Practice Guidelines

Intrapartum care of healthy women and their babies: summary of updated NICE guidance

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6886 (Published 03 December 2014) Cite this as: BMJ 2014;349:g6886
  1. Vanessa Delgado Nunes, senior research fellow and guideline lead 1,
  2. Maryam Gholitabar, research associate 1,
  3. Jessica Mai Sims, project manager 1,
  4. Susan Bewley, chair of the guideline development group, honorary professor of complex obstetrics2
  5. On behalf of the Guideline Development Group
  1. 1 National Collaborating Centre for Women’s and Children’s Health, Royal College of Obstetricians and Gynaecologists, London NW1 4RG, UK
  2. 2Women’s Health Academic Department, Kings College London, London, UK
  1. Correspondence to: V Delgado Nunes vnunes{at}rcog.org.uk

The bottom line

  • The care that a woman receives during labour can affect the woman herself (physically and emotionally) and the health of her baby in the short and longer term

  • Maternity services should provide a model of care that supports one-to-one care in labour

  • Low risk mothers and babies do not benefit from birth in hospital obstetric units or from many previously “routine” but unindicated labour interventions

  • Clinicians need to be familiar with the evidence and able to talk non-judgmentally to women about their choices

The care that a woman receives during labour has the potential to affect the woman herself, both physically and emotionally, and the health of her baby in the short and longer term. Good communication, support, and compassion from staff, as well as having her wishes respected, can help her feel in control of what is happening and help make birth a positive experience for the woman and her birth companion(s).

About 700 000 women give birth in England and Wales each year. Most are healthy, have a straightforward pregnancy, go into labour spontaneously, and give birth to a single baby after 37 weeks of pregnancy. Uncertainty around consistent practice and the availability of new evidence necessitated an update of 2007 guidance from the National Institute for Health and Care Excellence (NICE) on intrapartum care.1 This article summarises the most recent recommendations from NICE on the care of healthy women who go into labour at term (37-41 weeks’ gestation) (Clinical Guideline CG190).2

Recommendations

NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

Choosing the planned place of birth

  • Explain to both multiparous …

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