This guideline covers methods for monitoring the wellbeing of the baby during labour. It includes risk assessment to determine the appropriate level of fetal monitoring, using clinical assessment in addition to fetal monitoring, and interpreting and acting on monitoring findings.
For information on related topics, see our women's and reproductive health summary page.
In this guideline, we use the term 'woman' throughout. This should be taken to include people who do not identify as women but are pregnant.
This guideline includes new and updated recommendations on:
It also includes recommendations on:
- information and supported decision making
- assessment during labour and methods for fetal monitoring
- indications for continuous cardiotocography monitoring in labour
- use of cardiotocography for monitoring during labour
- making care decisions based on the cardiotocography trace
- fetal scalp stimulation
- record keeping for cardiotocography
Who is it for?
- Healthcare professionals
- Commissioners and providers of maternity services
- Pregnant women before and during labour, and their families and carers
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.