Sexual and reproductive health

Message from Director RHR/HRP

February / March 2018

Photo portrait of Ian Askew
Ian Askew,WHO Director, Department of Reproductive Health and Research

All women have a right to a positive childbirth experience, characterized by respectful, dignified and compassionate care. Sadly however, this is often not the case. Too many women feel disrespected and experience various forms of abuse when giving birth at a health facility. In addition, many women do not have sufficient – or are denied – emotional support from family or friends when giving birth. Evidence also shows that too many women are being given or offered medical interventions that are not necessary for their situation.

Many women want a natural birth and prefer to rely on their bodies to give birth to their baby without the aid of medical intervention. Even when a medical intervention is needed, the woman giving birth must be involved in making decisions about the care she receives.

WHO recommendations: intrapartum care for a positive childbirth experience

To help maternity programmes ensure that pregnant women everywhere are able to receive individualised, supportive care, WHO has launched a new guideline: Intrapartum care for a positive childbirth experience, which establishes global care standards for childbirth by women and reduces the number of unnecessary medical interventions. The new WHO guideline consolidates 56 new and existing evidence-based recommendations on the care needed throughout labour, delivery and immediately afterwards for the woman and her baby.

Worldwide, an estimated 140 million births take place every year. WHO recognises that every single one of these births is unique – and that the duration of the active first stage of labour varies from one woman to another. Recently completed research by HRP has shown, however, that the benchmark rate of 1cm/hour of cervical dilatation may be unrealistic for some women. Consequently, the guideline recommends that dilatation rate slower than this benchmark alone should not routinely be used to indicate a need for medical intervention to accelerate labour or to expedite birth.

Family Planning - A global handbook for providers

This month, WHO and the Johns Hopkins Bloomberg School of Health’s Center for Communication Programs, with support from the United States Agency for International Development (USAID), launched the third edition of the Family Planning Global Handbook – an updated and expanded version of this important guidance for providers of contraceptive services worldwide. This Global Handbook confirms that all women, including adolescent girls and young women, can safely use almost any contraceptive method. The new edition includes information about available and new methods, including the LNG-IUD and implants, long-acting reversible methods; subcutaneous depot medroxyprogesterone acetate (DMPA-SC), with the potential for self-injection; and the new progesterone-releasing vaginal ring for breastfeeding women.

Working to end myths and misconceptions about female genital mutilation

Earlier this month, I joined colleagues at UN agencies, and individuals worldwide, in marking the International Day of Zero Tolerance for Female Genital Mutilation. On this occasion, WHO exposed some of the many persistent myths and misconceptions about FGM that continue to support the perpetuation of this harmful practice. One such myth is that FGM should be carried out by healthcare workers so that it would be safer. WHO has consistently stated that there is no medical justification for FGM, and so medical practitioners must resist any requests to carry out FGM on girls. Healthcare workers who do carry out FGM are causing only harm, and are violating the human rights of girls and women.