Overview
This guideline covers the care of pregnant women and pregnant trans and non-binary people and their babies during labour and immediately after birth. It focuses on women and pregnant people who give birth between 37 and 42 weeks of pregnancy (‘term’). The guideline helps women and pregnant people to make informed choices about where to have their baby and about their care in labour. It also aims to reduce variation in aspects of care.
NICE has also produced guidelines on intrapartum care for women with existing medical conditions or obstetric complications and their babies, fetal monitoring in labour and caesarean birth. For information on other related topics, see our women's and reproductive health summary page.
Last reviewed: 14 November 2025
We made new and updated recommendations on labouring in water and water birth. See update information for further details.
This guideline updates and replaces NICE guideline CG190 (2014).
Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations.
How we prioritise updating our guidance
Decisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process, see NICE-wide topic prioritisation: the manual.
For information about individual topics, including any decisions affecting this guideline, see the summary table of prioritisation board decisions.
Recommendations
This guideline includes recommendations on:
- antenatal education about labour
- planning place of birth
- care throughout labour in all birth settings
- transfer of care and changing place of birth
- pain relief during labour
- prelabour rupture of membranes at term
- first, second and third stages of labour
- care of the newborn baby and care of the woman after birth
- service organisation
Who is it for?
- Healthcare professionals
- Commissioners and providers
- Healthy women who have had a straightforward pregnancy and give birth between 37 and 42 weeks of pregnancy
Guideline development process
How we develop NICE guidelines
Your responsibility
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.