Guidance

This guideline covers the care of women and their babies during labour and immediately after birth. It focuses on women who give birth between 37 and 42 weeks of pregnancy (‘term’). The guideline helps women 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.

Last reviewed: 29 September 2023

This guideline updates and replaces NICE guideline CG190. It includes new recommendations on pain relief, regional analgesia, prelabour rupture of membranes, care in all stages of labour and postpartum care. See update information for further details.

We reviewed this guideline as part of a wider review of all our guidelines, to ensure we are prioritising topics that we think will add the most value to the health and care system.

Monitoring decision: Water birth: we will reconsider the evidence when the POOL study has published (expected 2024). For more information, see the May 2023 surveillance decision.

We have agreed that the updates on angle of episiotomy and rectal examination recommended in the 2022 surveillance report will not proceed as planned.

Using inclusive language in healthcare is important for safety, and to promote equity, respect and effective communication with everyone. This guideline does not use inclusive language because it was developed before NICE’s style change to use gender-inclusive language.

Healthcare professionals should use their clinical judgement when implementing recommendations, taking into account the individual's circumstances, needs and preferences, and ensuring all people are treated with dignity and respect throughout their 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.

Recommendations

This guideline includes recommendations on:

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

This guideline was previously called intrapartum care for healthy women and babies.

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.