Care during labour and birth for women with a medical condition or complication in pregnancy or labour
Most women have no problems during labour and birth, but some need extra care because they have a higher chance of complications. For example, this could be because:
- they have had a caesarean section in a previous pregnancy
- the baby is thought to be either very small or large
- a problem happens during early labour, for example, the baby turns bottom down (called ‘breech’) instead of being head down
- they have a medical condition, like heart or kidney disease.
We want this guideline to make a difference to women and babies needing extra care during labour and birth by making sure that care teams:
- involve women in decisions about care at every stage
- explain what it means if a complication happens during labour and how this might affect any choices women have made in their birth plan
- explain why continuous monitoring of the baby’s heart rate might be recommended during labour to check the baby is coping well
- discuss options for labour and birth with women with medical conditions and include specialists for those conditions.
Making decisions together
Decisions about treatment and care are best when they are made together. Your care team should give you clear information, talk with you about your options, answer your questions and listen carefully to your views and concerns.
They should also:
- make sure that if there is a complication during labour, you fully understand what’s happening, and what may happen next
- make sure you understand the benefits and risks to you and your baby of different options, including any uncertainties
- respect what matters to you and support your plans and wishes for giving birth as far as possible.
If you can’t understand the information you are given, tell the care team who are looking after you.
Read more about making decisions about your care.
Where can I find out more?
The NHS website has more information about what happens during labour and birth and pregnancy for women with existing health conditions.
The organisations below can give you more advice and support.
- Action on Pre-eclampsia (APEC), 01386 761848
- Bliss, 020 7378 1122
- Twins and Multiple Births Association (Tamba), 01252 332344
NICE is not responsible for the content of these websites.
To share an experience of care you have received, contact your local Healthwatch.
We wrote this guideline with people involved in supporting women who need extra care during labour and birth. All the decisions are based on the best research available.
This page was last updated: 06 March 2019