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RCOG statement on revised NICE intrapartum care guidelines

News 3 December 2014

Today NICE publish updated guidance: Intrapartum Care: care of healthy women and their babies during childbirth

This guideline covers the care of healthy women who go into labour at term (37–41 weeks). It covers the care of healthy women with uncomplicated pregnancies entering labour at low-risk of developing intrapartum complications. In addition, recommendations are included that address the care of women who start labour as low-risk but who go on to develop complications.

The new guideline covers place of birth, care throughout labour, the different stages of labour, pain in labour and monitoring during labour.

Professor Alan Cameron, Vice President of Clinical Quality for the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“The RCOG welcomes these revised Intrapartum Care guidelines. They are a vital source of information for healthcare professionals involved in the care of women and their babies.

“The revised guideline places a greater emphasis on patient choice creating a culture of respect. Putting patients at the centre of their care is of paramount importance and healthcare professionals need to support women in these decisions.

“We also support the need for women to have one-to-one care in labour which leads to higher quality of care.

“For low-risk first-time mothers, we support the recommendation considering a midwife led-unit, however, if a woman decides on a freestanding unit she should take into consideration the significant transfer rate and time to the nearest obstetric unit. The new guidelines recommend that women giving birth should have timely access to an obstetric unit if they need to be transferred to hospital for medical reasons. The close proximity of alongside midwifery units provides easier transfer and can therefore reduce stress and anxiety for the mother.

“Moreover, the RCOG acknowledges the findings that selected home birth could be considered for low-risk women who have previously had a child. However, the revised guideline outlines that for first-time mothers planning to have a home birth, there is an increased risk of poor outcomes for the baby.

“The guidelines also give clear advice on cord clamping and timing. RCOG guidelines state that the cord should not be clamped earlier than is necessary, based on a clinical assessment of the situation. Delayed cord clamping may benefit the neonate in reducing anaemia, and particularly the preterm neonate by allowing time for transfusion of placental blood to the newborn infant.

"The RCOG recognises that some aspects of care were considered outside the initial scope of the guideline revision, particularly with regard to perineal protection and techniques used in operative delivery to reduce the morbidity of 3rd and 4th degree tears. We look forward to contributing to the evidence base in any future revision."


For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email