ABSTRACT
The National Institute for Health and Care Excellence Guidelines on Intrapartum Care outline medical conditions and other factors indicating increased risk and suggesting planned delivery in an obstetric unit conditions and factors indicating individual assessment when planning place of birth. Individual assessment can be used for women with conditions such as ulcerative colitis, previous intrauterine death due to a non-recurrent cause, age over 40 at booking or body mass index between 30 and 34 or single antepartum haemorrhage of unknown origin. Women choosing to labour at home or in a midwifery-led unit should be informed of the locally available services, the likelihood of being transferred into the obstetric unit and the time this may take. Different women need different approaches to labour–some require quiet support and others boisterous encouragement. Pain relief in labour has proven to be one of the most controversial areas of labour management, with women themselves being divided between ‘natural’ and ‘medicalised’ labour.
