Choice of place of birth and information about possible risks
Provision of one-to-one care in all birth settings
Assessment of need for intrapartum transfer
Multidisciplinary care throughout labour that includes good communication and support
Initial assessment
Observation of the woman
Observation of the unborn baby
Measurement of fetal and maternal heart rates
Ongoing assessment
Transfer of care if necessary
Care in established labour
Supportive one-to-one care
Control of gastric acidity
Pain relief: non-regional analgesia
Breathing and relaxation techniques
Massage
Labour in water
Transcutaneous nerve stimulation (not recommended in established labour)
Inhalational analgesia (Entonox)
Intravenous and intramuscular opioids (pethidine, diamorphine, other opioids) plus an antiemetic
Pain relief in labour: regional analgesia
Information about risks and benefits
Epidural or combined spinal-epidural
Maintenance of epidural analgesia
Management of prelabour rupture of membranes at term
Management of labour: first stage
Observations
Routine interventions: oxytocin, amniotomy (not recommended), vaginal examination
Diagnosis and management of delay
Management of labour: second stage
Observations and assessment of progress documented
Oxytocin or regional analgesia
Intrapartum interventions to reduce perineal trauma
Diagnosis and management of delay
Instrumental birth
Expediting birth
Management of labour: third stage
Diagnosis of prolonged third stage
Observations
Active physiological management
Management of retained placenta and postpartum haemorrhage
Management of labour: care of the baby and woman immediately after birth
Initial assessment of the newborn baby and mother
Neonatal resuscitation
Care of babies in the presence of meconium
Care of babies born to mothers with prelabour rupture of membranes