​Towards a universal positive childbirth experience: changing the focus of World Health Organisation global maternity guidelines, and associated impacts

Significant, global change in maternity guidelines and practice has taken place as a result of research led by Professor Soo Downe and the Research in Childbirth and Health (ReaCH) group.

They are the only transdisciplinary research team worldwide that has consistently explored positive childbirth experience programmatically over two decades. In 2016, their work identifying the importance of including the experience of pregnancy and childbirth alongside clinical interventions was pivotal in framing the recommendations and the title of the World Health Organization (WHO) antenatal guidelines with the concept of a ‘positive antenatal experience’. This concept is now also in the title of the 2018 WHO intrapartum guidelines. This has resulted in the WHO emphasising the importance of a positive antenatal and childbirth experience in all their associated materials and toolkits. Across the world, this approach to including both experience and outcomes in WHO guidelines has created far reaching paradigm shifts in approaches toward maternity practice.

The work has benefited families nationally and internationally, contributing to WHO implementation strategies in nine countries. During COVID-19, the research on what matters to women has supported WHO infographics, and has informed guidelines produced by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives. Three papers by members of the ReaCH group on positive childbirth and midwifery have been cited in the 2019 WHO global framework for action strengthening midwifery education for Universal Health Coverage 2030.

Slides 1 to 2 of 4

Academic expertise

Professor Soo Downe
Professor of Midwifery Studies
School of Nursing and Midwifery

Soo is a midwife with a particular research focus on the nature of, and cultures around, normal birth. Soo has undertaken research using a wide range of qualitative and quantitative methods, from phenomenology and ethnography to surveys, RCTs, and epidemiological analysis of lar…

Headshot of Kenneth.
Kenneth Finlayson
Research Associate
School of Nursing and Midwifery

Kenny works in the midwifery research team and holds a particular interest in qualitative research. Much of his work is focused on the inter-relational aspects of maternity care and the adoption of a salutogenic approach to care provision. Methodologically, Kenny is interested in…