Normal Labour & Birth Support: Safe, Respectful Childbirth Care

Core approach

Safe care and a positive birth experience belong together

WHO's intrapartum-care model combines clinical safety with respectful, woman-centred care. It emphasizes communication, companionship, continuity, appropriate monitoring, pain-relief options, mobility and a clear referral plan. citeturn0search0turn0search3

Respect

Woman-centred care

Care should protect dignity, privacy, informed choice, communication and emotional wellbeing throughout labour and birth.

Support

Companion of choice

WHO recommends a companion of choice throughout labour and childbirth, where feasible within the care setting.

Mobility

Movement & positions

For women with uncomplicated labour, mobility and comfortable upright or other preferred positions can be supported when clinically appropriate.

Monitoring

Regular assessment

Labour progress and maternal and fetal wellbeing should be monitored and documented using appropriate clinical tools.

Communication

Clear explanations

Women should receive understandable information, be able to ask questions and participate in decisions about their care.

Safety

Prepared for complications

Normal labour care includes readiness to identify complications early and activate referral or emergency management when required.

Respectful maternity care

What women should expect from good labour care

WHO recommends respectful maternity care that maintains dignity, privacy and confidentiality, protects women from harm and mistreatment, and enables informed choice and continuous support. citeturn0search1turn0search2

Dignity & privacy

Maintain dignity, privacy and confidentiality and protect the woman from harm and mistreatment.

Effective communication

Use simple, understandable language and explain procedures, findings and options in a culturally appropriate way.

Informed choice

Support the woman to understand available options and participate in decisions about her care.

Continuous support

Where possible, support a companion chosen by the woman throughout labour and childbirth.

Continuity

Continuity of care and clear handovers help maintain consistent, safe and person-centred support.

Referral readiness

A maternity service should have a clear plan for escalation and referral when complications arise.

During labour & birth

Support through the main stages

Labour care should be individualized. The maternity team adapts monitoring and interventions to the woman's condition, fetal wellbeing, labour progress and informed preferences.

01

Early labour

Assessment, reassurance & comfort

The maternity team assesses the woman and baby, establishes the clinical picture, explains what is happening and supports comfort, hydration and mobility according to the individual situation.

02

Established / active labour

Monitor progress without unnecessary intervention

Maternal and fetal wellbeing and labour progress are assessed at appropriate intervals. Care is individualized rather than based on a single rigid rate of cervical dilatation.

03

Second stage

Support pushing & birth position

The woman should be supported to use a comfortable birth position and to follow her physiological urge to push when appropriate, while the skilled birth attendant monitors safety.

04

Immediately after birth

Mother and newborn together

Routine post-birth care includes assessment of maternal bleeding and uterine tone, newborn assessment, skin-to-skin contact when appropriate and support for early breastfeeding.

Clinical principle: if labour is progressing normally and mother and baby are well, routine interventions to accelerate labour are not automatically required. Any intervention should have an appropriate clinical purpose and should be discussed with the woman when circumstances allow. citeturn0search6turn0search7

Labour monitoring

Regular assessment without unnecessary intervention

WHO's Labour Care Guide supports standardized, evidence-based monitoring and timely decision-making during labour. It was developed to support good-quality, respectful and person-centred intrapartum care. citeturn0search5turn0search10

What may be monitored

Maternal vital signs and clinical condition according to the stage of labour and clinical situation.
Fetal heart assessment using an appropriate method for the clinical context.
Contractions and other features of labour progress.
Cervical assessment when indicated and with consent.
Documentation of observations, interventions, decisions and responses to care.
Prompt recognition and escalation of abnormal findings or complications.

Why documentation matters

Creates a clear record of maternal and fetal wellbeing.
Helps the team recognize changes over time.
Supports communication between team members.
Helps identify when additional assessment or referral is needed.
Supports review, audit and quality improvement of maternity care.

Important update: WHO's 2025 Labour Care Guide implementation resource package describes the Labour Care Guide as a tool intended to support evidence-based, respectful, person-centred intrapartum care and timely decision-making. Local adoption and documentation should follow the applicable national and facility protocol. citeturn0search5

Comfort & pain relief

Support should be individualized

Women should receive information about available pain-relief options and be supported to participate in decisions about their care. WHO includes both non-pharmacological and pharmacological approaches within intrapartum care. citeturn0search22

Continuous emotional support, reassurance and encouragement.
Breathing, relaxation, massage and other manual comfort techniques when desired.
Movement, upright positions and position changes when clinically appropriate.
Warm water or other non-pharmacological comfort measures where available and suitable.
Pharmacological pain relief options, including regional analgesia or other medicines, according to the facility, clinical situation and informed choice.

Mobility & birth positions

Comfortable movement can be part of normal labour care

For women with uncomplicated labour, WHO supports mobility during labour and allows a woman to adopt a position of her choice for birth, subject to clinical circumstances and available support. citeturn0search6turn0search22

Standing

An upright position can support mobility and may be comfortable for some women.

Walking

Walking or changing position can be encouraged during labour when safe and clinically appropriate.

Side-lying

Side-lying can provide comfort and may be useful when resting or when an upright position is not preferred.

Kneeling / supported positions

Supported kneeling, hands-and-knees or other comfortable positions may be options depending on the clinical situation.

Sitting / supported sitting

A supported sitting position may be comfortable during labour and birth where suitable.

