Promoting optimal care in childbirth.

In 1996, the World Health Organization set out guidelines for normal birth. Because that time birth in the United States has continued to be intervention intensive, the cesarean rate has skyrocketed and maternal mortality, although low, is rising. At the same time, research continues to provide evidence for the benefits of supporting the normal physiologic process of labor and birth and the risks of interfering with this natural process. This article reviews the current state of U.S. maternity care and discusses research and advocacy efforts that address this issue. This article describes optimal care in childbirth and introduces the Lamaze International Six Healthy Birth Practices.