In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of allowing labor to begin on its own is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. The accompanying commentary—written by a leading home-birth midwife and prominent national and international speaker on maternity care—describes further evidence of the disadvantages of inducing labor. The indications for and risks of induction are also explored. Lamaze International recommends that, unless there is a medical indication for induction, labor should be allowed to begin on its own.

In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of allowing freedom of movement throughout labor is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. The accompanying commentary—written by a well-known author of numerous articles and books on childbirth—compares the activities of women in two birthing environments: the conventional medicalized setting and the unconventional naturalistic setting. Reasons why women may not move in labor are presented. Lamaze International encourages women to use movement in labor in order to make labor more comfortable and more efficient.

In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of continuous labor support is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Women with continuous support are less likely to have a cesarean, an instrument delivery, and regional anesthesia. They are also less likely to report dissatisfaction with or negatively rate their childbirth experience. The value of the doula for both the laboring woman and her labor partner is discussed. The accompanying commentary—written by a leading proponent of maternity care practices—supports evidence that promotes continuous labor support. Lamaze International encourages women to plan for a supportive birth environment that includes continuous support.

In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of no routine interventions during birth is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. It presents evidence related to restrictions on eating and drinking, use of intravenous fluids, continuous electronic fetal monitoring, artificial rupture of the membranes, augmentation of labor, and epidural analgesia. The accompanying commentary—written by an award-winning medical writer—supports and expands on the benefits of no routine interventions during birth. Lamaze International recommends that laboring women avoid restrictions on eating and drinking. The organization also recommends avoidance of IVs, continuous electronic fetal monitoring, epidurals, and efforts to speed up labor, unless a clear indication for their use is evident.

In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of non-supine positions for birth is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Upright and gravity-neutral positions facilitate rotation and descent of the baby and result in reduced duration of second stage, a reduction in episiotomies, and fewer abnormal fetal heart rate patterns. The accompanying commentary—written by a leading proponent of maternity care—supports these benefits. Lamaze International recommends that laboring women not push until they feel an urge to do so, and that they choose positions for birth that are most comfortable for them.

In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the value of keeping mothers and their babies together from the moment of birth is discussed and presented as an evidenced-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Babies held skin-to-skin with their mothers cry less often, breathe easier, and stay warmer than babies who are separated from their mothers. They also instinctively attach to the breast and begin breastfeeding, usually within one hour of birth. The advantages of rooming-in for mother and baby are also discussed. The accompanying commentary—written by two leading professionals in the field of maternity care and pediatrics—provides further evidence to support the practice of keeping mothers and their babies together after birth. Lamaze International encourages women to give birth in settings that do not separate mothers and babies after birth.

CONONGENITAL ADRENAL hyperplasia (CAH) is an inborn error of metabolism that can produce life-threatening disease in the first one to three weeks of life, unless properly diagnosed and managed. This autosomal recessive disease results in insufficient biosynthesis of cortisol due to an enzyme defect in the adrenal gland. CAH due to 21-hydroxylase (21-OH) deficiency is found in 1/11,000–1/15,000 people in the general population, with a prevalence as high as 1/750 people in some populations such as the Yupik Eskimos in Alaska and the people of La Réunion in France.¹ Males and females are equally affected by this disease due to the autosomal recessive pattern of inheritance.