This evidence based presentation will describe the physiologic process of birth including the vital role that hormones play in the process. The presentation will describe the important role that pain plays in labor, insuring the release of endogenous oxytocin as labor progresses, as well as our evolving understanding of birth as a neuro-psycho-social experience. The presentation will explore the neuro-psycho-social experience of birth as foundational to mothering.

Five evidence based practices that support the physiologic process of birth will be discussed. These include: letting labor start on its own, freedom of movement, labor support, birth in a non-supine position, and keeping mother and baby together. Each of these care practices facilitate the process and insure that the hormones that drive the process are released. The evidence based outcomes, including, but not limited to, dysfunctional labor, cesarean, and postpartum hemorrhage, that result from a lack of any one of these care practices will be presented.

The effect of the routine use of medical interventions, including restrictions on eating and drinking, use of intravenous, electronic fetal monitoring, episiotomy and epidural, on the physiologic process of birth will be presented.

The influence of midwifery care and community based childbirth on improving birth outcomes for mothers and babies will be presented.

In conclusion, this presentation will provide compelling evidence that promoting, protecting and supporting physiologic birth is necessary if maternal and newborn mortality and morbidity are to be reduced.