The push by physicians in industrialized countries to manage birth using extensive, expensive, invasive and inadequately evaluated technologies has largely remained unchallenged. Rigorous evaluation of this technological approach has become more and more imperative. In the face of reluctance by the medical profession to assess its own treatments, the World Health Organisation (WHO) undertook to evaluate the cost, efficacy and risk of this expanding birth machine through a series of consensus meetings to bring a scientific and multidisciplinary approach to the task of identifying the best ways of ensuring the safest outcome for women and babies during pregnancy, birth and following birth.

As a WHO staff person, Marsden Wagner was a convener of these meetings in North America (Washington DC), Suth America (Fortaleza) and Europe (Trieste). This book describes the pursuit of the birth machine initiated by these meetings: the scientific evidence used as a basis of discussion and the strategies used to disseminate their findings. Although a former clinician, it is from his subsequent training and position as a reproductive scientist that Marsden Wagner analyses current scientific research, suggests appropriate perinatal technology, and proposes ideas for its implementation.