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Management of normal labor and delivery

Edmund F Funai, MD
Errol R Norwitz, MD, PhD, MBA
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG


The World Health Organization (WHO) defines normal birth as "spontaneous in onset, low-risk at the start of labor and remaining so throughout labor and delivery. The infant is born spontaneously in the vertex position between 37 and 42 completed weeks of pregnancy. After birth, mother and infant are in good condition" [1].

This topic will present a paradigm for intrapartum management of women who are expected to have a normal birth. Many of the options for managing these women have not been studied in clinical trials or the data from clinical trials are insufficient for making strong recommendations for a specific approach [2]. Therefore, much of our approach is based upon our clinical experience, data from observational studies, and expert opinion.

Management of women with complicated labor and delivery is discussed in separate topic reviews (eg, malpresentation, protraction and arrest disorders, preterm labor, operative vaginal delivery, maternal medical/obstetrical disorders, hemorrhage) (refer to individual topic reviews on each subject).


Creating a satisfactory childbirth experience — Four factors important in determining a woman's satisfaction with her childbirth experience are personal expectations, the amount of support she receives, the quality of the caregiver-patient relationship, and her involvement in decision-making. Childbirth education classes inform women and their partners about what to expect during labor and birth and provide a foundation for developing personal plans for the birth experience. (See "Preparation for labor and childbirth".)

Support — One-on-one support by a doula during the birthing process may lower intrapartum analgesia requirements, decrease the rate of operative delivery, and increase satisfaction with the birth experience. (See "Continuous labor support by a doula".)

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Literature review current through: Nov 2017. | This topic last updated: Dec 14, 2017.
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