NICE Guideline - Intrapartum care for women with existing medical conditions or obstetric complications and their babies
NICE have published a new guideline ‘Intrapartum care for women with existing medical conditions or obstetric complications and their babies’.
The guideline covers recommendations for the care of women in labor and birth requiring additional support due to medical conditions or complications in pregnancy. The aim is to improve the outcome and experiences for women and babies.
The guideline includes recommendations on heart disease, bleeding disorders, sepsis, asthma, obesity, previous cesarean section and small/large for gestational age baby.
It is designed for both healthcare professionals and women and their families with the guideline highlighting that ‘Supporting women to make decisions about their care is particularly important during the intrapartum period. Healthcare professionals should ensure that women have the information they need to make decisions and to give consent’.
Along with the recommendations NICE have provided a baseline assessment tool to help care providers in reviewing current practice and assessing if it meets the guideline recommendations.
The guideline and supporting resources can be found here.
Techniques used by expert midwives to preserve the perineum intact
A study has been published exploring the views of midwives of the skills they use to avoid perineal trauma. Previous studies were found to show that the practice of midwives has a significant influence on the rate of perineal trauma and rates in Ireland and New Zealand were particularly low. The study involved interviews with midwives from both Ireland and New Zealand.
There were four themes identified:
Calm controlled birth
Position and technique in the early second stage
Hands on or off
Slow, blow and breathe the baby out
The study whilst only small provides some insight into techniques that have been successfully used by midwives. The study concludes: ‘we recommend that the advice of these midwife experts be followed, and that these techniques be taught to student midwives. Further research to test the ‘MEPPI’ method in a controlled, before-and-after study, or cluster randomised trial, is required to assess its applicability to all midwives, and for all women.’
The full study is available here.