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Summary of Results

Health Topic:   Gynaecology, pregnancy and birth
Guidance:   Intrapartum care
Description:   The summary of the published clinical guideline on Intrapartum care. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage

External literature

External literature Assessment Coverage

Mc Munn V et al (2009) A national survey of the use of TENS in labour British Journal of Midwifery 17(8):492-495

Description: The authors conducted a national survey of all maternity units in England, responses were received from 139 (76%) of the units. All respondents stated that TENS use was supported in their units. The findings demonstrate overwhelming support for the use of TENS. Furthermore the study identified a willingness among midwives to conduct a multi-centre trial of TENS versus usual care.

Not graded National

Healthcare Commission (2008) Towards better births: a review of maternity services in England Healthcare Commission

Description: A national review of maternity services: Results included: two-thirds of women received the pain relief that they wanted and one in five women reported that they were left alone in labour to the extent that it worried them

Doubts about or mixed impact in practice National

Care Quality Commission (2010) Survey of women's experiences of maternity services 2010

Description: The 2010 survey of women?s experiences of maternity services involved 142 NHS acute trusts and 2 primary care trusts (PCTs) in England. We received responses from over 25,000 women, a response rate of 52%. Results found that of expectant mothers offered scans for Down's syndrome in their baby: 52% had a blood test only, 6% had a nuchal test only and 38% had a nuchal and blood test. Only 3% of expectant mothers were offered no scan at all.

Doubts about or mixed impact in practice National

Kidney, E et al (2011) Does the level of evidence underpinning NICE recommendations influence adoption into trust maternity guidelines? Archives of Disease in Childhood Conference Publication: (var.pagings). 96 (Fa 75-Fa 96), 2011

Description: A structured audit of maternity guidelines from 12/15 Trusts in the West Midlands, England for incorporation of 15 NICE recommendations. Semi-structured interviews with 16 clinicians from five Trusts explored implementation. Results found that full adoption into local guidelines ranged from 100% for skin-to-skin contact and suture materials to 55% incorporating the 2-h wait for suspected delay in labour and 25% stipulating breastfeeding within the first hour.

Doubts about or mixed impact in practice Regional

Anantharachagan, A. et al (2012) Intrapartum care: Do we bother? An audit of practice in a District General Hospital. An International Journal of Obstetrics and Gynaecology. Conference Publication: (var.pagings). 119 (pp 73-74), 2012. Date of Publication: June 2012.

Description: This audit evaluated compliance with the NICE guidelines for Intrapartum care at St. Helier?s Hospital, London. A retrospective analysis of case notes of 40 randomly selected women who delivered over a week period during December 2010 was carried out. Findings show that 32% of women did not have their birth plan discussed; 18% did not have a partogram, with 30% of these not completed fully. Results also showed 5% of patients had a prolonged 2nd stage and appropriate action was not taken.

Doubts about or mixed impact in practice Local

Jigajinni, S. et al (2012) Oral intake in labour: A UK survey in collaboration with the Royal College of Midwives (RCM). International Journal of Obstetric Anesthesia. Conference Publication: (var.pagings). 21 (pp S54), 2012. Date of Publication: May 2012.

Description: The authors reviewed practice of oral intake during labour. Results from 105/145 respondents of an online survey sent to Heads of NHS Midwifery Services in 2010 show 105/145 (72%) units had a policy for oral intake in labour. Of these units: 90/105 (86%) policies differentiated between women with uncomplicated labour and women who had opioids or developed risk factors for operative delivery/GA; 15/105 (14%) policies did not differentiate.

Practice appears to be in line with guidance National

The Royal College of Midwives (2010) The Royal College of Midwives audit of midwifery practice

Description: One of the audit aims was to explore midwives? activities in antenatal, intranatal and postnatal care in relation to national guidelines. Questionnaires were sent to 13,782 Royal College of Midwives (RCM) members between 28/10/2009 ? 02/12/2009, the response rate was 15.6%. Findings show that the majority (75%) of women recalled in this survey who were initially identified as suitable for midwifery led care had intermittent auscultation either with a Doppler (61%) or Pinard stethoscope (13%).

Practice appears to be in line with guidance National

Centre for Maternal and Child Enquiries (2011) Saving Mothers' Lives. Reviewing maternal deaths to make motherhood safer: 2006?2008. Confidential Enquiries into Maternal Deaths in the United Kingdom 8th report.

Description: This eighth Report of the UK Enquiries into Maternal Deaths, continues a 56 year unbroken series of reviews of maternal deaths. The overall aim is to save the lives of as many mothers and new-borns as possible through the expert anonymous review of the circumstances surrounding and contributing to each maternal death in the UK. Findings from individual cases are also aggregated together to learn wider lessons and to formulate and disseminate more general recommendations.

Doubts about or mixed impact in practice National

Sabnis, H. et al (2013) FBS audit-a CNST requirement BJOG: An International Journal of Obstetrics and Gynaecology. 2013 Conference (var.pagings) PAGES June -

Description: All births during August 2012 at Pinderfields Hospital, West Yorkshire were audited to see whether the indications for fetal blood sampling (FBS) and guidelines were followed. Results found all 78 samples taken were documented in the patient?s notes and indications for FBS were followed in all cases.

Doubts about or mixed impact in practice Local

National Audit Office (2013) Maternity services in England

Description: This report examines the performance and management of maternity services in England. Evidence was collected between January and September 2013 using a variety of methods, including a web-based survey of all acute trusts and individual maternity units. Findings show mixed experiences relating to continuity of care. In 2010, 92% of women reported having a named midwife. However, 22% stated that they had been left alone, during or shortly after birth, at a time when it worried them.

Doubts about or mixed impact in practice National

This page was last updated: 01 November 2013

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.