California College of Midwives
State Chapter ~ American College of Community Midwives

Definition of Physiological Management of Normal Labor & Birth

Science-based principles of care for spontaneous labor and normal birth care include the following physiologically-sound practices: 


1. Continuity of care 
2. Patience with nature
3. Social and emotional support 
4. Full-time presence of the primary caregiver during active labor
5. Mother-controlled environment (place) for labor and birth 
6. Provision for appropriate psychological privacy (persons present) 
7. Mother-directed activities, (positions & postures) for labor & birth  
8. Opportunity for an upright and mobile mother during active labor  
9. Recognition of the non-erotic but none-the-less sexual nature of spontaneous labor & normal birth
10. Non-pharmaceutical pain management such as walking, one-to-one care, touch relaxation, showers & deep water tubs, other tradition midwifery strategies 
11. Judicious use of drugs and anesthesia when needed
12. Absence of arbitrary time limits as long some progress, mom & babe OK  
13. Vertical postures, pelvic mobility and the right use of gravity for pushing
14. Birth position by maternal choice unless medical other factors require otherwise
15. Mother-Directed Pushing --NO prolonged breath-holding (Valsalva Maneuver)
16. Physiological clamping/cutting of umbilical cord-- after circulation between baby and placenta has stopped  
17. Immediate possession and control of newborn by mother and father
18. On-going & unified care and support of the mother-baby during the postpartum/postnatal period

Physiological management is the science-based model of normal maternity care and, logically-speaking, should be the foremost standard of care for all healthy women with normal pregnancies, regardless of the category of maternity care provider (obstetrician, family-practice physician or midwife) and regardless of the setting for labor and birth (hospital, home or birth center).