Research and guidelines for birth 

Below is some Information and links on various topics surrounding your birth. Please ensure you read the full text. This information is to enable you to make informed choices about your care and your babies health during your birth. This information is added to regularly and should not be used in isolation. Use this information as a basis for conversations with your midwives or Obstetricians after reading the full text by using the link. Please advise us of any errors with the links. The information contained here is not guaranteed to be the latest research available on the subject however we try our best to keep the information up to date.

Electronic Fetal Monitoring during labour

EFM is associated with an increase in caesarean sections and instrumental vaginal births  - Read the full review Click here

'The use of admission cardiotocography (CTG) in low-risk pregnancy is not recommended in any birth setting'

Taken from the National Institute for Health and Clinical Guidance - Intrapartum Care Guidelines Click here

Prelabour rupture of membranes

Occasionally women's waters will naturally release prior to going into labour this information is relevant in those circumstances

'Women presenting with prelabour rupture of the membranes at term should be advised that:
• the risk of serious neonatal infection is 1% rather than 0.5% for women with intact membranes
• 60% of women with prelabour rupture of the membranes will go into labour within 24 hours
• induction of labour is appropriate approximately 24 hours after rupture of the membranes.

To detect any infection that may be developing women should be advised to record their temperature every 4 hours during waking hours and to report immediately any change in the colour or smell of their vaginal loss
• women should be informed that bathing or showering are not associated with an increase in infection, but that having sexual intercourse may be.

If there are no signs of infection in the woman, antibiotics should not be given to either the woman or the baby, even if the membranes have been ruptured for over 24 hours.'

Taken from the National Institute for Health and Clinical Guidance - Intrapartum Care Guidelines Click here

Women with prelabour rupture of the membranes at term (over 37 weeks) should be offered a choice of immediate induction of labour or expectant management.

'Expectant management of women with prelabour rupture of the membranes at term should not exceed 96 hours following membrane rupture'

86% of women will labour within 12–23 hours
91% will labour within 24–47 hours
94% will labour within 48–95 hours.

Taken from Royal College of Obstetricians and Gynaecologists guidelines on induction of labour Click here

'Avoid vaginal examinations once the membranes have ruptured.' Taken from World health Organisation Click here

Amniotomy

The information below is the conclusion taken from the Cochrane review. Please read the review Click here

Evidence does not support the routine breaking the waters for women in spontaneous labour

The aim of breaking the waters (also known as artificial rupture of the membranes, ARM, or amniotomy), is to speed up and strengthen contractions, and thus shorten the length of labour. The membranes are punctured with a crochet-like long-handled hook during a vaginal examination, and the amniotic fluid floods out. Rupturing the membranes is thought to release chemicals and hormones that stimulate contractions. Amniotomy has been standard practice in recent years in many countries around the world. In some centres it is advocated and performed routinely in all women, and in many centres it is used for women whose labours have become prolonged. However, there is little evidence that a shorter labour has benefits for the mother or the baby. There are a number of potential important but rare risks associated with amniotomy, including problems with the umbilical cord or the baby's heart rate.'

'On the basis of the findings of this review, we cannot recommend that amniotomy should be introduced routinely as part of standard labour management and care. We do recommend that the evidence presented in this review should be made available to women offered an amniotomy and may be useful as a foundation for discussion and any resulting decisions made between women and their caregivers.'

Stripping of membrane / Membrane sweep for induction of labour

Abstract Click here

Late vs early clamping of the umbilical cord in full-term neonates

'The authors concluded that delayed clamping is beneficial to the newborn and benefits extend into infancy'

Taken from Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials Hutton E K, Hassan E S  Click here