Natural childbirth--the Johannesburg Hospital experience, 1983-1989.

The Johannesburg Hospital Active Birth Unit (ABU), the only one of its kind in southern Africa to date, has provided an alternative to conventional labour practices since 1983. In a retrospective study of the results achieved in this unit the intrapartum records of 492 patients admitted to the ABU between 1 March 1983 and 30 June 1989 were analysed. During the 6.3-year study period 364 patients (74%) successfully laboured and delivered within the unit. These figures included 50 underwater deliveries. One hundred and twenty-eight patients required intrapartum transfer to the conventional labour ward and of these 44 achieved spontaneous vaginal delivery. Thirty-four patients (7%) 'self-selecting' for natural childbirth ultimately required caesarean section delivery. Primiparous patients were more likely than their multiparous counterparts to require intrapartum transfer to the labour ward (38% v. 13%). Birth outcome results achieved in the Johannesburg Hospital ABU compare favourably with those for 6 other ABUs reported in the literature.