In order to reduce maternal and neonatal morbidity at the time of childbirth, international organisms such as the World Health Organization and the National Institute for Health and Care Excellence, recommend that more humane care must be provided for childbirth, respecting its physiology and promoting the empowerment of pregnant women.

To determine the percentage of pregnant women who would potentially be candidates for normal childbirth in a region of northern Spain. To compare between the group of “pregnant women candidate for a normal birth” and non-candidate pregnant women, the main indicators of clinical practice and maternal and neonatal morbidity.

Cross-sectional study. The study population was the total number of hospital deliveries attended at Hospital Universitario Marqués de Valdecilla from January 1, 2014 to December 31, 2014 (n=3315). A “pregnant candidate for a normal birth” was defined as a pregnant woman with hospital delivery, without serious pathology (maternal, amniotic fluid or fetal), controlled gestation, simple fetus, spontaneous, term and neonatal state “newborn live” according to the National Clinical Practice Guide for Normal Delivery Care and international guidelines, being candidates for the implementation of the strategy of normal delivery care. Information was retrospectively obtained from secondary registers. Comparisons between groups were performed by using the Chi² or Student t-tests for categorical and quantitative variables respectively.

Among the deliveries, 1863 (56.20%) math the definition of “pregnant candidate for a normal birth”. In 50.86% of these candidate deliveries, a pregnancy episiotomy was performed against 60.96% in the non-candidate group (P<0.001). Caesarean sections were performed at 19.32% of candidate deliveries, compared to 26.79% of non-candidate deliveries (P<0.001). We also found statistically significant differences between groups depending on the type of delivery, need for delivery instrumentation, existence of perineal tears, Apgar test score, and the need for admission to ICU of the newborn.

Our results suggest a differential clinical practice according to the recommendations of the Clinical Practice Guide for Attention to Normal Childbirth. However, the percentages of episiotomies and caesarean sections remain high compared to standards and the results of other studies.