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Department of Reproductive Health and Research (RHR), World Health Organization

Managing Complications in Pregnancy and Childbirth

A guide for midwives and doctors 



This guide represents a common understanding between WHO, UNFPA, UNICEF, and the World Bank of key elements of an approach to reducing maternal and perinatal mortality and morbidity. These agencies co-operate closely in efforts to reduce maternal and perinatal mortality and morbidity. The principles and policies of each agency are governed by the relevant decisions of each agency’s governing body and each agency implements the interventions described in this document in accordance with these principles and policies and within the scope of its mandate.

The guide has also been reviewed and endorsed by the International Confederation of Midwives and the International Federation of Gynecology and Obstetrics.


The financial support towards the preparation and production of this document, provided by the Governments of Australia, the Netherlands, Sweden, the United Kingdom of Great Britain and Northern Ireland, and the United States of America is gratefully acknowledged.

WHO gratefully acknowledges the technical and editorial assistance provided by staff of JHPIEGO’s Training in Reproductive Health and Maternal and Neonatal Health Programs.  Financial support was provided by the Office of Population, Center for Population, Health and Nutrition/Global Programs, Field Support and Research Bureau/CMT Division, United States Agency for International Development (USAID), under the terms of Award No. HRN-A-00-98-00041-00, and by the Office of Population, Health and Nutrition, Bureau for Global Programs, Field Support and Research, USAID, under the terms of Award No. HRN-A-00-98-00043-00.



� World Health Organization, 2000

This document is not a formal publication of the World Health Organization (WHO) and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced and translated, in part or in whole, but not for sale nor for use in conjunction with commercial purposes. 

The views expressed in this document by named contributors are solely the responsibility of those contributors.

Major Contributors

Matthews Mathai

Harshad Sanghvi

Richard J. Guidotti


Fredrik Broekhuizen

Beverley Chalmers

Robert Johnson

Anne Foster-Rosales

Jeffrey M. Smith

Jelka Zupan


Melissa McCormick

Editing Assistance

Ann Blouse

David Bramley

Kathleen Hines

Georgeanna Murgatroyd

Elizabeth Oliveras 


Mary Jane Orley

Cover design 

M�ire N� Mhear�in


Deborah Brigade 

The special contribution of George Povey, whose original work inspired the idea for this manual, is gratefully acknowledged.


Sabaratnam Arulkumaran

Ann Davenport 

Michael Dobson 

Jean Emmanuel 

Susheela Engelbrecht

Miguel Espinoza

Petra ten Hoope-Bender

Monir Islam 

Barbara Kinzie 

Andr� Lalonde

Jerker Liljestrand 

Enriquito Lu 

Florence Mirembe 

Glen Mola

Zahida Qureshi

Allan Rosenfield 

Abdul Bari Saifuddin

Willibrord Shasha 

Betty Sweet 

Paul Van Look 

Patrice White

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