This guideline covers care during labour and birth for women who need extra support because they have a medical condition or complications in their current or previous pregnancy. The guideline also covers women who have had no antenatal care. It aims to improve experiences and outcomes for women and their babies.
NICE has also produced a guideline on care during labour and birth for healthy women and their babies.
In April 2019 we replaced recommendations on continuous cardiotocography for women with a previous caesarean section with links to our guideline on caesarean section.
This guideline includes recommendations on:
- heart disease, bleeding disorders and subarachnoid haemorrhage
- asthma, long-term systemic steroids and obesity
- acute kidney injury and chronic kidney disease
- sepsis and intrapartum haemorrhage
- previous caesarean section and labour after 42 weeks
- small-for-gestational-age baby and large-for-gestational-age baby
- no antenatal care
Who is it for?
- Pregnant women, their families and carers
- Obstetricians, midwives, anaesthetists and other healthcare professionals caring for women in labour
- Providers and commissioners of maternity services
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.