Position of choice

The preferred birth position should be considered alongside safety, clinical findings and the woman’s informed preference.

Safety comes first: a preferred position may need to change when maternal or fetal status, analgesia, procedures or other clinical circumstances require a different approach. The care team should explain the reason whenever possible.

Birth preparedness

Prepare before labour starts

Planning ahead can reduce delays when labour begins or when urgent assessment becomes necessary.

Know the maternity facility and how to reach it at any time.
Keep emergency transport arrangements ready.
Keep important pregnancy records and identification accessible.
Discuss who the chosen companion will be, according to facility policy.
Discuss pain-relief preferences and understand available options.
Ask the maternity team when to call or come to the facility after labour starts or if membranes rupture.
Know the important warning signs that require urgent assessment.
Plan for immediate newborn care and breastfeeding support.

Immediately after birth

Early care for the newborn

When mother and baby are stable, immediate care should support safe transition, bonding, breastfeeding and appropriate preventive newborn care.

Assess breathing & wellbeing

The newborn should be assessed promptly and receive appropriate skilled care if adaptation is not normal.

Skin-to-skin contact

When mother and baby are stable, immediate skin-to-skin contact supports early bonding and breastfeeding.

Delayed cord clamping

WHO recommends delayed cord clamping, not earlier than one minute after birth, for appropriate births unless urgent newborn or maternal care requires otherwise.

Early breastfeeding support

Support early initiation and continuation of breastfeeding when the mother and newborn are able.

WHO recommends delayed cord clamping, not earlier than one minute after birth, for appropriate births, while recognizing that urgent maternal or newborn care may require immediate action. citeturn0search22

Post-birth maternal care

Do not stop monitoring after the baby is born

The immediate postpartum period is important for detecting bleeding, blood-pressure problems, infection and other maternal or newborn concerns.

Monitor maternal vital signs and clinical condition.
Assess vaginal bleeding and uterine tone as appropriate.
Provide pain relief and comfort measures.
Support early breastfeeding and mother–baby contact.
Discuss warning signs and when to seek urgent help.
Provide appropriate postpartum contraception and health counselling according to individual needs and local practice.
Arrange postnatal follow-up and escalation if an abnormal finding is identified.

Urgent safety information

When to seek immediate maternity or emergency care

Labour and birth can change quickly. Seek urgent assessment if a serious symptom develops or if the maternity team advises immediate review.

Do not wait for a routine appointment

Heavy or significant vaginal bleeding.
Severe or persistent abdominal pain or another severe new symptom.
Convulsions, loss of consciousness or severe altered awareness.
Severe difficulty breathing, chest pain or collapse.
Severe headache, visual symptoms or other features concerning for a serious pregnancy complication.
Fever or severe illness, especially with other concerning symptoms.
Abnormal or markedly reduced fetal movement before birth when movements are normally expected.
Meconium-stained fluid or another concern identified by the maternity team.
Prolonged leaking of fluid or suspected rupture of membranes requiring assessment.
Any situation in which the woman or care team is concerned about maternal or fetal wellbeing.

Frequently asked questions

Normal labour & birth support FAQs

What does normal labour care mean?

Normal labour care means individualized, respectful and evidence-informed care for a woman and baby who are progressing without a complication requiring a different management plan. It includes regular monitoring, emotional support, communication, comfort measures and readiness to manage or refer complications.

Can I have a companion during labour?

WHO recommends a companion of choice for all women throughout labour and childbirth. The practical arrangements depend on the maternity facility, infection-control requirements and local policy.

Can I walk during labour?

For women with uncomplicated labour, mobility and upright positions can be supported when clinically appropriate. The maternity team may recommend a different position or activity if maternal or fetal conditions require it.

Do I have to give birth lying flat on my back?

Not necessarily. WHO supports a woman choosing a comfortable birth position, including upright positions, when clinically appropriate. The safest position may change depending on maternal and fetal condition and the interventions being used.

How is labour monitored?

Monitoring is individualized and includes assessment of maternal condition, fetal wellbeing and labour progress, with documentation and escalation when concerns are identified. The WHO Labour Care Guide is designed to support standardized, evidence-based monitoring and timely decision-making.

Does normal labour always mean no medical intervention?

No. Labour may require pain relief, monitoring, medication or an urgent intervention when clinically indicated. The goal is to avoid unnecessary intervention while providing timely treatment when it is needed for the woman or baby.

What happens immediately after birth?

When mother and baby are stable, care includes assessment of the newborn, skin-to-skin contact, support for breastfeeding, appropriate cord management and ongoing maternal assessment, including bleeding and uterine tone.

Related services

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Guideline references

Evidence sources

This page is primarily based on WHO intrapartum-care guidance. National, state and facility protocols may specify additional requirements or different implementation details.

WHO — WHO recommendations: Intrapartum care for a positive childbirth experience . citeturn0search3
WHO — WHO Labour Care Guide: user's manual . citeturn0search10
WHO — WHO Labour Care Guide: implementation resource package . citeturn0search5
WHO / NCBI — Summary of recommendations on intrapartum care . citeturn0search1

Medical information disclaimer: This page is for general educational purposes and does not replace individualized assessment, diagnosis or treatment by a qualified maternity-care professional. Labour and birth management must be adapted to maternal and fetal condition, gestational age, local protocols, available resources and the woman's informed preferences. In an emergency, seek immediate local maternity or emergency care.