Maternity care guideline

Intrapartum care for a positive childbirth experience | The World Health Organization

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This guideline brings together new and existing WHO recommendations that, when delivered as a package, will ensure good-quality and evidence-based care irrespective of the setting or level of health care.

It highlights the importance of woman-centred care to optimize the experience of labour and childbirth for women and their babies.

Full document: Intrapartum care for a positive childbirth experience


Additional links: WHO press release | Royal College of Midwives press release

Humanising birth: Does the language used matter?

A new post on the the BMJ blog outlines how those providing maternity care need to consider their language carefully. This requires thoughtful use of language, reflection on their practice as caregivers, alongside listening and communicating to women appropriately  and respectfully to guide them through the complexities of maternity care.

The authors highlight how the latest version of the NICE Intrapartum Care Guideline emphasises the importance of good intrapartum communication.  During a three month period, they  analysed the language used in maternity settings using a multidisciplinary, collaborative Facebook group to identify how language could improve the experiences of women, babies and families.



Within a week 121 comments were received offering further input regarding commonly used phrases and expressions used in maternity care, which should be challenged.
From these comments, six key categories were identified that required change:

  • paternalistic or patronising language
  • language which objectifies women
  • anxiety-provoking language
  • dictatorial language
  • discouraging language
  • exclusive or codified language.

Examples of poor language are shown alongside suggested alternatives, on the BMJ blog.

The researchers emphasise that good communication during the birthing process is critical to good maternity care; but achieving a shift in deeply ingrained language, and the thinking it reflects, is difficult.
They also recognise that  there is a fine line between changing terminology to use  language which is more respectful, and less intimidating for the mother, and substituting vague language which hinders the original message.

These newspaper articles may also be of interest:

Maternity services survey 2017

Maternity services survey 2017 |  The Care Quality Commission


This survey looked at the experiences of women receiving maternity services. The results show that overall women are reporting a more positive experience of maternity care and treatment. The publication highlights improvements in areas such as choice of where to give birth, quality of information and access to help and support after giving birth, when compared to the results from previous years’ surveys.

Compared with the last survey in 2015 a greater proportion of women said that they:

  • were offered the choice of giving birth in a midwife-led unit or birth centre
  • saw the same midwife at every antenatal appointment
  • were ‘always’ treated with dignity and respect during labour and birth
  • were never left alone during the birth of their baby at a time when it worried them
  • could ‘always’ get help from a member of staff within a reasonable time while in hospital after the birth

For more information, please see the statistical release, which provides the results for all questions: Maternity services survey 2017: Statistical release

Implementing Better Births: Continuity of Carer

This guidance sets out how local maternity systems can improve their services so that women experience continuity in the clinicians providing their maternity care | NHS England

Continuity of care and relationship between care giver and receiver has been proven to lead to better outcomes and safety for the woman and baby, as well as offering a more positive and personal experience. It was also the single biggest request of women using maternity  services heard during the 2016 National Maternity Review report, ‘Better Births’.

This guidance outlines four main principles that will need to underpin the provision of continuity of carer models across the country:

1. Provide for consistency of the midwife and/or obstetrician who cares for a woman throughout the antenatal, intrapartum and postnatal periods.

2. Include a named midwife who takes on responsibility for co-ordinating a woman’s care throughout the antenatal, intrapartum and postnatal periods.

3. Enable the woman to develop an ongoing relationship of trust with her midwife

4. Where possible be implemented in both the hospital and community settings.

Full document: Implementing Better Births: Continuity of Carer

better birth
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Each baby counts

Each Baby Counts 2015 | The Royal College of Obstetricians and Gynaecologists.

In the UK, each year over 1000 babies die or are left with severe brain injury because something goes wrong during labour.

Each Baby Counts is the RCOG’s national quality improvement programme to reduce the number of babies who die or are left severely disabled as a result of such incidents occurring during term labour.

The report presents key findings and recommendations based on the analysis of complete data relating to term stillbirths, neonatal deaths and babies with brain injuries born during 2015, the first full year of the programme.

Full report: Each baby counts


Access and quality of maternity care for disabled women

More disabled women are becoming mothers, and yet, their care is rarely the focus of quantitative research. This study aimed to investigate access and quality of maternity care for women with differing disabilities | BMJ Open

Results: Overall, 20‰094 women completed and returned the survey; 1958 women (9.5%) self-identified as having a disability. The findings indicate some gaps in maternity care provision for these women relating to interpersonal aspects of care: communication, feeling listened to and supported, involvement in decision making, having a trusted and respected relationship with clinical staff. Women from all disability groups wanted more postnatal contacts and help with infant feeding.

Conclusion: While access to care was generally satisfactory for disabled women, women’s emotional well-being and support during pregnancy and beyond is an area that is in need of improvement. Specific areas identified included disseminating information effectively, ensuring appropriate communication and understanding, and supporting womens sense of control to build trusting relationships with healthcare providers.

Full reference: Malouf, R. et al. (2017) Access and quality of maternity care for disabled women during pregnancy, birth and the postnatal period in England: data from a national survey. BMJ Open. 7:e016757


Reducing baby deaths and injuries

Teamwork in maternity units key to reducing baby deaths and brain injuries during childbirth. Adherence to best practice on fetal monitoring and neonatal care also identified as crucial to improving outcomes

The Royal College of Obstetricians and Gynaecologists has published Each Baby Counts: 2015 Summary Report. The report provides a detailed analysis of all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015 and identifies the key clinical actions needed to improve the quality of care and prevent future cases. These clinical actions include: improving fetal monitoring; enhancing neonatal care; and reducing human factors by understanding ‘situational awareness’ to ensure the safe management of complex clinical decisions.

The full report can be downloaded here

Additional links: Each Baby Counts project | Royal College of Midwives news | BBC News report