The World Health Organisation, 1985 define normal birth as: Spontaneous in onset, low-risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex position between 37 and 42 completed weeks of pregnancy. After birth mother and infant are in good condition. The majority of fit and healthy women invariably expect to have a 'normal' birth. In an attempt to understand what will happen to them during birth they devour childbirth magazines, women's magazines, health education leaflets and any other material they can find. Believing that the experts know best they happily follow the doctors' and midwives' advice in the expectation that they will be safe in the hands of professionals, and their birth plans, if they have made them, will be respected. In 1997 AIMS raised the question of what is normal birth? So often women tell us of their traumatic birth experiences and state that they are not going to have a 'normal birth' next time - they want to have an epidural right away; or book an elective caesarean the next time. So often when they are told that they did not have a normal birth last time such women are amazed. Unfortunately, if the baby is born vaginally (without forceps or ventouse) the midwife invariably writes 'normal delivery' on the case notes. The women then presume that the high-technology interventive, obstetric delivery they endured was 'normal'. Common or usual it may be, but normal it certainly was not (Beech, 2003) Recent decades have seen a rapid expansion in the development and use of a range of practices designed to start, augment, accelerate, regulate or monitor the physiological process of labour, with the aim of improving outcomes for mothers and babies, and sometimes of rationalising work patterns in institutional birth. Often though this can lead to a ‘cascade of intervention’. An assessment of need and of what might be called "birthing potential" is the foundation of good decision making for birth, the beginning of all good care. What is known as the "risk approach" has dominated decisions about birth, its place, its type and the caregiver for decades now. The problem with many such systems is that they have resulted in a disproportionately high number of women being categorised as "at risk" are having unnecessary intervention at birth. So how can a care giver work with a woman during normal birth? WHO point out four aims of care to be considered: support of the woman, her partner and family during labour, at the moment of childbirth and in the period thereafter, observation of the labouring woman; monitoring of the fetal condition and of the condition of the infant after birth; assessment of risk factors; early detection of problems, performing minor interventions, if necessary, such as amniotomy and episiotomy; care of the infant after birth and referral to a higher level of care, if risk factors become apparent or complications develop that justify such referral. Care givers must bear in mind that in normal birth there should be a valid reason to interfere with the natural process. Beech, B (2002) What is Normal Birth? AIMS Journal, Winter 2002/3, Vol 13 No 4 [online] Available from: http://www.aims.org.uk/Journal/Vol13No4/whatIsNormalBirth.htm accessed 10/06/2007 WHO (1997) Care in normal birth: A practical guide [online] Available from: http://www.who.int/reproductive-health/publications/MSM_96_24/MSM_96_24_Chapter1.en.html Accessed 11/06/2007