Introduction to Natural Childbirth 
Background
NHS Boards have embraced current maternity policy direction, outlined in the Framework for Maternity Services in Scotland and Report of the Expert Group on Maternity Services. These reports endorse the promotion of pregnancy and childbirth as normal life events, advocating woman centred care, with services and care tailored to need. They recommend community focussed, midwife led care for healthy women experiencing uncomplicated pregnancies, and multidisciplinary maternity team care for women with more complexity. It is well recognised that women should also have ongoing medical care provided by their general practitioner, as required, throughout the pregnancy episode. While there has been significant progress made towards implementing this policy, specific key principles are still to be achieved in some Boards. Examples include, positioning the midwife as the lead professional for the majority of low risk women, or ensuring a normal birth pathway for healthy women regardless of birth setting.
KCND
To address this, the Scottish Government Health Directorates (SGHD) established the multiprofessional Keeping Childbirth Natural and Dynamic (KCND) programme, aiming to support implementation of current maternity policy at NHS Board level. KCND aims to promote mutliprofessional working and implementation of care pathways for women and babies based on need. The programme has the support of the Royal Colleges of Midwives; General Practitioners; Obstetricians and Gynaecologists; Paediatrics; and Anaesthetics. KCND has progressed in partnership with these Colleges and other stakeholders including: NHS Quality Improvement Scotland (NHSQIS), NHS Education Scotland (NES), Chief Scientist Office Nursing, Midwifery and Allied Health Professions Research Unit (NMAHPRU), Health Scotland, service user representatives and all NHS Boards.
KCND aims and objectives
KCND aims to maximise opportunities for women to have as natural a birth experience as possible, through: providing evidence based care; reducing unnecessary intervention; ensuring informed choice; and developing multiprofessional care pathways. Key objectives are to support the following at NHS Board level:
· Implementation of national referral criteria and care pathways
· Implementation of the midwife as the first point of professional contact in pregnancy
· Implementation of the lead maternity professional based on risk
· Implementation of normal birth pathways regardless of birth setting