Guidance

Update information

Update information

January 2024: We have reviewed the evidence and updated the recommendations on placenta accreta spectrum. The new and updated recommendations are marked [2024] or [2011, amended 2024].

September 2023: We have updated the recommendations on the use of neuraxial opioids for postoperative pain relief, and monitoring for women and pregnant people who have had neuraxial opioids. The evidence has not been reviewed. These updated or new recommendations are marked [2004, amended 2023], [2021, amended 2023] and [2023]. In some cases, minor changes have been made to the wording to bring the language and style up to date without changing the meaning.

August 2023: We have reviewed the evidence and updated the recommendations on surgical opening technique. The updated recommendation is marked [2004, amended 2023].

June 2023: We have reviewed and updated the recommendations on maternal choice for caesarean birth by expert opinion and consensus. The evidence has not been reviewed. These recommendations are marked [2011, amended 2023].

March 2021: We have reviewed the evidence and made new recommendations on the benefits and risks of caesarean birth compared with vaginal birth, methods to reduce infectious morbidity, methods for uterine closure, methods to prevent and treat hypothermia and shivering, monitoring after caesarean birth and pain relief. These recommendations are marked [2021].

We have also made some changes without an evidence review:

  • We have updated some wording to bring the language and style up to date, without changing the meaning.

  • We have updated some recommendations to bring them in line with current terminology and practice.

  • We have combined, clarified or reworded some recommendations to make them clearer and to improve ease of reading.

These recommendations are marked [2011, amended 2021] and [2004, amended 2021].

Recommendations marked [2011] and [2004] last had an evidence review in 2011 and 2004, respectively. In some cases, minor changes have been made to the wording to bring the language and style up to date, without changing the meaning.

Minor changes since publication

May 2024: We amended recommendations on methods to reduce infectious morbidity to clarify which skin preparations should be used.

October 2023: We updated the link to the NICE guideline on intrapartum care, which has been updated.

October 2022: We added a recommendation to indicate that pulse oximetry may be less reliable in people with dark skin. We also added a link to the NHS patient safety alert on the risk of harm from inappropriate placement of pulse oximeter probes. See recommendation 1.6.6.

June 2022: We amended the name of the pain outcome measure in the explanation for why the committee made recommendations 1.1.3 and 1.1.4. We also updated the term 'morbidly adherent placenta' to 'placenta accreta spectrum' throughout the guideline.

July 2021: Recommendation 1.4.28 is being updated. We removed reference to the Joel–Cohen transverse incision to clarify what should be done in the meantime. See the exceptional surveillance review on surgical opening technique for more information.

ISBN: 978-1-4731-5712-5