat a specific complication.
11. Routine artificial membrane rupture is not scientifically justified.
12. A healthy newborn must remain with the mother, whenever both are in satisfactory conditions, without any type of restrictions. No type of routine test or procedure justifies the separation between the newborn and the mother.
13. Immediate breastfeeding must be encouraged, even before the mother leaves the birthing room.
14. Obstetric Care Units that don’t blindly accept all types of technology and respect the emotional aspects of labour should be identified and encouraged. In order to stimulate similar attitudes, the reasons that led them to adopt such measures should be studied.
15. Governments should consider regulations that allow the use of new technologies in labour only after adequate evaluation.