Tag Archives: childbirth

The care of the critically ill woman in childbirth – Royal College of Anaesthetists

RCOA critical care
Image Source: RCOA

The Royal College of Anaesthetists has published The care of the critically ill woman in childbirth: enhanced maternal care 2018.  The study summarises recommendations relevant to the care of pregnant or recently pregnant, acutely or chronically unwell women, who require acute hospital maternity and critical care specialist services.

This document replaces the former Joint Standing Committee 2011 standards document: Providing equity of critical and maternity care for the critically-ill pregnant or recently pregnant woman.

Download the latest document here


National Child and Maternal Health Intelligence Network – update

PHE has published the Child Health Profile pdfs which present data across key health indicators of child health and wellbeing. The profiles provide an annual snapshot of child health and wellbeing for each local authority in England and sit alongside an interactive version which is available for both local authorities and CCGs. They are designed to help local organisations understand the health needs of their community and work in partnership to improve health in their local area. Annual updates were also published for a number of pregnancy and birth indicators. The breastfeeding indicators have now been updated, including demographic information about mothers, caesarean sections, admissions of babies under 14 days as well as information about admissions for gastroenteritis and respiratory tract infections.


WHO recommendations: intrapartum care for a positive childbirth experience

WHO intrapartum care
Image Source: WHO

The World Health Organization has published Intrapartum care for a positive childbirth experience.  This guideline brings together new and existing WHO recommendations that, when delivered as a package, will ensure good-quality and evidence-based care irrespective of the setting or level of health care.  It highlights the importance of woman-centred care to optimize the experience of labour and childbirth for women and their babies.  It includes 56 evidence-based recommendations on what care is needed throughout labour and immediately after for the woman and her baby.

Read the full guideline here

Read the RCM press release here

NIHR Signal: Lying on one’s side in labour with an epidural is safe and leads to more spontaneous births

Women who lie on their side in the second stage of labour after a low-dose epidural are more likely to give birth spontaneously than those who remain upright when actively contracting. Lying down on either side doesn’t appear to be harmful to mothers or babies. This means that 17 of these women would need to lie on their side instead of maintaining an upright position for one more of them to have an unassisted or “spontaneous” birth.

This UK trial looked at how position in labour affects the type of birth in first-time mothers after a low-dose epidural.

The current guidance recommends an upright position when actively contracting in the later stages of labour. However, this research suggests that for first-time mothers with epidurals, lying on their side could be considered.

Read the full signal here

RCM – “The gathering storm: England’s midwifery workforce challenges”

Image Source: NHS Photobank

An Royal College of Midwives press release discusses a new report on the threats faced by maternity services.

The report ‘The gathering storm: England’s midwifery workforce challenges’  outlines how issues such as rising levels of complexity in pregnancy, midwife shortages and financial constraints in the NHS are ramping up the pressure on England’s maternity workforce and services.

The report also puts forward solutions to the problems in maternity services. It sets out ways in which decision makers across government and England’s NHS can tackle the situation. These include a more adaptable approach to requests for flexible working, and allowing the NHS Pay Review Body free reign to recommend staff pay wards. This will help retain midwives and not push them into costlier agency work. Implementing other changes will also help too, such as ensuring more low-risk women give birth outside of obstetric units.

To read the press release click here

Management of Breech Presentation (RCOG Green-top Guideline No. 20b)

Image Source: NHS Photobank

This guideline provides up-to-date information on methods of delivery for women with breech presentation, this is the fourth edition of this guideline, first published in 1999 and revised in 2001 and 2006 under the same title.

The aim of this guideline is to aid decision making regarding the route of delivery and choice of various techniques used during delivery. It does not include antenatal or postnatal care. Information regarding external cephalic version is the topic of the separate Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 20a External Cephalic Version and Reducing the Incidence of Term Breech Presentation.

To access the full guideline click here

External Cephalic Version and Reducing the Incidence of Term Breech Presentation (RCOG Green-top Guideline No. 20a)

Image source: NHS Photobank

This guideline summarises the evidence regarding the routine use of external cephalic version (ECV) for breech presentation, and is the second edition of this guideline, first published in 2006 under the title External Cephalic Version (ECV) and Reducing the Incidence of Breech Presentation.

It presents the best evidence concerning methods to prevent noncephalic presentation at delivery and therefore caesarean section and its sequalae. The mode and technique of delivering a breech presentation is summarised in the Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 20b Management of Breech Presentation.

For the full guidance click here