Practice Guidelines

Care of healthy women and their babies during childbirth: summary of NICE guidance

BMJ 2007; 335 doi: http://dx.doi.org/10.1136/bmj.39322.703380.AD (Published 27 September 2007) Cite this as: BMJ 2007;335:667
  1. Sara Kenyon, senior research fellow and guideline lead1,
  2. Roz Ullman, senior research fellow2,
  3. Rintaro Mori, research fellow2,
  4. Martin Whittle, clinical co-director2
  1. 1Reproductive Sciences Section, Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester LE2 7LX
  2. 2National Collaborating Centre for Women's and Children's Health, Royal College of Obstetricians and Gynaecologists, Kings Court, London W1T 2 QA
  1. Correspondence to: S Kenyon oracle{at}le.ac.uk

    Why read this summary?

    This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) for healthcare professionals caring for women during labour and birth.1 It defines the care that women who are at low risk of complications in labour at term should expect to receive, and therefore it relates to most women giving birth in the United Kingdom.

    Recommendations

    NICE recommendations are based on systematic reviews of the best available evidence. When minimal evidence is available, a range of consensus techniques is used to develop recommendations. In this summary, recommendations derived primarily from consensus techniques are indicated with an asterisk (*).

    General principles

    • • Provide information with clear explanation so that women are fully involved in decision making and supported through labour. Good communication with the healthcare team is valued by women and may improve their psychological wellbeing after birth.

    • • Provide supportive one to one care to women in established labour and ensure they are not left alone except for short periods—women receiving one to one care throughout their labour are significantly less likely to have a caesarean section or instrumental vaginal birth, will be more satisfied, and will have a positive experience of childbirth.

    • • Ensure that labour and birth progress without intervention, provided that labour is progressing normally and the woman and baby are well.*

    Place of birth

    • • Inform women that birth is generally very safe but that the available evidence on advantages and disadvantages or cost effectiveness of different places of birth is of poor quality. Current options for birth include obstetric units, midwife led units (either standalone or alongside obstetric units), or home, although availability of midwife led units may vary locally and most births take place in hospital nowadays.

    • • Inform women who plan to give birth at home or in a midwife led unit …

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